Pre and Post Surgical Period

Before the operation

1-2 days prior to your operation your hospitalization will be performed and blood diluting medicine and purgative medicine for the cleaning of the intestines will be supplied. Your blood sugar and hyper tension will be taken under control. 1 day prior to the operation you will need to start a liquid diet (water, fruit juices, soup, tea, ayran, stewed fruits and the like) and not to eat and drink anything after 10 pm. (This will provide that your intestines remain clean, so an enema will not be necessary, the operation will be clean and the risk of an infection will decrease).

During the operation

An oxygen measurement pin will be attached to your finger during the operation in order to control the oxygen saturation in your blood, and a blood pressure device is used to automatically measure your blood pressure levels, in order to control tension. A venous path will be established in order to provide the flow of the anaesthesia and other medicine. While you are under anaesthesia catheters allowing sufficient and safe liquid flow. Access to a vein in your hand or arm will be maintained after metabolic surgery applications. (These will be removed after 3-4 days upon the start of intake of sufficient liquid after the operation.) In extremley overweight patients, or with additional problems, a vein path is opened in the hand or wrist in order to measure blood pressure and oxygen quantity in the vein (this is removed 1 day after the operation). You will wear tight leg socks in theatre, and afterwards, which will ensure sufficient blood flow in your legs until you start to walk. In addition to these, massage will be applied on your legs with pressurized devices in order to prevent blood accumulations in your legs during the operation. You will have a urine catheter inserted prior to the operation. This catheter will be removed when you start to meet your toilet needs by yourself.

After the operation

• Commonly you will need to stay in the intensive care unit on the first day after the operation in order to keep you under close observation. The effects of the anaesthesia will continue while your are being transferred to the intensive care unit.
• You may move your hands and legs and take a comfortable position after having been transferred to the Intensive Care Unit.
• You will have a blood pressure device attached to your arm in order to measure your blood pressure every 15 or 30 minutes. A measurement clip will be on your finger in order to provide control of the oxygen quantity after the operation.
• Besides this, an oxygen mask will be applied to you for a term of 2-4 hours. (You will be able to breath normally.)
• You can drink only water during the first day after the operation. Other liquids and proteins will be supplied to you intravenously, until your oral nutrition achieves a sufficient level.
• You should start breathing excersizes 1 day after the operation in order to strengthen your lungs.
• 1 day after the operation, you may need assistance when you sit and stand up, as you may experience dizziness for a couple of seconds when you stand. It is ofteh the case that you will start taking liquid food within 2-3 days. It will be ideal to take small meals every 3 hours.

Discharge

• Patients are normally discharged 4-5 days after the operation.
• You should, depending on the operation, continue with the liquid or semi-solid food diet and take your meals in 2-3 hours intervals.
• You need to drink at least 1.5 litres water per day. Your daily urine amount needs to be above 1.5 litres.
• You will need to take stomach protector (Pantoprazole pill 40 mg, daily 1 pc.) for 1 month and gallbladder protector (ursodeoxycholic acid 250 mg, daily 2 pc.) for 2 months.
• You will need to take vitamin syrop and calcium supplements until your oral nutrition becomes sufficient.
• Depending on your blood sugar level, it may be necessary that you take diabetes medication after the operation until your blood sugar reaches normal levels.
• You will need to measure and record your weight and blood sugar daily.
• Your tension medication needs will decrease, too, but it is recommended you measure and record your blood pressure for 15 days.

Follow-up Tracking

You will need to perform blood and urine tests, respectively in the 1st 3rd 6th 12th 18th and 24th month after the operation. It may be necessary to perform an endoscopy in order to review the status of the stomach.