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FAQ

Can I be pregnant after surgery?

Yes. Pregnancy is quite possible after weight loss surgery. But it is preferable to wait 12 to 18 months after, until weight has stabilised and to make sure there is no nutritional deficiency. It is then recommended to have a nutritional follow up from start to several months after delivery. Different types of contraception may be used. Take medical advice.

 

Does Health insurance take in charge surgery?

Yes (for people resorting of French system). Once the agreement given, it takes in charge surgery and hospital stay unless an eventual over fee taken by the surgeon. On the other hand, it does not reimburse supplementary vitamins (about 9 to 25 € per month), most of the protein supplements, post-op consultation with psychologists and dieticians, some biological tests and some of the reconstructive surgery.

 

Should some medicine be avoided?

Yes. All medicines with toxic effect on stomach such as aspirin, anti-inflammatory drugs, corticoid, must not be taken unless necessary. Always take medical advice before taking any drug.

 

How to calculate your BMI?

The body mass index (BMI) is used to estimate excess fat in the body and to define how overweight a person is. The higher the BMI, the greater the risks associated with obesity. To calculate it, divide your weight (in kg) by your height times your height (in m):

BMI (kg/m2) = weight (kg)

height (m) x height (m)

 

Can I have surgery if I have other pathology beside obesity?

Alcoholism, cirrhosis, psychopathy with compulsion, on-going cancer, all these are contra-indications. Other pathology, to the opposite, are rather indication for surgery: sleep apnoea, high cholesterol, degenerative osteoarthritis, type II diabetes, high blood pressure.

 

I smoke. Is surgery possible?

It is not a contra-indication but smoking can complicate post-surgical wellness.

 

How do I choose the right procedure for me?

 

The surgeon will give you a first opinion at the end of a first pre-surgical consultation. The final decision comes at the end of a thorough health assessment and is taken by the multidisciplinary team, the surgeon and yourself. The first indication is your BMI, then other comorbidity likely to improve with surgery such as diabetes. Some procedures obtain better results in the long term but have a higher mortality rate: the bypass and the sleeve. The ring keeps a good efficiency but suffers from a negative current trend. In future days, it could be specific to BIM between 30 and 35 such as it is already in England and USA. Surgeon experience is also decisive in the choice.

 

When is the expected weight loss reached?

Weight loss varies from one person to another. It often occurs rapidly during the first weeks then reaches its higher level around the 8th month to a year. Weight gets stable during the three years following surgery. Weight loss varies too with the type of surgery (see cross reference chart).

 

Can I regain weight after surgery?

After weight loss it is sometimes observed that a patient take on about 10 % to a maximum of 20 % of the excess weight.

 

Can surgery fail?

There are few failures and mostly due to technical surgical problem like a too large new stomach pouch. However, some factors can contribute: a very high BMI, second surgery for 50 and over women that had a ring in the first place.

 

Which examination is to be done before surgery?

Various examinations are requested with the multidisciplinary team among which:

  • an assessment of your eating habits with a nutritionist (blood test)

  • a psychological assessment in order to offer you proper follow up

  • an upper gastrointestinal endoscopy with biopsies

  • a cardiac check up

  • a consultation with the anaesthetist

 

How long does last the pre-surgical phase?

It is the time necessary to complete your health assessment examinations and make sure the patient knows enough about surgery and has a complete understanding of it and the resulting commitment: usually about 4 to 6 months.

 

Should I exchange with operated persons?

Yes. That allows you to talk freely with other persons that doctors and comfort your knowledge about surgery, compare your experience to others and strengthen your motivation.

 

How long will I stay off work?

From 10 days to 3 weeks according to your personal context.

 

Surgery and hospital stay

 

In what kind of service will I stay?

You will be admitted in a digestive surgery unit. After surgery, you will be taken care of in an intensive care unit for total safety.

 

When will I be able to stand up after surgery?

You mays stand up the day after surgery. You can then have visits too.

 

Is weight loss surgery painful?

No, it’s usually not, partly thanks to coelioscopy. Anaesthetists take good care of that. Surgery may however makes the patient feels somewhat nauseous.

 

Does surgery leave scars?

It results in only six small scars of about 1 cm thanks to coelioscopy

 

After surgery, will I have a stomach tube? A drain?

No, no tube nor drain unless complications. You will only wear disposable nasal cannula for the first night.

 

After surgery when will I be able to eat and drink?

A soon as the next day, you will be able to drink water. You will first feed liquid then semi-liquid for a few weeks up to mashed food. Quantities are reduced, food taken in small amounts and beverage apart from meals.

Do I have to bring my sleep apnoea syndrome device?

Yes, at the request of anaesthetists.

 

Back home

 

If I don’t loose enough weight, what should I do?

You must consult with the multidisciplinary team that follows you to identify the cause.

 

Can I eat as soon as I come back home?

When you leave the clinic, you will receive information about what to eat during the first weeks and model meals. During the fist week, you only eat liquid food split in 6 to 8 takes along the day if necessary.

Which food is harder to digest?

