 Gastric
Surgery - Frequently Asked Questions
Do I need a referral from my doctor?
No, a doctors referral is not necessary, however, it is very helpful to have their support.
We prefer where possible, prefer to work with your doctor or GP. This can only benefit the
patient in the long run. Should your GP or doctor wish to know more about our organisation,
we would welcome a contact from them.
How do I know if I am suitable for obesity surgery?
Check your BMI below. This will normally indicate whether you are suitable
for obesity surgery.
BMI Categories:
- Normal weight = 18-25
- Overweight likely to have mediacl problems= 25 – 30
- Obese = BMI of 30 or greater
- Morbidly Obese = BMI of 40 or greater
I have a BMI of over 40. Does this mean I cannot
have Adjustable Laparoscopic Banding?
It is important to us that you receive the treatment you are most comfortable with. Each
type of obesity surgery has it own pros and cons. Many people express a preference for one
type of surgery. Having a high BMI doesn’t prevent us from carrying out your preferred
surgery - it is merely an indicator for the most suitable and effective surgery statistically
for your BMI.
Can I expect to have any health problems as a result
of weight loss surgery?
It is possible to suffer from gallstones after weight loss surgery. If you have concerns
about this or have experienced gall bladder problems in the past, it is possible to remove
the gallbladder during your surgery.
Can I have my consultation in the UK?
All consultations take place in Belgium only. In many cases its easier and faster to travel
to Belgium than it is to travel within the UK.
Will smoking affect my surgery?
You are encouraged to stop smoking at least one month before surgery.
Will I have the opportunity to ask questions?
Yes of course. You will meet with your surgeon and a nutritionist the day before surgery
for a pre-surgery consultation. You will find that the surgeon is quite open to answering
all of your questions.
Can my partner attend the consultation?
Yes, they are welcome to attend.
Can I have my surgery even though I’m on medication?
Please ensure that we are informed of any medical conditions associated with excess
weight, such as Diabetes II or heart problems. You will need to stop taking any medication
for thinning the blood such as Coumadin, Aspirin or Warfarin, 10 days before travelling.
If you take any of these medications are unsure or unclear about this, please contact us.
How will it affect contraception?
Following weight loss surgery the body may absorb fewer hormones thus making the
contraceptive less effective. Weight loss surgery will make you both more attractive and
fertile.
Will I be able to have IVF treatment afterwards?
Yes there is no reason why not but keep in contact with the aftercare program. Please
be aware that after treatment you will become more fertile in any case and pregnancy may
well follow without the need for IVF.
Should I inform the surgeon if there is anything
unusual in my medical history?
Yes - also ensure you have completed the pre-surgery questionnaire, which you can
download at : www.direct-healthcare.com/download.htm
I am thinking of having Adjustable Laparoscopic Banding, what kind
of band is placed?
The inamed LAP-BAND®
System. FDA approved over 300,000 have been fitted since 1990.
What sort of fluid is inserted into an Adjustable
Laparoscopic Band?
The band is filled with surgical saline solution. Normally your weight should start
to reduce immediately, you will need to have the band adjusted. Please see our postoperative
aftercare program.
What type of anaesthesia is used?
General anaesthesia. When you are undergoing general anaesthesia, you will be put
asleep by IV-medication. The anaesthetist will discuss the type of anaesthesia to be used
prior to surgery.
Can I fly after having my surgery?
You can fly home after your surgery. Low weight heparin 'B' may be administered to
reduce the possibility of thrombosis. Ask the surgeon about this.
What is the risk of infection?
Our partner hospital has successfully treated hundreds of our patients with no cases
of cross infection. Should a patient be found to have an infection on arrival, they are
isolated and treated accordingly. If a secondary infection did occur, it would manifest
itself during the stay in hospital. Belgium has one of the lowest secondary infection rate
is in Europe. Rates in the UK and Eire continue to remain at alarming levels. In the USA
occurrences are on the increase. As recently as 2006 reports from within the UK and Eire
health services, the news media, and senior consultants indicate that the problem remains
acute in most hospitals. So far, all our clients have remained free of secondary infections.
