- Patients attending for weight loss surgery
- Fasting prior to your surgery
- What to expect on admission prior to your operation
It is very important that you are as healthy as possible before the operation and that you continue to do your best to lose weight. You are also strongly advised to stop smoking at least 6-8 weeks prior to your surgery. Your GP/Practice Nurse will be able to provide advice on this.
As well as seeing the Surgeon at your initial consultation you will also be seen by a Dietitian who will obtain your diet history and give you dietary advice for before and after the operation. You will be required to follow a strict diet for two weeks prior to your operation. This is in order to shrink your liver size to aid the operation. (The guide to this in pdf format is available in the downloads section) You may also be seen by the Bariatric nurse who will discuss the operation with you and discuss the lifestyle changes you will need to make to ensure you get the best results from your surgery.
Before coming in for your surgery, you will be asked to attend for a pre-operative assessment in the Outpatients Department, this will take place 10-14 days prior to the date of your admission.
You should have nothing to eat for at least 6 hours before your operation. You may drink water-based fluids that do not contain milk for up to 3 hours before surgery. (If you are diabetic, specific instructions will be discussed with you at your pre-operative assessment.) If your mouth is dry, you may brush your teeth and rinse your mouth out without swallowing any water.
You will normally be admitted to hospital on the day of your surgery.
On arrival at the hospital you will be escorted to your room and shown around the facilities. Registration documentation will be completed.
The nurse caring for you will:
- Confirm that there have been no changes in your health since your preoperative assessment and that if relevant, you have followed the strict dietary requirements for 2 weeks prior to your admission.
- Record your blood pressure/pulse/temperature/weight and the last time you ate and drank.
- Place a bracelet on your wrist with your name, date of birth, and hospital number. An allergy bracelet will be placed on your wrist if applicable.
- Talk through the events of the day and allow time for you to ask any questions.
- Check all test results are available.
- Ask you to undress and change into a hospital gown. You may wear your own dressing gown over the top and you should wear slippers to walk to theatre. If you wear dentures, wig, spectacles or hearing aid these can be left in place until you are in theatre. Contact lenses will need to be removed before going to theatre and you will also be asked to remove any jewellery, including body piercing, make up and nail varnish.
- There is no need to shave the operative area as this will be carried out in theatre if required. Shaving any earlier can increase the risk of wound infection.
Before you go to theatre your Surgeon and Anaesthetist will visit you to answer any further questions you may have and obtain your consent for the operation.
When it is time for you to go for your operation you will be escorted to theatre and after your details have been checked, your care will be handed over to a member of the theatre team who will accompany you into the anaesthetic room and stay with you during your operation.
After the operation (Post-operative Care)
When you are back in your room, the nurse will continue to monitor your blood pressure and pulse at regular intervals for several hours. You will have a drip (intravenous infusion) until you are tolerating fluids by mouth.
You will not be allowed a drink until one hour after your surgery.
Anaesthetics can sometimes make people feel sick. It is important that you inform the nurse immediately if you feel sick, as you can be given medication to alleviate this.
The small wounds on your abdomen will normally be glued; if the glued wounds open slightly, do not worry, this sometimes happens and all that is required is a simple dressing.
It is likely that you will require some pain relief following the surgery. If you are in pain, you must tell the nurse so that prescribed pain relief can be administered to you promptly.
You will be instructed in deep breathing to minimize lung congestion after surgery. You should breathe deeply 2-3 times every hour to help keep your lungs clear.
You will be given an anti-coagulant (blood thinning) injection whilst you are in hospital and you may be required to wear a pair of elastic stockings (called TEDS) to help maintain the circulation in the deep veins in your legs. The nurse will encourage you to move your legs at regular intervals whilst you are in bed to help prevent deep vein thrombosis. As soon as you are awake enough you will be encouraged to get up and move around. It is important that you mobilize as soon as possible to reduce the risk of blood clots.
You will start on sips of fluids one hour after your surgery and, if tolerated, you will be able to progress to free fluids. Please see the separate diet sheets explaining the dietary requirements after Laparoscopic bariatric (weight loss) or antireflux surgery in the downloads section.
You will usually be discharged the day following your surgery, if you have Laparoscopic surgery. This may vary according to your own personal circumstances and the complexity of the operation.
Wound Care - Your wounds are usually glued together, and require no after care, but do observe for signs of infection as listed below. It is safe to shower after the surgery but long soaks in the bath ought to be avoided for the first week. The wounds can be patted dry after washing.
Pain Relief - If required you will be prescribed painkillers to take home. It is advisable to take soluble forms of painkillers in the early period following the operation. Some of your usual medication requirements may alter significantly following bariatric (weight loss) surgery. It is therefore advisable to contact your GP and local pharmacy prior to your admission to ensure you have an appropriate supply of your usual medication and also in the early post-operative period. Anti inflammatory tablets and aspirin should be avoided if possible after both bariatric (weight loss) and antireflux surgery.
Follow-up Appointment - You will be given a follow up appointment to attend the Outpatient Department, usually for 6 weeks after your surgery.
Driving - Do not drive until you are able to wear a seat belt comfortably and feel able to do an emergency stop. This should normally be within the first two weeks of your operation. Your insurance company may refuse to meet a claim if they feel you have driven too soon. It is advisable to contact your insurance company with regards to cover following a general anaesthetic.
Lifting - You should avoid heavy lifting for four weeks. Very strenuous exhertion should be avoided for 12 weeks after antireflux surgery.
- Shower after your operation as soon as you feel able to do so.
- Return to work after 1-2 weeks.
- Resume exercise ie swimming after two weeks. However it is important to introduce gentle exercise such as walking as soon as possible after surgery, increasing the distance you walk as you feel able.
- Resume sexual activity when you feel comfortable to do so.
- Following Bariatric (weight loss) Surgery
It is very important that you continue on the prescribed liquid diet for two weeks and follow the advice given to you by the dietitian (a simple soluble multivitamin is recommended at this time). Liquid diets may cause constipation so make sure you drink at least 2 litres of fluids per day and exercise regularly. Gentle laxatives, eg Senna, can be taken at this time, which is available from any pharmacy. (The guide to this in pdf format is available in the downloads section)
- Following Antireflux Surgery
You should normally continue with a soft diet for at least two weeks following surgery. Solid food can be reintroduced gradually after that time. You may find foods such as bread and meat can get stuck for up to six months following surgery. If you experience difficulty with a particular food refrain from having it before trying again a few weeks later.
- There are no dietary restrictions following any other type of laparoscopic surgery.
- If you experience difficulty swallowing liquids at any time please contact your surgeon directly as this may require urgent treatment.