Each person has his (hers) lesser tolerances. During the weeks after surgery, you must prefer a simple cooking with little fat and avoid food requiring long digestion time such as cabbages, raw vegetables, foods containing much fibres, etc., sodas, sweetened and fizzy drinks. In the long run, bread, steak, fatty foods may be harder to digest and sugar sometimes causes “dumping syndrome”.

 

When should I drink and what?

You must drink 1,5 litres each day and always apart from meals. You should avoid fizzy, sweet and alcoholic drinks.

 

Can I drink alcohol?

Yes, but with moderation and you’ll have to wait approximately one month, the time necessary to tissue healing.

 

What should I do if I don’t feel full?

Call surgeon.

 

What are the examinations after surgery?

There is no particular examination except a fiberscope inspection in the following year. There are four consultations for check up during the year after surgery. A possible nutritional deficiency is verified with a blood test in the weeks after.

 

 

What should I do in case of problem if I am far from the team that follows me?

Nowadays there is a specialized team in each region of France.

 

How do I know if I suffer from nutritional deficiency?

Your nutritionist will take care of that with regular blood tests.

 

What can I do if I can’t take my vitamin supplements?

They can be prescribed by injection every 3 months.

 

What are the possible complications after surgery?

The main one is a possible peritonitis. 90% cases occur during the 72 hours after surgery. But it can always happen in the following 30 days (abscess). Another complication is sutures ulcer. It is prevented by specific medicine.

 

What are the warning signs for complication?

In case of repeated abdominal pain, important repeated vomiting, tachycardia, breathlessness, you should consult. Do not be mistaken by alimentary vomiting that stops right after rejecting food or usual post-surgical aches. Unexpected tachycardia over 120 is the main symptom. You then ought to consult rapidly your surgeon.

 

What is dumping syndrome?

The dumping syndrome is the occurrence of deep malaise accompanied by sweats. It happens when too fat or sweet food passes roughly from stomach to intestine. Lie down promptly and it will decrease and disappear. It tends to repeat with the same foods but will eventually disappear in the long run.

 

What is to be done in case of diarrhoea?

They occur in 20% cases after surgery but are not severe. It will generally stop after three months.

 

What if I vomit?

Vomiting after eating something too big, too fat or insufficiently chewed, if on occasion and that it stops after rejecting the food, should not worry you. It becomes pathologic if you can’t take any liquid food. It can be the sign for a stenosis: you must consult! In most cases, it happens during the two months after surgery. More serious, if heavy, green and bilious vomiting occurs without having eaten anything: it’s a sign for intestinal obstruction and you must consult rapidly.

 

What if acid reflux?

Consult your regular practitioner.

 

What if I feel food gets stuck?

Stop eating or drinking to let it passes. You must wait quietly that food bowl goes one-way or the other.

 

More

 

Can I still take my usual medicines (aspirin, oral contraceptive, etc.) and how?

Yes. But for some of them it will be necessary to increase the dosage due to a lesser intestinal absorption in reason of the bypass.

Example: some treatment for epilepsy will have to be increased to be efficient. To that condition, almost all prescribed drugs can be continued.

 

What kind of contraceptive device should I use? When can I be pregnant and do I need a special follow up ?

There are no official waiting period required. Some patient got pregnant four or five months after surgery without complications. However, it is preferable to wait to have reached a stable weight (about 12 to 18 months after surgery) as well as to be followed by a nutritionist to prevent deficiencies.

 

What the benefits, the restrictions after weight loss surgery : psychological, everyday life, social relations, work, common life ?

Most patients give account of a greater well being in their lives. However they can go trough psychological stress mostly during the first year. That is why it is advised to get psychological follow-up to get used to one’s new image. Many studies have shown quality of life improvement, both on personal level and common life. It may however imply deep changes. Family reaction varies: it is mostly positive but sometimes brings out old conflicts.

 

Can I get psychological support before and after surgery?

It is highly recommended to get support both before and after. Weight loss changes your self-image. It is mostly an objective improvement. But some patients may be disturbed, mostly during the first year. That will be prevented with support.

 

How can I explain my health problem to my family circle?

Very simply and plainly like for any illness, insisting on the morbid aspect, medically speaking, of obesity and its known pathological consequences: cardiovascular complications, depression and higher cancer effects. That justifies resorting to surgical solutions.

 

I tried to tell my employer about my surgery but I didn’t dare to. What to do?

It is better to let him (her) know but you don’t have to. Medical confidentiality applies.

 

Will I need reconstructive surgery after the operation?

Abdominoplasty is often required to remove excessive skin that results from weight loss. That abdominal “apron” may generate repeated cutaneous infections and is often seen as an aesthetic prejudice. It is therefore covered by Health Care after agreement as well as is mammoplasty for reduction.

 

Is there a higher risk for a second surgery?

Yes it is in the most common case: surgery for bypass after having no result with a ring. It the operation is the same, it is done on harder tissue due to the chronic inflammation caused by the ring on stomach. The cicatrisation takes longer and there is an increased risk for fistula.

 

Is a second surgery efficient?

It is not as performing with a lower weight loss. The hardness of tissues makes it difficult to create a small enough new stomach pouch.

 

What are the chances of success for a second surgery?

When gastroplasty or bypass has failed in the first place, chances for a success of a second surgery are rather low unless the reason for failure was a technic fault.

 

 

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