Procedure Information

Morning of Surgery
You will receive a call from the office the night prior to your EGD and/or surgical procedure to be told when to report to the hospital. You will be asked to report between 5:30 AM and 9:30 AM to the AM Procedure Unit on the 7th Floor of Atlanta Medical Center. For patients going to Crawford Long Hospital, you will be given specific instructions when you go for your pre-op evaluation. If you are having your surgery at the Atlanta Ambulatory Surgery Center you will go to the facility on your pre-op visit and sign consents and be oriented to the facility. Please remember to bring a picture ID and/or driver’s license with you to the surgery center. We will need to verify your identification prior to placing an arm band on your wrist.

You will be asked to remove all of your clothing and put on a patient gown and a pair of booties. The nurse will start an IV in preparation for surgery.

You will receive medications that have been ordered by your physician or anesthesia at this time in preparation for surgery.

If you consumed any medication the morning prior to reporting to the hospital you let the nurse know.

You will be taken to the Operating Room and placed in the Holding Area. Upon arrival to the holding area, you will meet the individuals who will be taking care of you during surgery. The anesthesiologists will speak to you as well, and you will be given some medication that will make you very drowsy prior to actually being taken to the Operating Room suite.

Your family members will be asked to wait in the Surgical Waiting Room. Family members of other patients undergoing surgery that day also share this waiting room. Please limit your family members to two (2) adults. Children under the age of 12 should not accompany patients to the hospital or surgery center.
After Surgery

You will be taken to the Recovery Room following surgery where they will monitor your respiratory status and other vital signs to be sure you are stable before sending you to the nursing unit. If there should be any concerns regarding your vital signs or respiratory status, you may be sent to the Surgical Intensive Care Unit to be monitored post operatively. If you are in the Ambulatory Surgery Center, you may be transferred to the hospital. This does take place on occasion and you should be aware of the possibility.

You may experience pressure in your abdomen during your stay in the recovery room. This is a normal occurrence; however, you should notify your nurse of any discomfort that you may be experiencing.

When the Anesthesiologist feels you are stable and doing well, you will be transferred to the Surgical Unit.
Post op on Surgical Floor

Most of the Bariatric patients are placed on one wing of the surgical unit. These rooms are specially designed for our Bariatric patients. If the physician feels like you are stable and doing well post-op those patient will go home the evening of their surgery.
Upon arrival to your room the nurse will ask your family member to step out so the nurse can get you checked in from surgery. Once you are checked in the nurse will allow your family to return to your bedside.

The nurse or PCA will bring you a 1oz/30 ml cup which contains ice chips. You will be allowed to have a 1oz cup of ice every two (2) hours for that day.
Most of you will have a PCA (Pain Controlled Analgesia) pump that provides you with pain medication. The nurse will demonstrate how to use the pump. Most of the patients experience very little pain after surgery.

For patients that are on CPAP or Bi-PAP prior to surgery, you may be given your pain medication as needed by the nurse. We do ask that you do not bring your CPAP machine to the hospital and refrain from using it for 3 days after your procedure.

When you are in bed you will have wraps around both of your lower legs. These are placed on your legs in the Operating Room. They are connected to a pump that inflates and deflates. They are called SCD or sequential compression device. The SCD’s help prevent blood clots and improves the circulation in your lower extremities. Be sure these are on your legs while you are in bed. They may be removed when you get up and walk but they should be placed back on your lower legs when you are in bed.

You will also be given a piece of equipment called an incentive spirometer. This equipment will help you take deep breaths and helps prevent pneumonia.
Once you are awake from the anesthesia and your vital signs and urine output are good, the staff will get you out of bed and start walking you in the halls. Please try to start walking as soon as possible. Ask the nurse to assist you the first time you try to get out of bed.

Some patients will on the following morning be taken down to the Radiology (x-ray) Department for a leak test or gastrograffin swallow study. The technician will give you a small amount of fluid to drink. As you drink this fluid, the radiologist will take pictures as it flows down into the new pouch. If you do not have a leak, you will return to the floor and the nurse will give you 1 oz/30ml of fluid every 30 minutes.

If you tolerate the liquids without experiencing any nausea or vomiting your IV will be removed and you will be able to go home.
Discharge Instructions

BATHING: You may shower 48 hours after surgery. No tubs baths, swimming or hot tub use for 4 weeks following surgery.

DRESSINGS: Keep the dressing dry for 48 hours after surgery. After 48 hours you may remove the top dressing and leave the steri-strips (thin white pieces of tape). These may get wet and will eventually fall off voluntarily. The ones remaining will be removed in 2 weeks on the first post-op visit. The umbilical area may not have steri-strips. The umbilical area may drain a clear light brown or pale red color fluid. This is o.k. as long as the drainage is not pale yellow or tan in color. Some of you will have a clear glue like substance over your incisions. This will stay on until it peels off by itself.
Your incisions should be cleaned once a day with Hydrogen Peroxide. Clean the umbilical area with Hydrogen Peroxide or alcohol as long as it is draining.

ACTIVITY: You may resume usual self-care. You may drive when you feel you are able. No lifting, pushing, pulling or tugging over 25 lbs. for 4 weeks. Walking every day and using incentive spirometry at least 4 times a day (for 2 weeks) is very important.