Commonly Asked Questions

Your surgeon will determine and explain what you need to do before having obesity surgery, but these are answers to some of the more common questions regarding tests and procedures you may be asked to do in preparation for your surgery.

What are the routine tests before weight loss surgery?

Certain basic tests are done prior to surgery: a Full Blood Count, Urinalysis, and a Biochemistry Analysis, which gives a readout of about 20 blood chemistry values. Often a Glucose Tolerance Test is done to evaluate for diabetes, which is very common in overweight persons. Patients may require an X-ray and electrocardiogram. Many surgeons ask for a gallbladder ultrasound to look for gallstones. Other tests, such as pulmonary function testing, echocardiogram, sleep studies, gastrointestinal evaluation, cardiology evaluation, or psychiatric evaluation, may be requested when indicated.

What is the purpose of all these tests?

An accurate assessment of your health is needed before surgery to minimise the chance of complications and this will be determined by your surgeon. 

Why do I have to have a Gastrointestinal Evaluation?

Patients who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid, etc., may have underlying problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer.

Why do I have to have a Sleep Study?

The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the muscles relax during sleep. This condition is associated with a high mortality rate. After surgery, you will be sedated and will receive narcotics for pain, which further depress normal breathing and reflexes. Airway blockage becomes more dangerous at this time. It is important to have a clear picture of what to expect and how to handle it.

What impact do my medical problems have on the decision for obesity surgery, and how do the medical problems affect risk?

Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the surgeon from recommending obesity surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average.

What can I do before the appointment to speed up the process of getting ready for obesity surgery?

Select a general practitioner if you don't already have one, and establish a relationship with him or her. Work with your doctor to ensure that your routine health maintenance testing is current. For example, women may have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific antigen test (PSA).

• Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
• Bring any pertinent medical data to your appointment with the bariatric surgeon - this would include reports of special tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
• Bring a list of your medications with dose and schedule.

Laparoscopic Bariatric Surgery

Does Laparoscopic Surgery decrease the risk?

No. Laparoscopic operations carry the same risk as the procedure performed as an open operation. The benefits of laparoscopic surgeries are typically less discomfort, shorter hospital stay, earlier return to work and reduced scarring.

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. Often several drugs are used together to help manage your post-surgery pain. While you are still in the hospital, a Patient Controlled Analgesia (PCA), which allows you to give yourself a dose of pain medicine on demand, may be used by your doctor. Various methods of pain control, depending on your type of surgical procedure, are available. Ask your surgeon about other pain management options.

How long do I have to stay in the hospital?

As long as it takes to be self-sufficient. Although it can vary, the hospital stay (including the day of surgery) can be between 1- 8 days depending on the procedure.

Will the doctor leave a drain in after laparoscopic surgery?

Depending on the procedure, patients may have a small tube to allow drainage of any accumulated fluids from the abdomen. This is a safety measure, and it is usually removed a few days after the obesity surgery. Generally, it produces no more than minor discomfort.

If I have laparoscopic bariatric surgery, what can I expect when I wake up in the recovery room?

Some doctors will provide a Patient Controlled Analgesia (PCA) or a self-administered pain management system, to help control pain. Others prefer to use an infusion pump that provides a local anesthetic in the surgical site to control pain without the side effects of narcotics.

How soon will I be able to walk?

Almost immediately after surgery doctors will require you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks the next day and thereafter. On 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 medications and can move quickly and alertly to stop your car, especially in an emergency. Usually this takes 7-14 days after surgery.

The Hospital Stay

What is done to minimize the risk of deep vein thrombosis (DVT)/pulmonary embolism (PE)?

Because a Deep Vein Thrombosis 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. 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 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 easy to put on and take off. Because of your incision, your clothes may become stained by blood or other body fluids. Other ideas:

• reading and writing materials
• crossword and other puzzles
• personal toiletries
• bathrobe