The doctor will assess the necessity of various individual tests such as blood tests,
urine tests, electrocardiograms, chest X-rays, echocardiograms (ECHO), abdominal ultrasounds, sleep studies, cancer screenings, etc., to detect comorbidities, abnormalities in vitamins and minerals, and the readiness of organs for surgery.
Weight Loss Before Surgery
You should lose at least 5-10% of excess weight on your own before surgery to reduce liver size and prepare new lifestyle habits after weight loss surgery.
Diet
It is recommended to consume 1-2 kcal per day, choosing quality calories, focusing on low-fat protein, vegetables, reducing starch, fatty foods, and fruits. Avoid calorie-containing drinks and stop unhealthy eating habits such as eating without hunger, craving sweets, eating quickly, and drinking liquids with meals. This dietary control will help build new eating habits that continue after surgery, enabling long-term weight control post-surgery.
Exercise
Start exercising early. Exercise will become easier after surgery, helping blood circulation and heart rate during surgery, improving breathing efficiency during recovery. Begin moving more now but avoid injury. Prepare an exercise plan in advance with periodic goals. Exercise at a moderate level (zone 2)-(zone 3) (breathless but able to speak in sentences, not sing, or fat burn/cardio) consistently for at least 3 minutes per day, 5 days a week. Use a heart rate or step counter. If joint pain hinders walking, water exercise is recommended to reduce joint weight-bearing and improve breathing.
Chronic Diseases
Control chronic diseases such as managing HbA1C and FBS levels in diabetic patients, and use a sleep apnea device in patients with moderate to severe obstructive respiratory disease.
Medications for Chronic Diseases
- Stop blood thinners and anticoagulants such as Aspirin, Clopidogrel, Warfarin at least 7 days before surgery.
- Inform the doctor about all herbal medicines and supplements you are taking.
Smoking
Smoking causes lung infections, increases the risk of respiratory and heart complications, infections, increases the chance of blood clots in the legs and heart, worsens circulation, delays wound healing, causes leakage at gastrointestinal anastomosis, marginal ulcers, and severe bleeding. Smokers must quit smoking at least 8 weeks before surgery and avoid secondhand smoke.
Alcohol
Alcohol affects liver function, causes fatty liver and hepatitis. In the early postoperative period, even a small amount of alcohol can have severe effects and may cause the following symptoms:
- Increased palpitations
- Low blood sugar, dehydration
- Abdominal pain (dumping syndrome)
It is recommended not to drink alcohol for at least 1 year after surgery and then avoid it as much as possible.
Work
Most people can return to work about 2-4 weeks after surgery. Avoid heavy lifting for at least 8 weeks. It is important to understand that you are not only recovering from major abdominal surgery but also adjusting to a period of significantly reduced food intake and rapid weight loss.
It is recommended not to rush back to work and to use the valuable initial recovery period to gradually adapt to the new digestive system, start exercising slowly, and get plenty of rest.
2 Weeks Before Surgery
Consume only liquid foods and limit energy intake to 8-1 kcal/day (low-calorie diet). Exercise as usual. Drink at least 1.5 liters of water per day.
* Patients with BMI > 5 kg/m² may need to be hospitalized for preoperative weight loss by limiting food to 6-8 kcal/day (very low-calorie diet) along with close monitoring of physical condition (Preoperative in-hospital weight loss).
Surgery Day and Preparation Steps
- On the morning of surgery, take a shower and clean the body, especially the abdomen. Avoid moisturizers, creams, lotions, and makeup.
- Remove nail polish if any and do not apply nail coating. Remove jewelry, dentures, contact lenses, and glasses.
- Bring personal medications and sleep apnea devices if used.
- Do not eat or drink for at least 6 hours before surgery.
- Surgeons, anesthesiologists, and nurses will reassess surgical readiness, administer IV fluids, and necessary medications.
2 Weeks to 6 Months After Surgery
This is the period of the greatest weight loss. The doctor will schedule regular follow-ups. You can gradually eat more soft and solid foods while controlling diet and eating habits as practiced before surgery. Be mindful of eating, stop when full, drink at least 1.5 liters of water daily, and avoid fruits, sweets, and calorie-containing drinks.
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