Bariatric Surgery: Pre-operative Requirements
Now that you have made the decision to pursue gastric bypass surgery, you have a commitment to prepare yourself mentally and physically for the surgery.
Your role as the patient will require honesty, responsibility and cooperation with the surgeon and staff at Crown Surgery, as well as the interdisciplinary team that will be involved in your care, to ensure your success.
- If you are a smoker, stop smoking immediately. The decision to quit smoking will lessen your chances of anesthesia complications during surgery.
- Immediately avoid soda and carbonated beverages. This is a necessary behavioral change as carbonation may expand your pouch after surgery (bigger pouch translates into eating more and hence regaining weight), as well as add to your caloric intake.
- Start on protein supplements and on a high protein, low carbohydrate diet. Buy a protein supplement that has at least 20gms or more of protein and less than 2gms of sugar (max 5 gms) and 8 gms of carbohydrates.
- Cut back on your portions to reduce caloric intake. This will help you lose weight and adjusting your eating habits prior to surgery makes it that much easier to adjust to the post operative eating regimen.
- Strive to lose approximately 10% of your excess body weight as this correlates to the technical ease of the operation as the liver does shrink in size with immediate preoperative weight loss. Additionally, weight loss shows commitment and compliance.
- Eat three meals a day to avoid "starvation mode".
- Start taking vitamin C 1000 mg daily, in increments of 500 mg.
- If not taking multivitamins, this is a good time to start on multivitamins and zinc (to minimize hair loss after surgery).
- Follow up with your primary care physician for the preoperative work-up necessary for surgery.
- Attend a seminar and at least one support group meetings as soon as you can as this will be a requirement prior to having your surgery. Attending the seminar and support groups will enable you to receive answers to any questions or concerns that you may have, as well as provide you with invaluable information needed for the lifestyle changes that are necessary to your success.
- If you do not exercise, start an exercise program now. EXERCISE! Not only will you feel better but you will look better.
Patient Checklist of Preoperative Tests
These tests are required for all patients:
- Chest Xray within 6 months
- EKG within 3 months
- Psych Evaluation within 1 year
- Labs as follows:
- comprehensive metabolic panel
- cbc with differential and platelets
- liver function test or hepatic panel
- thryoid function test - TSH with free T4
- lipid panel
The following tests are ordered at the surgeon's discretion:
- Echocardiogram if there is prior use of Fen-Phen or Redux.
- US Abdomen is required if you have not had gallbladder surgery.
- EGD if previous history of ulcers.
- Cardiac, pulmonary or endocrinology clearances at surgeon's discretion.
Please note that if you have had previous gastrointestinal surgery, you will be required to bring an operative report to the consultation. If you have had previous procedures eg angiogram or angioplasty, those reports will be required at the consultation. Please note that the EKG, UGI, labs and US abdomen are good for only three months and the chest xray and echo for six months.