Before & After Surgery


Metabolic Surgery:  Patient  Information about operation

Before Operation

For 2 days before operation  you will be on liquid diet ( water, coconut water, juices, clear soups, butter milk).1 day before operation you can take only water, lime juice, coconut water & clear soups.

You have to bring your blood sugar measuring instrument(Glucometer) so that you can do blood sugar check yourself & for correct readings even after your discharge

You will be admitted one/two days before the operation for starting blood thinning medicine, steam inhalation, laxative tablets to clean your bowels & breathing exercises (spirometry). Your weight & abdominal girth will be measured; high glucose will be controlled with insulin.

After 10 pm on night before surgery only sips of water will be allowed till before the operation( This keeps your intestine clean & empty without giving enema & makes  operation cleaner & without infection)

At operation

A Blood Pressure measuring arm cuff will be applied, to measure your BP automatically by inflation of the cuff during operation

A body oxygen measuring probe will be attached to your finger to continuously monitor oxygen saturation during operation

In the operation theatre an intravenous line will be introduced through a needle in your arm, for fluids & medicines & anesthesia medicines

Tight stockings upto mid thighs will be placed with leg sleeves to rhythmically  massage  your legs. This will continuously keep your leg blood circulation going, till you start walking after the operation

A urinary catheter will be put to remove urine at operation & will be removed after operation as soon as you can walk to the toilet on your own

After the operation

You will be shifted to Surgical ICU to keep you under observation & pain free for 1-3 days. You will be in your senses at the time of shifting to ICU. You can move your hands & legs & turn any side in the bed into a comfortable position soon  after shifting

A B.P. measuring arm cuff will be applied, to measure your BP automatically by inflation of the cuff every 15-30 min

A body oxygen measuring probe will be attached to your finger to continuously monitor oxygen saturation after surgery.

Oxygen will be given to you for 2-4 hrs using a face mask . Just breathe normally in it.

You will only be allowed sips of water for 2 days following operation, & coconut water & clear soups from day 3-4. Intravenous fluids & proteins (diabetic surgery) will be supplemented through IV line till your oral intake is adequate by 3-5 days

To keep your lungs strong you should start spirometric exercises using your own spirometer a day after surgery

You will be helped to stand & made to sit in a chair 1 day after surgery, when you may feel dizzy for few seconds on standing

By day 6-7 you will be put on semi-solids by which time you would have passed flatus; small meals every 3hrs & water in-between separately, would be ideal.

At Discharge

You will be discharged from 4-5 days after operation. A liquid & semi solid diet has to be taken as prescribed at 2-3 hrly intervals. To know that you are taking enough liquids you have to measure your 24hr urine output & keep it above 1.5 lits

You will have to take an antibiotic for 3-5 days, an anta-acid for 2 months, a vitamin & a calcium tablet supplement along with a protein supplement till your oral intake improves

After diabetic surgery depending upon blood sugar levels, a mild antidiabetic Metformin 500mg  2-3 tablets may have to be taken till blood sugar levels are under control. Monitor your blood sugar daily using your glucometer at home for 1month to fine tune metformin requirement

Your blood pressure tablet requirement will also reduce. Thus you have to measure your blood pressure every day for 15 days

Follow-Up

You will have to come for check-up & with fresh blood reports after 1 month, 3 months ,6 months, 1 year, 11/2 years, & 2 years. You have to undergo Upper GI endoscopy at1 month & 1 year to see healing of stomach