1. Which operation should I have?
Although it is an excellent question, it is a complex question as well. To answer this, we have to know the specific patient´s characteristics. Every bariatric procedure that we perform has specific criteria that must be adhered to in order to do the procedure.
In addition to the medical criteria, we must emphasize that the best bariatric technique must conform to the patient´s weight, alimentary and psychological profile, as well as, his or her life style.
These qualities are taken into account when deciding what is the best procedure to perform on the patient. As a result of this, the shared decision will give the patient the incentive and motivation to develop the new life style that they are seeking. (See section #6)
2. How long does it take to do the surgery?
The lenght of the surgery depends on which surgery has been chosen. There are certain procedures that take just ½ hour but there are others which are more complex that may last as long as 3 to 4 hours. The best time to inquire about this is at the time when discussions are being made about the specific procedure to be performed. This is the time to also discuss in detail the chosen procedure including the possible complications, risks, expectations and any doubts or concerns that you may have about the surgery.
3. How long will I have to remain in the clinic and in Santo Domingo?
Naturally the stay in the clinic and in Santo Domingo will depend on what procedure is done. These are some of the guidelines that we tell our patients:
Intra Gastric Balloon:
- 2 to 3 hours in the clinic after the procedure has been performed.
- Approximately 3 – 4 days in Santo Domingo and/or the Dominican Republic
Adjustable Gastric Band
- 1 night stay at the clinic.
- Around noon on the following day after the surgery, if the post-operative course has been uneventful and the vs. are stable, the patient will be discharged.
- Afterwards, the patient should remain from 7 to 8 days (minimum) in Santo Domingo and /or the Dominican Republic.
Sleeve gastrectomy
- 2 nights stay at the clinic
- Afterwards, the patient will be discharged if the post-operative course has been uneventful with stable vital signs.
- The patient should remain in Santo Domingo and /or in the Dominican Republic approximately 2 weeks.
Gastric By-pass
- 2 to 3 nights stay at the clinic
- Afterwards, with a stable post operative evolution and stable vs., the patient can then be discharged.
- The patient should remain no less than 3 to 4 weeks in Santo Domingo and /or in the Dominican Republic.
* We have to emphasize that these patterns are just “suggestions” and that each patient has different threshold of tolerance. Because of this, the patient´s evolution will be dictated by their own personal progress and consequently the individual discharges may vary.
4. What do I have to do before and after the surgery?
The first thing that has to be done before the surgery is a series of routine examinations to determine your general health. These include, but are not limited to, blood tests, chest x-ray and a PRE-operative cardiovascular evaluation. All these can be done up to 30 days before the surgery (without these analyses the procedure can NOT be scheduled). All of the instructions for these requirements will be given to you with enough time so they can be done with no inconveniences. Also, some recommendations will be given regarding your food intake, exercise and medicine management BEFORE the surgery. Most importantly no use of ASPIRIN or any of its derivate s (ie. Motrin/Ibuprofen, Diclofenac, cataflan, Voltaren, Ultram, etc.) will be allowed to be taken before the surgery; the time to discontinue these medications will be discussed when giving the final instructions for the surgery. In the case that the patient is taking “PLAVIX” (Clopidrogel), its discontinuation timing before the surgery will be coordinated with your personal physician.
After FINALIZING your procedure/surgery and before discharging from the clinic, detailed intructions will be given to you for what to do, the physical activity that you can do, what you can have (“the menu”) and what medications (prescriptions) you will have to get before going home. These instructions will be for the first 72 hours after the surgical procedure.
AFTER this, on your first visit to the doctor´s office, you will be given a pamphlet that details “what you can´t do, what you can do, when to do it, and when not to do it”. The same way, you will discuss with the doctor the steps to take with your intake of food and your medical prescriptions.
We want to INSIST, that when you have any concerns, doubts and /or uncertainties, please get in touch as soon as possible to clarify any problem you might have.. This includes any subject that you might have forgotten to ask or clarify and that you wish to have explained before your next visit. DO NOT hesitate to call....
5. What are the expectations of how much weight I will lose and what guarantee will I have of maintaining my new weight the rest of my life?
I want to stress what has been emphasized along all the discussions about ALL the different procedures / surgical options. Its recommended that even though it is an ambulatory procedure or a bariatric surgery that is invasive or minimally invasive , “IT IS NOT A MAGIC WAND”.
It ALSO DEPENDS on the patient cooperation. This is so because “ the doctor CAN NOT eat for the patient and the doctor CAN NOT exercise for the patient...”. Being said that, the mayority of the patients should be able to lose and maintain a 60 – 70 % of the excess weigh. What you should strive to do is to create a “new real life style”, to modify your eating habits (amount and pattern) and establishing exercise habits (avoiding sedentarism to the max).
We have to again emphasize that ALL THE PATIENTS have to understand and accept in order to achieve the most success with the procedure: “The doctor CAN NOT eat for the patient and the doctor CAN NOT exercise for the patient...”