Could you tell me a little more about the intensive care facilities?
The hospital has a fully functioning 24 - hour accident & emergency department,
paramedics, and fully equipped intensive care unit. Response time for a doctor to be at
bedside - day or night - is under 2 minutes.
Which tests will be taken before the surgery?
If you are older than 45, there will be a chest X-ray, ECG and a laboratory investigation.
If you are younger than 45 there will only be a laboratory investigation. The surgeon will
judge whether other tests are necessary.
Will my stay in hospital be extended?
If you have any preoperational risk factors your stay may be extended.
What are preoperational risk factors?
Preoperational risk factors are any risk factors in determining a patient's eligibility
for obesity surgery.
Serious preoperational risk factors include:
- Type II diabetes mellitus
- Obstructive sleep apnea
- Pseudotumor cerebri
- Heart conditions
- Excessive BMI - over 50
- Less serious preoperational risk factors include:
- Hypertension
- Dyslipidemias
- Non-alcoholic steatohepatitis
- Venous stasis disease
- Significant impairment in activities of daily living
- Intertriginous soft tissue infections
- Stress urinary incontinence
- Gastroesophageal reflux disease
- Weight-related arthropathies which impair physical activity
- Obesity-related psychosocial stress
Having risk factors such as these does not mean that you are not eligible
for surgery, but we do need to be informed if you have any health problems.
What should I bring with me?
- Slippers, trainers or walking shoes; loose comfortable clothing; dressing
gown or bath robe; personal toiletries; eye glasses; dentures; reading materials or anything
to help you relax such as a personal walkman and music.
- Phone numbers of people you may want to call.
- Money for telephone calls and items such as a magazine.
- Passport.
- Form E111 (obtainable from your local post office - UK only).
- Because you will be on a soft food diet for a while its useful to bring
protein shake mix, broth, soups, and tea. These can all be found in dry forms and mixed
with hot water.
- Bring any medication and a list of any medicines that you have been
taking.
If you have a heart condition bring along any medical reports that may be relevant.
- It is not necessary to have a medical referral and if you are unable
to get hold of your medical records we can manage without them.
- one week before travelling, using an antiseptic cleansing shower gel
such as "Hibiscrub" may reduce germs that may be present on your skin. This
is obtainable from a pharmacy.
Can I eat whatever I wish after obesity surgery?
You will need to change your eating habits. You must not take fluid with your meals. You
will need to emulsify solid food for a while and eat 4-5 small meals a day. It is important
for you to get a good intake of proteins and so a good healthy balanced diet is recommended.
For the rest of your life, you will need to take multivitamins with B12 and Iron. You may
not take gassy drinks such as colas or lemonade.
Can I relax my eating regime for a few days before having surgery?
This is a bad idea! The surgeon finds that those that relax their eating habits for a few
days or weeks before surgery often find that their BMI has increased and that the surgery
has less chances of long term success. It is far better to start right away in reducing
your food intact and see if you can loose a little weight before surgery. This will make
the surgeons job and your progress much easier.
What is “dumping syndrome”?
This term refers to the emptying of concentrated food directly into the small intestine.
Gastric bypass surgery empties food from the small stomach pouch directly into the small
intestine without first being diluted with fluids in the rest of the stomach. Therefore,
whatever you eat empties directly into the small intestine. Sweets and fatty foods irritate
the small intestine and causes discomfort. Eating and drinking fluids simultaneously will
also cause this dumping syndrome. This is why we recommend waiting half an hour between
eating and drinking.
When can I return to normal daily activity?
This depends on what your normal activity involved. Providing your vocation is not too physical,
you may return to work shortly after returning home. Any pain related to the surgery should
go away after 10 days or so. General fatigue can last from 3 to 4 weeks after surgery. 4
to 6 weeks after your operation, you should be completely back to normal.
How soon can I drive?
For your own safety, you should not drive until you have stopped taking medications and
can move quickly and alertly to stop your car, especially in an emergency. After major surgery
you should wait 8 weeks before driving unless you have seen your physician.
Should I exercise after obesity surgery?
