Before weight loss surgery, you will need to have certain investigations to ensure that the procedure is safe and suitable for you. These assessments include:
- Physical assessment: The physical assessment is intended to assess your medical history and identify factors that can cause complications to weight loss surgery. The examinations include blood tests, chest X-rays, electrocardiograph (ECG) to determine the electrical activity of your heart, spirometer to check your breathing pattern and ultrasound scan to detect the presence of gallstones and non-alcoholic fatty liver disease.
- Psychological assessment: The psychological assessment is carried out to assess your general mental health status and to assess for any emotional problems that could hinder your success. These may include conditions and emotional problems that prevent you from following a healthy lifestyle after surgery, and unhealthy patterns of eating that could lead to problems following surgery.
- Nutritional assessment: The nutritional assessment is carried out to assess the history of your diet, eating patterns and its effect on your obesity, and your awareness on the changes in diet and lifestyle you will have to follow after surgery. It helps your dietitian to plan the post-surgery dietary commitments for you.
Your doctor will get detailed information about your symptoms, and history of your current and past ailments. He/She will perform a thorough physical examination and may order certain diagnostic tests such as blood tests or imaging tests to confirm your disease. After reviewing these results, your doctor will recommend appropriate treatment.
It’s not uncommon to have questions or doubts, which we will encourage you to clarify before you leave the clinic. Your doctor will take time to explain your options for treatment and our administrative staff will go through the details of costs and logistics with you. Our aim is to provide you with all the information that you would need to make an informed decision about managing your health. If you still have questions when you leave our rooms, please do not hesitate to contact us - we are here to help.
Your dietitian may recommend a strict calorie-controlled diet for two weeks before weight loss surgery. The diet aids in shrinking the liver so that your surgeon can easily push it to the side in order to access the stomach. This is required for a minimally invasive laparoscopic surgery. Reducing a moderate amount of weight before surgery can also decrease surgical complications. The pre-operative diet includes:
- Food low in carbohydrates and fats
- Drinking at least 2 litres of fluid a day
- Avoiding alcohol
- Taking mineral and multivitamin supplements
- Intake of food at regular intervals (spread throughout the day)
If you are diabetic, you need to reduce your medication as suggested by your doctor. Your surgeon will also give you clear instructions as to the medications that you can/should take and those you should avoid.
Once you and your doctor decide that surgery is required, you’ll need to prepare mentally and physically for surgery. Understanding the process and your role in it will help you recover more quickly and have fewer problems.
Working with your doctor
Before surgery, you should have discussed with your surgeon any medical conditions you have now or have had in the past that could interfere with the surgery or anaesthetic or its outcome. Routine tests, such as blood tests and x-rays, may be required prior to the surgery. You should speak with your surgeon about this.
Discuss any medications you are taking with your surgeon and/or your general practitioner to see which ones you should stop taking before surgery.
Discuss with your doctor options for preparing for potential blood replacement, medical interventions and other treatments, prior to surgery.
If you are overweight, losing weight is advisable. However, you should not excessively diet in the month before your surgery. If you are undergoing bariatric surgery, you may need to have a special meal replacement diet in the lead up to your surgery; however your Doctor and dietitian will provide full instructions.
If you are taking anti-inflammatory medication or any other blood thinning medications, you may need to stop taking them in the week prior to surgery to minimise bleeding, please speak to your surgeon about this.
If you smoke, you should aim to stop smoking 6 weeks prior to surgery, or at least try to cut down on your smoking to reduce your surgery risks and improve your recovery.
Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
Report any infections to your doctor. Surgery should not be performed until all infections have cleared up.
- Arrange for someone to help out with everyday tasks like cooking, shopping, laundry and cleaning.
- Put items that you use often within easy reach before surgery so you won’t have to reach and bend as often.
- Remove all loose carpets and tape down electrical cords to avoid falls.
- Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.
Preparing for Procedure
If you are having Day Surgery, remember the following:
- Have someone available to take you home as you will not be able to drive for at least 24 hours.
- Do not drink or eat anything in the car on the trip home.
- The combination of anaesthesia, food and car motion may cause nausea or vomiting. After arriving home wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.
Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain. Also be aware if you are taking some stronger pain medications you should not drive.
Following a strict pre-operative diet is very essential for patients undergoing weight-loss surgery in order to decrease the size of your liver and facilitate minimally invasive laparoscopic surgery, which is associated with less post-operative pain and faster recovery. This diet is also necessary to prepare your body for the surgery, protect your muscle tissue and help in a faster recovery.
Your pre-op diet should be low in carbohydrates and fats, and include moderate amounts of protein as well as multivitamin and mineral supplements. It is advisable to avoid fried food, fatty meat, sweets, whole milk products, smoking, alcohol and binge eating. Your surgeon may also design a specific pre-operative diet specifically for you, based on your body type and the type of surgery you’ve opted for. Your pre-op diet for weight-loss surgery should start 2 to 3 weeks prior to your surgery.
You will be instructed on the continuation of your regular medication and which ones will be stopped before the surgery. If you are diabetic, your insulin and medication will be adjusted.