Immediate Post-operative Period*
Recovery Room: Patients will first go to the recovery room after the operation is over. There he/she will be closely monitored while waking up from anesthesia. Family members are usually not allowed because of Government rules concerning privacy of other patients.
2 Hours Post-op: With assistance from a nurse the patients’ needs to walk outside the room, in the hallway, at least 20 steps. After walking, the patient will be allowed to take low sugar liquids by mouth. Initially this is usually ice chips and sips of water. However, broth, sugar free Jell-O, sugar free popsicles and no calorie-non carbonated drinks are encouraged. Once the patient in ambulatory and able to drink water, the nurse will discharge the patient to a designated care giver. The hospital or surgery center will not release the patient without accompaniment.
At Home – Week 1
Medications: All necessary previous medications should be taken at the prescribed intervals after returning from the hospital. Tablets will need to be crushed and capsules opened for the first week. Usually these are taken with water or crystal-lite. Any medication that can be skipped should wait until 1 week post-op. Examples are: cholesterol medications, previous pain medications, muscle relaxants, special vitamins, etc. Absolutely necessary blood thinners such as aspirin, plavix or coumadin should be restarted 48 hours after surgery. If any signs of bleeding occur they should be discontinued and the patient should call the office immediately. Diabetes medications should be reduced to ½ dose, and blood sugar levels should be monitored every 6 hours if the patient is on any insulin. If you are on diabetes medication, make an appointment to see the prescribing physician within 2-3 weeks.
Activities: Patients can do their activities of daily living (ADL) such as going up steps, or taking care of themselves in the bathroom or shower.* The patient does not need special assistance from someone else.* He/she should not stay in bed; moving about and even light exercise are encouraged. Strenuous activities, such as lifting more than 20 lbs, are not allowed for 48 hours. The patient’s activity level should increase within 48 hours. All exercise is allowed after 2-3 days, including strenuous activity and lifting can. Normal sexual activity can occur as soon as the patient feels comfortable enough.
Driving: A typical patient will be able to drive his/her car approximately 2-3 days post-operatively. Driving should only be attempted if the patient feels that he/she can turn the wheel or apply the brakes in an emergency. If not, the patient should not attempt to drive.
Return to Work: Patients are able to return to work by day three post-op.
Diet: After the ESG procedure patient will be on a clear liquid low sugar diet for 7 days. Please see the diet section for a description of the diet. Do not attempt to take soft or solid foods yet as these could breakdown the upper connection sutures. Also, avoid carbonated beverages until 1 month after surgery. Caffeine is allowed (with sugar substitutes and non-dairy, low fat creamer). Concentrated fruit juice and processed sugars should be avoided to avoid cramping, flushing and diarrhea which are the symptoms of the dumping syndrome.
APPOINTMENT 1 week Post-op
Call the office to schedule an appointment 1 week after surgery. We will see how you are doing and answer questions.
Medications: All previous medications should be resumed and can be taken normally (i.e. as whole pills or capsules. Diabetes medications should remain at ½ the previous dosage, and the patient should make an appointment to see the prescribing physician to alter the dose.
Diet: Warning: it is ABSOLUTELY ESSENTIAL NOT TO OVEREAT after the ESG procedure. The length of the suture line will be vulnerable to stretching and inhibiting the expected success. A revision may be required to tighten the stomach or move to the more invasive laparoscopic sleeve gastrectomy. At this point the patient can follow the regular prescribed diet provided.
Vitamins: A multivitamin with folic acid (folate) should be started one week after surgery. Although this can be chewable, it is not necessary. The patient should take some form of a multivitamin indefinitely.
APPOINTMENT 1 Month
Schedule an appointment for 1 month after surgery. It will be necessary to have blood tests done a few days before the appointment. This will include blood counts, electrolytes, protein levels, calcium, iron, vitamin B1, vitamin B12 and folic acid levels.
After 1 Month
Activity: Normal with increased exercise.
Diet: No change after week 2
Vitamins: Continue the multivitamin
Blood work, as described above, will be done prior to each visit. If any unpleasant symptoms occur that could be related to your Gastric Sleeve operation call the office immediately. Please see the section on problems that can occur after Gastric Sleeve.