You are recommended to exercise daily. Whether you have surgery or not, exercise is important
to overall health. The more you exercise, the healthier you will be and the more weight
you will lose. Walking greatly accelerates weight loss, specifically fat loss. It is suggested
that you walk a little every day - gradually increasing the length of your walks.
How much should I exercise after surgery?
Following weight loss surgery, your weight reduces because you eat less food energy (calories)
than your body uses. The body makes up the difference by burning reserves of fat. Your body
will want to burn unused muscle first before it burns fat. Daily aerobic exercise for 20
minutes will tell your body to burn the fat instead of your muscles.
When do I have my stitches removed?
After surgery, the incisions on your abdomen are closed with internal stitches, which dissolve
in 4 to 6 weeks.
How many times do I have to get my Lap band refilled?
Lap band refills vary from person to person. The band will need adjusting 3 - 4 times in
the first year and normally yearly thereafter.
Can I get this done in the UK?
For refills in the UK, please see our website for details.
Can I get this done in the USA, Canada or Europe?
For refills in the USA, Canada or Europe, please contact our office for details.
What if something goes wrong after I return home?
There are a number of aftercare and emergency systems in place should they be needed. Please
remember that these should only be used in the event of urgent need. Patient seeking urgent
assistance should follow the steps laid out below. If the patient ‘s condition appears
serious your local Physician, GP, or Accident and Emergency Centre should be contacted in
the first instance otherwise:
- Call DHI (preferably during office hours) if necessary use the 24hr
response emergency phone number.
- The treating surgeon will be contacted and asked take direct contact
with the patient or their physician.
- The patient may be asked to see their physician or GP if this is more
practicable or attend their local hospital.
- A doctor can be called to attend at the patients home (UK only) in
the event of any significant problems. The doctor can take a wound swab which will be
tested in our labs, report and if necessary medicate.
- If the problem appears significant but not an emergency the patient
may need to return to the operating facility for further examination and treatment.
- DHI also employs consultant surgeons and labs (within the UK) that
will assist in the event that it is needed.
Please remember that DHI have successfully sent thousands of people for
treatment. No significant or urgent medical problems have occurred. No patient has ever
had a cross infection of any kind in one of our partner hospitals.
How many operations has the Surgeon done?
The surgeon has performed approximately 8,000 successful obesity surgeries.
Can I talk to someone who has already had the surgery?
Yes, we have many previous clients who are willing to talk to you and answer any questions
you may have. Please contact us for details.
Can the surgeon refuse surgery?
The surgeon would only refuse to operate where medical conditions prevent surgery. Please
contact us if you feel that you may have any medical conditions that may prevent surgery.
How big are the hospital rooms? Are they en-suite and do they have
TV?
Each hospital room normally contains 2 beds. If a 2-bed room is not available, you may be
placed in a 4-bed room. Rooms have a TV, telephone and en-suite toilet. Telephones function
with a call card system that requires a 10 Euro returnable deposit. The deposit together
with any remaining credit is refunded when you leave the hospital.
Why do I have to stay extra days in Belgium after I am released from
the hospital?
Patients are asked to stay a few days extra after surgery is for their safety. If any postoperative
complications should occur, this will happen within 2-3 days of surgery. We therefore like
the patient to be near the surgeon during this period so that he may monitor the recovery
progress. There is a final examination before departure as well as a postoperative visit
by our nurse at your hotel.
Is there any additional cost associated with obesity surgery?
The DHI fully inclusive package includes DHI overrun Medical Cover, however this doesn’t
cover the first two additional nights in intensive care. (Please see our DHI overrun insurance
for details.) Normally, our surgery allows for patients occasionally staying an extra day
in hospital and in such cases no additional fee is charged. However, if the duration of
stay becomes longer, there may be some extra charges involved.
Can DHI Organise My Accommodation?
Yes, the DHI fully inclusive package takes care of your travel, flights, accommodation and
all transfers. If you have booked the Basic Package, we can direct you to a website featuring
hotels in Bruges.
Can I bring friends or family with me?
Yes you can bring one friend or family. We would prefer it if one person accompanies you
for moral support.
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