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Sleeve Gastrectomy Uretz J. Oliphant, MD Blair M. Rowitz, MD Carle Bariatrics Sleeve Gastrectomy Before Surgery: Months Before Quit Smoking and using tobacco AT LEAST two months before surgery and do not resume after. This can interfere with surgical healing and create complications down the road Medications to Avoid Discontinue any aspirin products or NSAIDs (non-steroidal anti-inflammatories: Aleve, ibuprofen, etc.) These medications should be avoided FOR LIFE to due to risk of stomach ulcers. Concerns should be directed to your Primary Care Provider. After Surgery Follow Up After surgery, we will see you for visits at the following intervals: 7-10 days 1 month 3 months 6 months 1 year Every 6 months to 1 year thereafter Helpful Home Supplies Baby Spoon Sippy Cup Blender Vitamins Before Surgery: The Day Prior to Surgery Maintain a clear liquid diet consisting of ONLY: Clear Broth Pear Juice Clear Jell-O Apple Juice Water Cranberry Juice Popsicles Iced Tea Black Coffee What to Expect: Report time and location: Preop Center will call the day before with time. One Day Surgery Center is located on North Tower 2 (NT2) What to bring What not to bring What to Expect: Day of Surgery Upon arrival to One Day Surgery Center: Nurse will admit/assess you. An IV will be started. Preop blood thinner injection may be given. Anesthesiologist will see you prior to surgery. What to Expect: In the OR General anesthesia with Endotracheal tube (ET tube) placement. Urinary catheter placed after put to “sleep.” Inflate abdomen with CO2. Surgery will take approximately 2 hours Recovery room approximately 1-2 hours Admission to NT 7 What to expect: After Surgery Arterial Blood Gas (ABG) CPAP/BiPAP: used in recovery, night of surgery and after as needed. Multiple laparoscopic incisions-with absorbable sutures. Urinary catheter Sequential Compression Devices (SCDs) Pain control Abdominal binder Anticoagulation injections: Lovenox or Heparin ASBS What to expect: Evening of Surgery Up sitting in a chair by the evening. This is a STRICT ORDER from your physician NO food or drink. ASBS What to expect: First Day after Surgery Walking up and down the hallways This is a STRICT order from your physician. Walk a minimum 3-4 times per day. Our goal is to prevent blood clots and maintain physical activity. What to expect: First Day after Surgery Upper GI X-ray will be done. Assess for any leaks or strictures. If the X-ray is normal, a clear liquid diet will be ordered. Diet: You will be encouraged to drink 2 oz. of fluid every 15-20 minutes Dressings and catheter removal. Shower What to expect: Second day after Surgery DISCHARGE HOME Medications: Lortab Elixir- or other pain medication Lovenox- blood thinner to prevent blood clots Diet: full liquid diet for two weeks Lovenox Injection Sites 2 inches away from belly button Rotate your sites with each injection 2 inches away from previous injections Lovenox Injection Steps Clean site Pinch up 2 inches of skin Insert needle into pinched skin 1. 2. 3. • • 4. 5. 6. 45-90 degree angle TIP-if you insert quickly it will hurt less Release skin with syringe in place Push plunger Remove needle What to expect: Second day after Surgery DISCHARGE HOME Activity Restriction: X No lifting ANYTHING more than 10 pounds for ONE MONTH—this includes children and animals. No heavy housework or laundry for ONE MONTH. May drive after one week and when no longer taking pain medication. What to expect: Second day after Surgery DISCHARGE HOME Activity Restriction: – – – No sexual intercourse for ONE MONTH: Birth control measures must be taken upon resuming sexual activity. Rapid weight loss increases fertility Do not risk pregnancy for two years after surgery. Please Call if you experience… Redness, swelling or drainage from the incisions. Fever greater than 101 degrees. Increased pain at incision site. Elevated heart rate. Pulse 110 or greater, sustained. Shortness of breath. Worsening abdominal pain. Please Call if you experience… Vomiting – Call the office if persistent vomiting occurs. Bariatric Clinic number (217-383-3240) If occurs after hours, call the Patient Advisory Nurse (217-383-3233) Diet: Full Liquids Two full weeks following surgery. Only liquid form, since your stomach is tender and swollen. Full Liquid diet ONLY. Liquids should be free of lumps and pieces of food. Refer to nutritional booklet for list of foods Protein Your body needs protein to heal Complications if you DO NOT get enough protein: Infection Delayed healing time Loss of muscle mass Hair Loss High protein foods: Seafood/Fish – Tuna, salmon, shrimp, clams, crab meat… Other Meats – Lean beef, lean pork, venison, wild game, chicken and turkey Dairy – Egg/Egg beaters – Low fat cottage cheese – Light or non-fat yogurt – Skim or 1% milk Diet: To avoid weight gain Surgery is a tool to keep the weight off. Foods with high calories MUST BE AVOIDED Chips and the chip aisle Fast Food Fried Foods – – – French Fries Onion Rings Pork Rinds Popcorn Nuts Diet: Sugars to Avoid Read food labels carefully. If sugar is listed as one of the first 3 ingredients-DO NOT eat that food Sugar is AKA (also known as): Brown Sugar Corn Sweeteners Fruit Sugar Honey Levulose Maple Sugar Raw Sugar Sucrose Confectioner’s Sugar Dextrose Glucose Invert Sugar Maltose Maple Sugar Sorbitol Corn Syrup Turbinado Fructose Granulated Sugar Lactose Mannitol Sorghum Xylitol Emotional Distress—Mourning the loss of food Questions or Concerns: We want your recovery to go smoothly! If you have any concerns or questions between scheduled visits, please call the General Surgery Department at (217) 3833240. Thank you for letting Carle serve you! Created June 2013; Reviewed 2/3/16 Thank You