¿Who is a general surgeon?
A general surgeon is well trained in the diagnosis and management of a wide variety of congenital diseases, infectious, benign and evil. In addition, he or she has extensive knowledge of the postoperative and critical care patients.
The focus is on the abdominal organs, chest, neck, peripheral arteries and veins, skin and soft tissue. The training is given separately for those who specialize in bones (orthopedic), the genitourinary system (urologist), brain and spine (neurosurgeon), and ear, nose and throat (ENT).
What is minimally invasive surgery (or laparoscopic)?
Minimally invasive surgery is the term used to describe abdominal surgery performed without making a large incision through skin and muscle to open the abdomen. In an endoscope is inserted through a trocar in the abdomen by an incision of 1 / 2 inch. The abdomen is inflated with CO2 gas to dilate as a store, allowing the visualization of abdominal organs.
The long hand instruments are inserted through small trocar and used to perform surgery while the surgeon looks inside the abdomen on the monitor screen. Special tools such as scissors, graspers, staplers and endoscopic ultrasonic dissector facilitates the surgeon’s ability to perform complex intraabdominal surgery using advanced laparoscopic techniques.
How to schedule surgery?
Decide on a few dates you would like, then call us to reschedule. For you to choose a date and time for surgery.
What analysis are needed before surgery?
- Blood tests such as an account of blood, electrolytes, liver function tests and PT, PTT may be necessary, depending on their age and medications.
- An EKG within six months after surgery is necessary if you are older than 50.
- If you have an abnormal EKG or a history of heart disease, you may need a stress test or an echocardiogram. Your surgeon will discuss this with you.
- A chest radiograph may be needed if you have a history of lung disease or smoking.
Where do I get my pre-operative testing?
You should be able to obtain pre-operative testing with their primary care physician. If not, the tests are ordered by the surgeon and performed in the hospital.
What are the general instructions I should follow before my surgery?
- You need to stop taking any medication that makes changes to blood, such as Plavix, Ecotrin, Ticlid, Persantin etc. This includes aspirin, Motrin, Ibuprofen or other anti-inflammatory medication except Tylenol. This also includes, Ginko, and other herbal medications. You should stop these medications 10 days before surgery.
- If you take the blood thinner Coumadin, special measures should be taken. You will leave the 3 or 4 days before surgery.
- If you are having surgery of the colon, you need to clean your bowels starting the day before. We will give separate instructions for this.
- You should not take any FOOD or DRINK by mouth after midnight the night before surgery if you are going to receive any anesthesia other than local.
- You can take your medication for high blood pressure with a sip of water the morning of surgery. If you are a diabetic, please call your surgeon to see how much insulin or medication to take on the day of surgery.
- You must call to report to a doctor the day before surgery to confirm the time of the transaction, if the schedule changes.
Where should I go the day of my surgery?
You must report to the office for admission to the hospital two hours before your surgery. You will prepare in advance before entering the operating room.
Where do I recover after surgery Outpatient internship?
After the procedure you go to the recovery room to wake up. You will go the same day of surgery, before you take some fluids to drink. Will feel when you are stable, usually 2-3 hours. If you receive an intravenous sedative or anesthesia, you need someone to accompany you to your home.
Where do I retrieve the hospitalized after surgery?
After surgery the hospital will go to the recovery room until one hour after surgery, and then transferred to a hospital room. Your surgeon will talk with his family and friends in the waiting room after the procedure. May not visit him in the recovery room.
What are the general rules I have to follow after surgery?
A list of postoperative instructions will be given after discharge.
How can I contact my surgeon for questions after the surgery?
If you have any questions after discharge, or if you think there is a problem, call our number in the office and the doctor will call you.
How many appointments are necessary then?
Patients are usually one or two views below. First is 7-10 days after surgery unless a contrary specification.
What are the postoperative instructions that I must follow?
Each listing of post-operative instructions vary depending on the physical condition of the patient.
The doctor in charge will take you step by step in terms of diet, attention to the operational area, physical activity, medication, and in subsequent consultations and instructions in case of emergencies.
Download our Pre-Surgery Instructions
QUESTIONS OF OBESITY
¿How do I know if I’m morbidly obese?
La morbid obesity is defined as an index of body mass (BMI) of 40 or greater, or 35 or greater for people who have medical problems related to obesity. This is almost 100 pounds overweight.
Ahora calcule su IMC (Indice de Masa Corporal)
2. ¿How is morbid obesity?
For Morbidly Obese, surgery offers the only proven method for achieving sustained long-term loss of weight. Create a permanent change in the amount of calories absorbed.
Diet, exercise, weight loss drugs and behavior therapy have had very little success for the morbidly obese, with long-term success classified under five percent.
3. ¿What is the proceduregastric bypass de Roux -en-Y?
Gastric Bypass Roux-en-Y is the most widely performed surgery to treat morbid obesity. The procedure can reduce or eliminate obesity-related diseases such as diabetes, hypertension, heart disease and sleep apnea. The procedure Roux-en-Y usually has fewer complications and better metabolic long-term loss of weight than other surgeries for this purpose.
4. ¿How thegastric bypass Roux -en-Y funciona?
Gastric bypass Roux-en-Y works by reducing the amount of calories your body absorbs.
First, your stomach capacity is reduced from two to four ounces. Second, high-calorie sweets disrupt the digestive process, causing nausea and diarrhea when they have eaten. Fat absorption is reduced.
5. ¿What are the most serious risks of bariatric surgery?
Any major surgery can be life threatening. Obesity increases the risk of complications from blood clots and breathing problems. Surgery can be complicated when released from the suture lines, but the incidence of this occurring is small. As with any surgery, complications such as bleeding and anesthetic problems may occur.
