Providing Post-Operative Care for Bariatric Surgery Patients
Follow-up with your patient
After gastric bypass surgery, it is helpful to see your patients within one to two weeks after surgery to review medications, and to check the status of the abdominal wound.
- Patients who have diabetes may need decreased amounts of diabetic medication within a few days of surgery. Patients are instructed to monitor their glucose levels four times daily.
- The need for antihypertensive medication may change early after surgery, as well. Patients who take antidepressant medications should be encouraged to remain on these medications for the first few months following surgery.
- Patients are encouraged to drink at least 48-64 ounces of non-caloric fluids daily.
After surgery patients will progressively advance their diet from liquids to solids, over a seven-week period. Read about the bariatric surgery post-operative diet.
Patient discharge materials
All patients are provided with a 90-page "Bariatric Surgery Handbook" that contains extensive information regarding the risks and benefits of surgery, diet instructions, vitamin and mineral supplements, and discharge instructions. They are also discharged from the hospital with written home care information.
Patients may choose to have a wound check in the DHMC General Surgery Clinic or with their primary care providers.
- Laparoscopic gastric bypass patients will have six small incisions that are covered by steri-strips. The strips should be allowed to fall off normally, which can take approximately five to seven days.
- Patients who have had open surgery will have an upper midline abdominal incision, and might have skin staples. The skin staples are ideally removed ten days post-operatively. When the staples remain in for extended periods, the staple line will show a reactive erythema, which will generally not need to be treated with antibiotics.
Post-operative evaluations by the Bariatric Surgery Program
We evaluate the patient on the first, fourth, twelve, eighteenth, and twenty-fourth month, and then yearly thereafter for life. Some patients are evaluated more frequently, as needed. At each visit, the patient is seen by a dietitian and a surgeon or nurse practitioner.
Post-operative lifetime vitamin and mineral supplements are required.
Post-operative lab work
Lab work is done at 4, 12, 18, and 24 month visits after surgery, and then yearly:
- Ferritin, iron, iron saturation
- Comprehensive metabolic profile
- Intact parathyroid hormone
- RBC folate
- Vitamins A, B1 (thiamine), B12, and 25 hydroxy Vitamin D
You will receive a copy of the labwork. If you prefer to have the labwork drawn during your visits with the patient, please send a copy of the labwork to:
Maureen Quigley, APRN
General Surgery Clinic
Dartmouth-Hitchcock Medical Center
One Medical Center Drive
Lebanon, NH 03756
Repeat sleep studies after weight loss
Patients are advised to check with their Sleep Center regarding recommendations for repeat testing. Most patients need to have a pressure setting adjustment on their CPAP/BiPAP after weight loss.
If you or your patient have any questions, please contact us at (603) 650-7913.
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