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- What should I bring with me to the hospital?
- How long do I have to stay in the hospital?
- Does Laparoscopic Surgery decrease the risk?
- What happens to the lower part of the stomach that
is bypassed?
- How big will my stomach pouch be after surgery?
- Do I need my gallbladder removed?
- What is a hernia and what is the probability of
an abdominal hernia after surgery?
- If I have a hernia will you fix it during surgery?
- What are the possible complications of weight loss
surgery?
- What are the risks of developing a complication?
- What is the "Candida Syndrome"?
- What causes Candida syndrome to appear?
- Can Candida be cured?
- Is a blood transfusion required?
- What is deep venous thrombosis (DVT) and is it
preventable?
- What is done to minimize the risk of deep vein
thrombosis (DVT) and pulmonary embolism (PE)?
- What are adhesions and do they form after this
surgery?
- Will the doctor leave a drain in after surgery?
- How soon will I be able to walk?
- How soon can I drive?
- Will I have a lot of pain?
- What will the staples do inside my abdomen? Is
it okay in the future to have an MRI test? Will I set off metal
detectors in airports?
- What should I bring with me to the hospital?
- Basic toiletries (comb, toothbrush, etc.) and clothing
may be provided by the hospital, but most people prefer to
bring their own. Choose clothes for your stay that are loose
fitting and easy to put on and take off. Please be aware that
because of your incision, your clothes may become stained
by blood or other body fluids. Dr. Raja also requires that
patients bring their own CPAP machine (if they are using one
at home) and the medications prescribed at the pre-operative
visit to the hospital.
- Other ideas: reading and writing materials, crossword and
other puzzles, personal toiletries, bathrobe, etc.
- How long do I have to stay in the hospital?
The typical in hospital stay for our patients is 1 night.
- Does Laparoscopic Surgery decrease the risk?
No. Laparoscopic operations carry the same risk as the procedure
performed as an open operation. The benefits of laparoscopy are
typically less discomfort, shorter hospital stay, better cosmetic
outcome, earlier return to work, and reduced scarring.
- What happens to the lower part of the stomach
that is bypassed?
In some surgical procedures, the stomach is left in place with
intact blood supply. In some cases it may shrink a bit and its
lining, the mucosa, may atrophy, but for the most part it remains
unchanged. The lower stomach still contributes to the function
of the intestines even though it does not receive or process food,
it makes intrinsic factor, necessary to absorb Vitamin B12 and
contributes to hormone balance and motility of the intestines
in ways that are not entirely known. In the sleeve gastrectomy
procedure, a large portion of the stomach is completely removed.
- How big will my stomach pouch be after surgery?
This can vary by surgical procedure and surgeon. In the Roux-en-Y
gastric bypass, the stomach pouch is created at 1 ounce or less
in size. In the first few months it is stiff due to natural surgical
inflammation. About 6-12 months after surgery, the stomach pouch
can expand and will become more expandable as swelling subsides.
Many patients end up with a meal capacity of 3-6 ounces.
- Do I need my gallbladder removed?
At your initial consultation Dr. Raja will review your medical
history and determine if you need an ultrasound of your gallbladder.
If you are having gastric bypass or sleeve gastrectomy and the
ultrasound is positive for gallstones your gallbladder may be
removed at the same time as your weight loss surgery.
- What is a hernia and what is the probability
of an abdominal hernia after surgery?
A hernia is a weakness in the muscle wall through which an organ,
usually fatty tissue, can advance. Approximately 3-5% of patients
develop a hernia after laparoscopic surgery. Most of these patients
require a repair of the herniated tissue. The use of a reinforcing
mesh to support the repair is common.
- If I have a hernia will you fix it during
surgery?
Dr. Raja generally fixes any existing hernias during the
surgical weight loss procedure.
- What are the possible complications of weight
loss surgery?
Complications include: nausea, vomiting, diarrhea, constipation,
hair loss, infection, bleeding, pneumonia, DVT/PE, heart attack,
kidney failure, hernia, bowel obstruction, leak, stricture, fistula,
weight gain, malnutrition, death, etc.
- What are the risks of developing a complication?
The rate of complications for gastric bypass is 10-15%, for sleeve
gastrectomy is 5-10%, and for adjustable gastric band is 3-10%.
- What is the "Candida Syndrome?"
Some patients have a Candida type of yeast present on the surface
of their skin, intestine or vagina at the time of surgery. The
use of antibiotics at the time of operation can lead to overgrowth
of Candida in certain circumstances. A whitish coating may occur
on the tongue or throat, also known as thrush. This syndrome is
associated with a frothy mucous, nausea, difficulty swallowing,
sore throat, loss of taste and appetite, and occasionally abdominal
bloating and diarrhea.
- What causes Candida syndrome to appear?
It is promoted by the use of most antibiotics and some other medications,
stress, reduced immune response, and diabetes.
- Can Candida be cured?
There are several effective medications now available for treating
the overgrowth of Candida.
- Is a blood transfusion required?
Infrequently: If needed, it is usually given after surgery to
promote healing.
- What is deep venous thrombosis (DVT) and
is it preventable?
DVT is undesired blood clotting in veins, especially of the calf
and pelvis. It is not completely preventable, but preventive measures
will be taken, including: pulsatile boots, early ambulation, and
blood thinners
- What is done to minimize the risk of deep
vein thrombosis (DVT) and pulmonary embolism (PE)?
Because a DVT originates on the operating table, therapy begins
before a patient goes to the operating room. Generally, patients
are treated with sequential leg compression stockings and given
a blood thinner prior to surgery. Both of these therapies continue
throughout your hospitalization. Dr. Raja also requires that blood
thinner (Lovenox) therapy be continued for the first two weeks
after the operation. The third major preventive measure involves
getting the patient moving and out of bed as soon as possible
after the operation to restore normal blood flow in the legs.
- What are adhesions and do they form after
this surgery?
Adhesions are scar tissues formed inside the abdomen after surgery
or injury. Adhesions can form with any surgery in the abdomen.
For most patients, these are not extensive enough to cause problems.
- Will the doctor leave a drain in after surgery?
Very few patients will have a small tube to allow drainage of
any accumulated fluids from the abdomen. Most patients will not
have a nose tube, urine catheter, or any drainage tube as they
awake from their operation.
- How soon will I be able to walk?
Almost immediately after surgery, the nursing staff will require
you to get up and move around. Patients are asked to walk in the
hallway on the day of surgery, and take several walks the next
day. Upon leaving the hospital, you may be able to care for all
your personal needs, but will need help with shopping, lifting
and with transportation.
- How soon can I drive?
For your own safety, you should not drive until you have stopped
taking narcotic pain medications and can move quickly and alertly
to stop your car, especially in an emergency. Usually this takes
7-10 days after surgery.
- Will I have a lot of pain?
Every attempt is made to control pain after surgery to make it
possible for you to move about quickly and become active. This
helps avoid problems and speeds recovery. While you are still
in the hospital, Dr. Raja may use a Patient Controlled Analgesia
(PCA) machine that allows you to give yourself a dose of pain
medicine on demand.
- What will the staples do inside my abdomen?
Is it okay in the future to have an MRI test? Will I set off metal
detectors in airports?
The staples used on the stomach and the intestines are very tiny
in comparison to the staples you will have in your skin or staples
you use in the office. Each staple is a tiny piece of stainless
steel or titanium so small it is hard to see other than as a tiny
bright spot. Because the metals used, titanium or stainless steel,
are inert in the body, most people are not allergic to staples
and they usually do not cause any long term problems. The staple
materials are also non-magnetic, which means that a MRI will not
affect them and they will not set off airport metal detectors.
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