Pre-surgery diet and activity
Your dietitian may give you a special diet to follow during the weeks leading up to your surgery. The diet will help to shrink your liver so it’s easier for the surgeon to access your stomach.
Losing weight before surgery is often recommended as it can reduce the risks associated with general anaesthesia. It can also reduce the risk of complications afterwards.
Your surgeon may also recommend that you increase your level of physical activity.
Your surgeon may ask you to have a psychological assessment to check if you have any emotional problems that could make it difficult for you to cope with the lifestyle changes you need to make after surgery. Your psychologist can help you to learn to manage emotional stress and other factors that trigger you to eat. They can also help you make behavioural changes that can lead to a healthier lifestyle.
You may need to have a nutritional assessment with a specialist dietitian to make sure you understand the changes you need to make to your diet. A good dietitian will also give you advice about food preparation and reading food labels to help you keep track of your caloric intake.
If you have signs of cardiovascular disease, your anaesthetist may ask you to see a cardiologist to make sure your heart is healthy enough for the surgery and anaesthesia.
If you’re taking medication for diabetes, your surgeon may ask you to reduce the dose. They’ll also let you know if there are any other medications you should take, or avoid.
Tests and imaging
Before surgery you may need to have some tests and imaging, including:
- blood tests
- chest X-ray
- electrocardiogram (ECG)
- breathing test
- ultrasound to check for gallstones and liver disease.
Your doctor may ask you to have a gastroscopy, a test that lets your doctor look inside your oesophagus (the pipe that leads to your stomach), stomach, and duodenum (top part of your small intestine). This is to check for abnormalities that might affect your surgery.
If any issues are raised by your tests and imaging, your surgeon may have to postpone or cancel your surgery.
If you smoke, your surgeon may insist you stop before surgery. Although weight loss surgery is relatively safe, the risk of death is double in people who smoke. Smokers also have a 30% complication rate after surgery, which is 1½ times the rate for non-smokers. Smoking increases the risks of blood clots, pneumonia, ulcers and wound infection.
Many smokers with weight problems think it helps them to control their weight. If you're one of them, the positive effects of weight loss surgery and lifestyle changes are yet another incentive to quit.
Before your surgery you'll have to do a ‘bowel prep’ to clear your gut. The type of bowel prep will depend on the surgery you're having and your surgeon’s preference. Either way you'll get detailed instructions on what to do.
Bowel prep usually begins 24 to 48 hours before surgery and involves a combination of fasting, drinking only clear fluids, avoiding foods containing seeds or fibre and/or taking laxatives. The laxatives usually induce diarrhoea and sometimes cramping pains. You’ll need to stay close to a toilet while the laxatives do their work.
Bowel prep will also make your first bowel movements after surgery easier.