Procedures and Outcomes

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Clinical Pearls for Emergency Room Care



Important diagnoses to rule out after bariatric surgery:

Bleeding

Leak

Perforation

PE/DVT

Obstruction

Internal Hernia

Intestinal Ulcers



Click below for a comprehensive algorithm for the care of bariatric patients in the emergency room.
We provide 24-hour access to a bariatric surgeon through the M-Line.



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Recovery and Follow-Up



Gastric bypass and sleeve gastrectomy follow the same recovery plan and diet progression.

2-3 day
hospitalization

2 week follow up in Bariatric Surgery Clinic

2 month follow up in Bariatric Surgery Clinic

6 month and yearly follow-up in the MEND clinic

It is important that bariatric surgery patients receive life-long follow up.


Post-operative Restrictions (for 2-4 weeks):

No heavy lifting (over 10 lbs)

No driving while taking narcotic pain medication

No baths or pools (showers are okay)



Diet Progression

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The GOAL:
70 grams of protein/day
64 fl oz/day

Small portions
No concentrated sweets
No carbonated drinks



Vitamin Supplementation



Vitamin supplementation after bariatric surgery is essential to prevent anemia, neurologic deficiencies and osteoporosis.
Vitamin supplementation requirements after gastric bypass and sleeve gastrectomy are different.
We provide specific recommendations for each operation below.





Pregnancy



Weight loss improves fertility. However, we recommend avoiding pregnancy for 12-18 months after surgery as this will be the time when weight loss is maximized. We encourage our patients to use two forms of birth control during this time.


Weight Regain



Studies have shown that it is normal for most people to regain a small amount of their weight (5-10%) before stabilizing. Ultimately, long-term maintenance of weight-loss is a complex mix of adhering to the appropriate diet and exercise as well as genetics, age, gender, stress and social living conditions. Regular follow up is essential for long-term weight maintenance.