Before and After Surgery
On the day of surgery
Don't worry if . . .
Call your surgeon if . . .
On the day of surgery
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Following surgery and initial time in the recovery room, you will be brought to the bariatric unit, depending on your surgeon's orders. A nurse will monitor your temperature, pulse and blood pressure every few hours, including during the night. During the next 24 hours, you may expect:
Intravenous fluids and medications: You will receive fluids and antibiotics through an intravenous line (IV) inserted in a vein in your arm or neck until you are able to drink an adequate quantity of fluids.
Oxygen assistance: For most patients, the respirator used during surgery will be removed in the recovery room. Sometimes it is necessary to administer oxygen for a short time following surgery. This is done through a nasal tube that will be removed according to your doctor's orders, usually within 24 hours.
People who have severe sleep apnea or other major health problems may need to continue on the respirator for up to 24 hours following surgery. These patients will be monitored in the intensive care unit for one to two days. While on the respirator, you will not be able to speak. Your nurse can help with communication by using "yes-no" questions or by giving you pen and paper.
If you have sleep apnea and use a breathing machine at home during sleep, please bring the machine with you on the day of surgery. The respiratory therapy staff will help you to use your machine during sleep periods in the hospital.
Breathing exercises: It's very important after surgery that you take deep breaths and cough forcefully every hour to keep your lungs clear and prevent pneumonia. You will be taught how to use a hand-held device called an "incentive spirometer" to help you take at least 10 deep breaths an hour. Hold a pillow against your incision to minimize the discomfort of coughing. Ask your nurse if you need assistance.
Pain medication: Modern techniques make it possible to successfully control post-operative pain by a number of methods. Your nurses will regularly assess your pain by asking you to rate your pain level on a scale from 0 to 10 before and after you receive pain medication.
Although some pain is unavoidable after surgery, our goal is that you be as comfortable as possible so you can do your breathing exercises, walk and regain strength. Your surgeon may prescribe a PCA (patient-controlled analgesia) machine that allows you to control pain by pressing a button to release small doses of medicine into your IV line. Your nurse will teach you how to use the PCA. If you do not have a PCA, you may receive pain medication by IV or injection as needed. Tell the nurse if your pain is not well-controlled, or if you experience uncomfortable side effects.
Diet: You will not be able to eat or drink anything, including ice chips, for at least 36 hours. To keep your mouth moist, use moist swabs frequently or swish with water and spit it out.
Gastric tubes: In some cases, patients will have a nasal gastric tube in place during the first 24 to 36 hours to drain the stomach pouch. Some patients will also have a small temporary rubber tube called a "G-tube" inserted while in the operating room to drain the bypassed part of the stomach. This tube is connected to a drainage bag during the first few days. The bag is removed and the G-tube plugged before going home.
Toileting: You will have a tube in your bladder to drain urine during the first 24 to 36 hours. It will be removed once you are able to get out of bed to use the toilet or commode with minimal assistance.
Wound care: The nurse will check the dressings over your incisions and change them as needed. Some drainage is expected. Some patients will have an abdominal binder in place to provide extra support to the incision.
Leg exercises: It's very important that you do leg exercises every hour to prevent blood clots in your lower legs. Slowly rotate, flex and extend your feet at least 10 times every hour while you are awake. You will wear inflatable compression stockings in the operating room and while in bed during the first 24 to 36 hours. These plastic stockings gently inflate and deflate at regular intervals to stimulate blood circulation in your legs and help prevent blood clots.
Activity: On the evening of surgery, the nursing staff will help you get out of bed briefly and take a few steps. Getting up will be less uncomfortable if you time pain medication to receive a dose just before getting out of bed and hold a pillow against your abdomen when you move. Walking is extremely important during recovery to prevent complications and promote the return of normal bowel function. If you had laparoscopic surgery, walking will help ease shoulder and chest discomfort caused by the procedure.
Beds: Patients with a body mass index over 50 will be placed in a special bed. This bed has extra room and can be raised to a standing position by the nursing staff to help you get out of bed. The nursing staff will show you how to operate the controls so you can change position. Ask for help any time you wish to get out of bed to minimize the risk of falling.
Don't worry about:
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Call your surgeon right away if you develop any of the following:
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Most patients who have Laparoscopic Gastric Bypass surgery are discharged two to three days after surgery. Open incision Gastric Bypass patients are usually discharged four to five days after surgery and Lap-Band patients are discharged one day after surgery.