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Dr.Weight // BEFORE and AFTER bariatric operation - practical guidelines // Preparation for bariatric operation

Preparation for bariatric operation

Bariatric Surgery - Ц 2008

Preparation is similar for all types of bariatric procedures, involving consultation with a surgeon and preoperative investigation (blood tests, urine test, chest X-ray, ECG, weight and height measurement, and pulmonary function assessment). In some cases a doctor may also refer a patient to another specialist such as a cardiologist or pulmonologist.

When you talk to your doctor, give him/her full details of any medication you take regularly (including food supplements and vitamins), any previous surgery and any history of allergies. This information is needed by your anaesthesiologist and your surgeon.

During your personal consultation your doctor will explain the details of bariatric surgery, advise on the best method for you and discuss possible complications. For example, the possibility of laparotomy (the incision of the abdominal wall) can not be ruled out. If changes to the gallbladder are apparent, removal is possible during the same procedure. In case of hernias and gynaecological pathology (ovary cysts, adhesions in the pelvis, endometriosis), surgical treatment may be performed simultaneously. Where a situation is unclear, a biopsy (small piece of tissue) can be taken for histological study. Additionally, during the operation there is a fair probability of blood (or blood component) transfusion. For these and other reasons, patients must sign an Сinformed consentТ form detailing the operation, its complications and consequences.

A special diet is recommended for a week before the operation. This is important because in patients with excessive weight there is an enlargement of the left lobe of the liver, which can cause technical difficulties during the operation as it obscures the stomach and the oesophagus (the zone of the procedure), sometimes necessitating a laparotomy instead of laparoscopy. Fortunately, the fat in such a liver is burned rapidly if the patient adheres to a strict diet for the period advised.

Sample diet (per day)

Protein. 200g chicken breast, turkey or lean meat. 1 cup low-fat (1%) milk.

Starch. 2-3 portions (1Ц1½ cups) starch-containing food (rice, spaghetti, bread, potato).

Vegetables. 2-3 portions (1Ц1½ cups) boiled vegetables or salad.

Fruits. 2-3 portions (1Ц1½ cups or 1½ whole pieces of fruit) apples, oranges or tinned fruits.

Soup. 1 cup vegetable soup.

Non-caloric liquids. Very important Ц unlimited water and non-caloric beverages (beverages without sugar).

Fat. As little as possible. No butter or oil; only fat-free or low-fat dairy produce; no cakes, cream, chocolate, ice-cream, milk shakes or mayonnaise.

Seven days before the operation, patients must stop taking aspirin and other aspirin-like drugs (consult your doctor if these are taken for heart or vascular conditions); the same is true of oestrogen (female sex hormone). Your surgeon must also be informed if you take medication to reduce blood coagulation.

Glucose reduction tablets may not be taken within one day before the operation.

Do not eat or drink after midnight on the eve of the operation (or in the morning), but shower before going to bed.

If your surgeon or anaesthesiologist has given you tablets to take, swallow them with a small amount of water.