The patient will be asked to cough, breath deeply and to walk the night of surgery. This is important to prevent pneumonia and blood clots. Pain is initially controlled with intravenous medication and then transitioned to oral medication the day after surgery. If the patient experiences nausea, the nurse will provide additional medication.
The patient is transferred to a nursing unit the day after surgery where the IV and the catheter are removed. Oral pain medication is started and the diet is advanced.
Most patients are discharged from the hospital two to three days after the laparoscopic surgery and four to five days after an open procedure. Patients are discharged only when the surgeon feels it is safe to go home.
At home, the patient is expected to take short walks for exercise. Patients may take short showers - no baths. There may be some oozing from the incisions and bruising of the skin that disappears over time. If the patient had an "open" procedure, sometimes a collection of pink fluid develops under the skin. This may suddenly "squirt" from between the sutures. This is not dangerous, but the Case Manager should be notified.
If the patient is on routine medications, the patient should discuss with the surgeon which ones to take prior to being discharged from the hospital. We may need to coordinate with the primary care physician with respect to certain medications. In addition, as the patient loses weight, certain medication dosages will need to be adjusted. This will require close follow-up with the primary care physician.
In addition, the patient will need two chewable multi-vitamin tablets and two grams of calcium citrate each day.
Patients absolutely should not drive or operate mechanical equipment until authorized by the surgeon. The patient will be seen again by his or her physician within 7-10 days of discharge and should contact the office by telephone if questions or problems arise.
The patient's return to work will depend on many factors. Most patients are able to return to work within five to seven days after laparoscopic surgery or two to three weeks after open surgery, if the occupation does not require strenuous activities. The patients' particular occupation and recovery progress will dictate when they will be able to return to work.
Possible Complications During the Recovery Period
Nausea, Vomiting, Bloating and/or Heartburn
These can be caused by:
- Eating or drinking too quickly
- Drinking cold fluids
- Not chewing food adequately
- Eating too much (quantity)
- Using drinking straws
- Eating rich or sweet foods
- Eating gas-producing foods or drinking carbonated beverages
- Eating foods that are unusually stressful to the stomach
Dumping Syndrome
This occurs when food composed of simple sugars rapidly enters the small intestine, which may result in a feeling of abdominal fullness, nausea, weakness, cramping, flushing, vomiting, diarrhea, rapid pulse and cold sweats. Eliminating concentrated sweets and taking fluids 30 to 40 minutes before or after meals can avoid dumping syndrome.
Blockage of the Stomach
The opening created by the surgery is smaller than the original opening that released food from the stomach into the small intestine. This new opening may become blocked when food has not been thoroughly chewed, and this may result in vomiting.
Chew all food to the consistency of applesauce before swallowing to prevent blockage from occurring.
Overeating
The purpose of this drastic procedure is to create a smaller stomach. Therefore, the stomach cannot hold the large volumes of food it once did. Constant overeating can stretch the pouch and tear the staple lines. To prevent this, you must follow the nutritional instructions prescribed for you.
These normally include:
- Eating only three or four small meals each day, measuring the foods before consumption to prevent overfilling the stomach
- Eating slowly to allow the nerve receptors in stomach area time to replay the message to the brain that the stomach is full
- Stop eating as soon as a full feeling is experienced
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