Preoperative_and_per#353166.doc

Preoperative and Perioperative Instructions
Mini Gastric Bypass/Sleeve Gastric Bypass
One Month Before
Stop Smoking! Clinical studies have shown that smoking cessation at least twoweeks prior to surgery significantly reduces your risks of serious lung problemsafter surgery. Your primary medical doctor will be happy to start you on anicotine patch or other program to help with your transition to a healthy lifestyle.
Two Weeks Before
Stop taking Aspirin and NSAIDS (Motrin, Advil, and many other arthritismedicines). These medicines can cause serious problems for the stomach.
Stop taking any blood thinners. Aspirin, Coumadin, and Plavix are some popularblood thinners that can cause bleeding difficulties with your surgery. Thesemedicines should be stopped only after careful review with your primary medicaldoctor and surgeon. Avoid excessive Vitamin E supplements as these may alsocause bleeding difficulties. The small amount in a daily vitamin is permitted.
Discuss any other prescription medicines or herbal supplements with the surgicalteam.
Stop caffeine intake. Coffee, tea, and sodas are not part of your new MGB diet(ever) and you should avoid having an unpleasant caffeine withdrawal right aftersurgery by weaning off these items ahead of time.
Plan on staying within a one-hour drive of the hospital for the first week aftersurgery. We have negotiated special discounts at many of the neighboringhotels. Please ask our administrative staff for details. You must have yoursupport person with you the day before surgery, the day of surgery, as well asthis first week after surgery.
Remember to bring any medical equipment you regularly use. This would
include a blood pressure cuff, diabetes-testing device, and sleep apnea
equipment.
The Day Before Surgery
Shave any facial hair. Beards and mustaches can interfere with the anesthesiamask used and add an unnecessary risk.
Eat a light dinner. Do not treat this as your last “normal” meal, as the foodoverload and gas will make your operation much more technically challenging.
Do not eat or drink after midnight! This includes gum.
Hibiclens (chlorhexidine) shower the night before surgery as well as the morningof surgery. This antibacterial shower helps lower infection rates. Use this as asoap and NOT shampoo, as exposure to your eyes and ears can be harmful.
• Milk of Magnesia. This laxative is taken the morning of the day before your surgery, NOT the morning of your surgery. Take 60mls (4tablespoons). This cleans out your digestive tract.
• Prilosec OTC (omeprazole): Take one 20 mg tablet the night before surgery (9 to 11 p. m.). This lowers stomach acid and makes youranesthesia and operation safer. Nexium, Aciphex, and Prevacid are allacceptable substitutes.
• Levofloxacin: take 500mg the night before surgery (9 to 11 p.m.).
The Morning of Surgery
• Prilosec OTC: Take one 20 mg tablet the morning of surgery (5 am.). This lowers stomach acid and makes your anesthesia and operation safer.
Nexium, Aciphex, and Prevacid are all acceptable substitutes • Reglan (Metoclopramide): take 10mg early the morning of surgery (5 a.m.). This empties the stomach and helps protect against pneumonia.
Take with a sip of water.
Arrive at the time specified by our surgical team. Once checked in at the hospitalyou will have an IV started and then proceed back to the operating area with theanesthesia team. Your operation will likely take about one hour. It will seem likemuch longer to your family/friends as they will be waiting separately while manypreoperative and postoperative requirements are fulfilled. Tell them to relax.
Your surgeon will visit with them after you are safely in the recovery room. Donot ask the volunteers in the waiting room to call into the operating room for anupdate. This will only add more time to the case and distract the surgical team.
Bring any special items you may need. This would include any BIPAP or CPAPequipment you may regularly use for sleep apnea.

Source: https://www.highpointregional.com/sites/www/Uploads/files/Form/Preop_and_Periop_inst-MGB.pdf