BEFORE YOUR BARIATRIC INTERVENTION
If your doctor has recommended surgery for morbid obesity (BMI>40, or BMI>35 with comorbidities), you should follow some simple guidelines to make the surgery process easier. Make sure you complete the pre-operative check-up your doctor gave you.
ATTENTION: If you are a smoker, you shoud stop smoking immediately after the decision to have surgery! A heavy smoker is not considered a good candidate for the operation. It has been proven that in addition to the respiratory complications, smoking is also responsible for an 85% greater risk of leakage from the staple line! (PubMed study 2020 : https://link.springer.com/article/10.1007/s00464-020-07838-4)
All bariatric patients should undergo the following tests:
- gastroscopy
- upper abdominal ultrasound
- general blood tests, CBC, CRP and ESR
- blood glucose curves
- Blood chemistry tests: sodium, potassium, urea, creatinine, GOT GPT, serum amylase, serum bilirubin, vitamin 12, iron and ferritin, serum magnesium, serum calcium and phosphorus, triglycerides, total lipids, cholesterol, HDL, LDL, total albumin and albumin, albumin electrophoresis, and glycated hemoglobin.
- Spirometry and pulmonary assessement
In selected cases, Dr. Hirides may recommend more tests, such as endocrinological-diabetic assessment, thoracic/ abdominal CT scans, and/or colonoscopy. If hiatal hernia-reflux is present, full GERD investigation protocol should be completed before we proceed with bariatric surgery (barium swallow, pH-impedance and esophageal manometry tests).
Also, all patients must provide a certificate from a clinical nutritionist attesting to at least one longterm unsuccessful attempt to lose weight with conservative means, as well as a certificate from a clinical psychologist certifying the patient's eligibility for the operation.
Please send all above tests and certificates to our email at least 10 days prior to surgery (savashiridis@gmail.com)
THE NIGHT BEFORE SURGERY
Confirm the Operation Date and if in doubt check the Admission Paper or contact the doctor's Secretariat for any clarification. The night before surgery make sure you go to bed early after a relaxing bath and light dinner. Take care for an adequate and full hydration one day before the operation. It is best not to eat or drink anything after midnight. You must fast for at least 6-8 hours before surgery. If you are taking medications, you will normally continue your treatment with some water until the morning of the operation. If you are taking anticoagulants or aspirin and have not stopped them, contact your doctor. Be informed at least 72 hours in advance of current pandemic prevention guidelines to be allowed admission to the hospital and operating theaters. If you wish to have the Covid test included in your hospitalization package, you must visit the hospital at least 24-48 hours before your admission, and provide a sample.
On the day of the operation you will come to the Admission Office, usually early in the morning (8am) to be admitted to the hospital. It is a good idea to have all your insurance-related forms, booklets and ID documents with you. In the outpatient clinics, the standard pre-operative examinations will be performed:
- general blood tests, CBC
- biochemical blood tests (sodium, potassium, sugar, urea, creatinine)
- coagulation test (APTT, INR)
- chest X-ray
- and electrocardiogram
Don't forget to take all of your recent exams with you, especially those related to the operation. Once the pre-operative check-up in the outpatient clinics is over, you will go up to the room. There the medical assistants will take your history and you will be examined by a cardiologist and an anesthesiologist. Remember to mention any chronic conditions, previous surgeries and any drug allergies. You will then be given elastic protective stockings and a surgical gown. Once you are ready, you will be taken to the operating room. There the head of surgery and the anesthetist will be waiting for you who will guide you through the anesthesia process. Again discuss the exact diagnosis, and the exact operation you will undergo. Again remember to mention if you have any serious health history or drug allergies.