Q: What are the tradeoffs with incision size? A: Is it better to do the gastric bypass through a standard incision, a very small incision (mini-lap), or laparoscopically? There are pros and cons. In general, laparoscopy virtually eliminates two common postoperative complications: wound infections and hernias. The frequency of bowel obstructions and leaks is increased from about one in 35 to about one in 15. The results with the small incision are intermediate.
Q: Can the surgery be reversed? A: Yes, but it would take another operation and it is not advisable.
Q: What are the main risks of surgery? A: As with any surgical procedure there are risks. The most common complications are wound infections, strictures, and hernias. In 1/200 patient’s death has resulted.
Q: Are there long term risks after surgery? A: Any abdominal operation sets the stage for a possible bowel obstruction the lifetime frequency of which is approximately 8%. Vitamin and mineral deficiencies can occur if calcium, B12, and iron supplements are not taken as prescribed. Less commonly protein deficiency can occur.
Q: How long is the hospital stay? A:Our average patient stays 1-2 days.
Q: Will my overall health improve? A: Morbid obesity can also cause serious health problems. Post surgery, many of our patients no longer experiences many of the life threatening symptoms they did before their weight loss, i.e. sleep apnea, joint pain, back pain or high blood pressure.
Q: Will I be able to have children after the procedure? A: Ideally, pregnancy should be delayed until weight loss is maximal, usually 2 years after surgery. Weight loss makes women more fertile and decreases the likelihood of complications related to pregnancy.
Q: What is dumping? A: Foods high in sugar and some fats will cause the intestine to release vasoactive chemicals which cause sweating, flushing, weakness, fatigue, and sometimes abdominal cramps and diarrhea—a phenomenon called ‘dumping.’
Q: Will I experience dumping? A: Dumping will occur if a large amount of foods high in sugar and fats are consumed after the procedure has taken place. It is imperative to stick to the diet guidelines set forth by your doctor.
Q: Will I be required to drink protein shakes? A: No. The shakes ensure adequate protein and calorie intake after surgery, which is important for healing and other reasons. A liquid diet ensures that the pouch and opening will not be stretched early on when that is more easily accomplished. The shakes also interpose a significant change between the way you have eaten and the way we hope that you will eat in the future. Because the shakes are somewhat monotonous, once you switch to a low fat, more healthy diet it will be ‘tasty’ by comparison and therefore more likely to be preferred in the long run.
Q: How can I prevent stretching out my new stomach? A: Don’t eat after you feel full.
Q: Does surgery affect how well I absorb my medications? A: Generally speaking not, but with certain medications it may be wise to check blood levels after surgery.
Q: How long before I can go to work? Make exercise? Drive a car? A: We advocate walking and light weight lifting immediately after surgery. Typically patients can return to normal activities two to three weeks after their procedure.
Q: Will I ever eat normally again? A: It depends on what you mean by normal. Many overweight people eat more and make higher calorie food choices than the rest of the population. So it is possible that you were not eating ‘normally’ to begin with. After surgery although you can eat small amounts of anything, we hope that you will choose low fat foods for the most part. Also you will in general consume fewer calories than someone your size who was not previously overweight. You could eat frequent small amounts of high calorie foods and gain your weight back.
Q: What kind of exercise should I do after surgery? A:We advocate increasing two kinds of exercise as part of a post surgical lifestyle change: 1) Increase the difficulty of unscheduled everyday activities. For example, try to walk farther — a pedometer is helpful in this regard — climbs the stairs instead of taking the elevator; volunteer for small tasks that you might not otherwise choose. 2) Schedule workouts two or three or four times a week simply for the purpose of exercising. Although any activity is helpful, weightlifting is the most efficient for extra weight loss.
Q: Will I need plastic surgery after I lose weight to remove loose skin? A:Whether plastic surgery is desirable depends on how old you are (skin is less elastic with age) how much weight you lose (the more the more skin) and individual differences in elasticity. Loose skin bothers some more than others, but there is nothing shameful about wanting to look your best.
Q: How much food can I eat after surgery? A: The gastric pouch although initially very small has a hole in the bottom so that a reasonable amount of food can be eaten if taken slowly. As time passes the pouch enlarges and where initially only one or two bites could be taken without a sense of fullness, later a small adult meal can be consumed. As it becomes possible to eat more food it becomes also more important to have developed good habits with regards to food choices.
Q: Are there specific foods or drugs that I should avoid after surgery? A: Except for the tiny hormone replacement pills most tablets should be crushed after surgery. Foods high in sugar and some fats will cause the intestine to release vasoactive chemicals which cause sweating, flushing, weakness, fatigue and sometimes abdominal cramps and diarrhea—a phenomenon called ‘dumping’.