IV Omeprazole change to oral Pantoprazole 20mg daily After a Gastric Bypass you are more likely to develop vitamin and elemental deficiencies. The
duodenum and first part of the small bowel is on longer in contact with your ingested food.
It is here that some vitamins and elements are absorbed into the blood stream. This is
generally less following a Sleeve Gastrectomy, as there is no mal-absorptive component (the
gut continuity is 'normal'). Guidelines may vary from person to person, but may include the following: A Gastric Bypass is a major operation to create a small stomach pouch and rearrange the small
bowel to partially "bypass or delay" the food eaten from being in
mixed with the digestive enzymes. This results in
both malabsorptive and restrictive changes that results in weight loss and
generally improvement in various comorbidities (such as diabetes and hypertension). Sleeve gastrectomy is the removal of a large part of your stomach. This results in
both metabolic and restrictive changes that result in weight loss and generally
improvement in various comorbidities (such as Diabetes and Hypertension). The Omega Loop is the reduction in the size of your stomach and re-arrangement of your small
bowel such that the mixing of digestive enzymes / bile (required for the breakdown of
calories / vitamins) with swallowed food is delayed (bypassed) to decrease absorption. This
results in respective restrictive and malabsorptive changes that results in weight loss and
generally improvement in various comorbidities (such as diabetes and hypertension). Bleeding and infection rates are very low. Occasionally there can be
bruising in
the inguinal region. Recurrence rates for the Laparoscopic inguinal hernia is approximately 1%,
this is
similar to the traditional Open inguinal hernia repair. Conversion to an Open Inguinal hernia (i.e. larger scar) repair occurs in
less than
1%. The Laparoscopic inguinal hernia (Totally Extra Peritoneal; TEP) surgery is a
technique to repair your hernia with three small scars placing the mesh in
the preperitoneal plane. This has a number of advantages You may be told to discontinue your blood thinning agents preoperatively. Recently there has been some discussion into the validity of mesh. This was due to the use of
mesh in repair of the pelvic floor (not inguinal hernias). Mesh placed incorrectly can cause
problems. Mesh is indicated in inguinal hernia repairs and has been used successfully for over 30
years. The NZ General Surgical Association recently released a statement affirming the
above.Bariatric (Weight Loss) Surgery
POST OP PROTOCOL; Sleeve gastrectomy
Day 0: Day of surgery
Day 1: Post op
Bariatric (Weight Loss) Surgery: Post operative blood tests
January 1, 0001Bariatric (Weight Loss) Surgery
Post operative blood tests
Blood Procedure Frequency of Monitoring HbA1c Sleeve
gastrectomy
Gastric
bypass As appropriate in those with preoperative diabetes U+E, LFT, FBC, ferritin,
folate, Calcium, vitamin
D, PTH Sleeve
gastrectomy
Gastric
bypass At 3, 9 months in the first year, then annually. Vitamin B12 Sleeve
gastrectomy
Gastric
bypass At 6 and 12 months in first year, then annually. Zinc, Copper Gastric
bypass Annually.
Monitor Zinc if patient has unexplained anaemia, hair loss,
changes in taste perception. Monitor Copper if unexplained
anaemia and poor wound healing. Vitamin A Gastric
bypass Annually. Monitor if concerns regarding steatorrhoea or symptoms
of vitamin A deficiency. May need to monitor in pregnancy Vitamin E, K Gastric
bypass Measure vitamin E if unexplained anaemia, neuropathy. Consider
measuring INR if excessive bruising / coagulopathy as may indicate Post operative bloods
3 months U+E, Liver function, Full blood count, Ferritin, Folate, Calcium,
Vitamin D,
Parathyroid hormone ↓ 6 months U+E, Liver function, Full blood count, Ferritin, Folate, Calcium, Vitamin D,
Parathyroid hormone, Vitamin B12 ↓ 12 months and annually U+E, Liver function, Full blood count, Ferritin, Folate, Calcium, Vitamin D,
Parathyroid hormone, Vitamin B12, Zinc, Copper, Vitamin A Bariatric (Weight Loss) Surgery: Postoperative vitamin and element replacement
January 1, 0001Bariatric (Weight Loss) Surgery
Postoperative vitamin and element replacement
Bariatric (Weight Loss) Surgery: Preparing for surgery
January 1, 0001Bariatric (Weight Loss) Surgery
Preparing for surgery
Prior to Very Low Calorie Diet (i.e. OptiFast)
Bariatric (Weight Loss) Surgery: Roux-en-Y Gastric Bypass
January 1, 0001Bariatric (Weight Loss) Surgery
Roux-en-Y Gastric Bypass
Bariatric (Weight Loss) Surgery: Sleeve Gastrectomy
January 1, 0001Bariatric (Weight Loss) Surgery
Sleeve Gastrectomy
Bariatric (Weight Loss) Surgery: The omega loop gastric bypass (mini-loop gastric bypass)
January 1, 0001Bariatric (Weight Loss) Surgery
The omega loop gastric bypass (mini-loop gastric bypass)
Laparoscopic Hernia: Complications
January 1, 0001Laparoscopic Hernia
Complications
Laparoscopic Hernia: Keyhole repair of inguinal hernia
January 1, 0001Laparoscopic Hernia
Keyhole repair of inguinal hernia
Preoperative cares
Laparoscopic Hernia: Mesh Controversy
January 1, 0001Laparoscopic Hernia
Mesh Controversy
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