6. ¿How to decrease my risk of complications from surgery?
It is important that you be honest and a team doctor your complete medical history, psychiatric stability, personal habits and medications. Part of his preparation at the pre-surgery will focus on reducing their risk status. In keeping with this preparation, you can reduce your risk. Preparation may include diet and exercise.
7. ¿Who is a candidate for bariatric surgery?
Patients with a body mass index of 40 or higher, or about 100 pounds or more of excess body weight and have significant medical problems related to obesity. The patient who has a history of being unable to maintain target weight programs, such as plans prescribed by a physician, counseling by a nutritionist, or weight loss programs or group. A medical program to monitor the weight loss is recommended before a person considers weight loss surgery. Patients must also successfully complete their medical evaluations, nutritional and psychiatric disorders. Candidates should be entrusted to a permanent lifestyle and behavioral changes that are necessary to achieve weight loss long term.
8. ¿Besides surgery, what other form of change of life should be made?
Successful treatment for morbid obesity also includes permanent changes of lifestyle such as reduced caloric intake, increased exercise, and other behavior modifications. The tips and advice can help with these changes.
9. ¿I can lose much weight after surgery?
Immediately after surgery, you can expect to lose about 15 to 20 pounds a month, slowing in certain periods. However, each person is different, and weight loss will depend on your metabolism.
10. ¿What I can eat after having bariatric surgery?
To begin with, only two ounces can be eaten at one time, or about 400 to 600 calories a day.
This amount increases gradually over time, to about 1,200 calories a day. Your diet must be carefully balanced to include foods high protein, low fat, low sugar. Protein is especially important to ensure healing after surgery, and preserving muscle tissue. You can eat regular food about six weeks after surgery, no concentrated sweets, in six small meals a day. You have to eat only tiny amounts, chew your food well, and eat very slowly.
11. ¿How I make sure my body gets all the nutrients it needs after surgery?
You need to take vitamins and mineral supplements for the rest of his life after surgery. Because bariatric bypass surgery, most of the stomach and duodenum, where they absorb the vitamins, their caloric intake of 1,200 calories a day can not provide all the nutrients your body needs
12. ¿What will keep me from losing too much weight ?
Your body will slow weight loss over time and eventually stabilize their weight. It also will monitor your weight loss to ensure that their nutrition is stable.
DIABETES QUESTIONS
Cure
Cure for type 1 Diabetes
Cure for type 2 Diabetes
FAQs
1 ¿How long does an operation?
In most cases about two hours of actual operating time. This can be somewhat variable and depends on the anatomy of the patient and the interventions in the abdomen and depends if previous operations.
2 ¿How long will I be in hospital?
Most stay in until the second postoperative day in the bypass. Some lap-band patients are discharged the same day of its operation. If circumstances arise that require continued monitoring or therapy, the stay can be prolonged. Some patients are ready to go the first postoperative day but is relatively rare. You require a stay in an area near the city for a week after their operation.
3 ¿How long does the process after the consultation?
That depends on the basis of other elements that work should be completed. The time it takes to reach the operation is longer. If tests are made before operation and the required information is available can usually be scheduled within a week.
4 ¿Surgery may be canceled or stopped?
This test may be canceled by incomplete and can be stopped by the unexpected for the operation and be done afterwards.
5 ¿I have a NG tube (nasogastric)?
Not unless you have a problem with its operation and requires an open incision.
6 ¿How often passes?
In 1000 surgery has occurred 5 times due to unexpected circumstances that prevent or to surgery is safe.
7 ¿How big is the bag in the gastric bypass?
Approximately 30-40cc
8 ¿The time away from work?
Different people recover at different times. You expect to go through the halls at night after your operation and regular as in the days following, but many people realize that this list to return to work within 2 weeks, some feel they can return soon, others later.
9 ¿How is the gastric bypass surgery as it helps me lose weight?
The patient is taken to the operating room and given general anesthesia. Six small incisions are made in the abdomen and the carbon dioxide is admitted to the abdomen creating enough space to display its contents and thus carry out the intervention. A telescope is inserted through one of these incisions and a pouch is created from the patient’s stomach using a special tool to clamp and cut. The segment up (pancreatic loop) is reconnected to the downstream segment to a selected distance corresponding to the patient and BMI using a special tool to clamp and cut into ranges anywhere from 75 cm. to 180 cm., so the patient’s stomach has been drastically reduced in size and the amount of food patients can eat has been drastically reduced.
The food that is served does not begin to be digested until it reaches the site of reconnection of the two parts of the small intestine. It is the only site where food meets pancreatic juices and bile to begin the process of digestion. A major portion of the intestine is bypass so that this element does not remain an absorber of nutrients and assist in the process of weight loss.
10 ¿What are some of the possible complications of gastric bypass?
A patient may develop deep vein thrombosis (a blood clot in the leg) may be a threat to life. If the blood clot travels to the heart and lungs can cause death. A leak in the places where the intestine is reconnected can occur and cause severe infection, leading to death. A reoperation may be necessary for a number of reasons. Leaks narrowing in connection sites, bleeding and injuries to other organs are some reasons for reoperation.
The goal is the doctor’s practice laparoscopic gastric bypass surgery, anyway there is no guarantee that the transaction will be completely laparoscopically. If the operation can not be completed safely by the laparoscopic method, an open technique is required although our intention is to avoid an open technique if possible. There is no guarantee that the patient will lose all the weight he desired, and moreover there is no guarantee you will not lose too much. Deficiencies of vitamins and minerals are a real danger and should be given strict attention to the patient and the doctor who follows the postoperative period.
11 ¿What are the costs for surgery?
The values vary depending on technique, body mass index patient, associated diseases and whether the patient lives in Guayaquil – Ecuador or are an international patient (costs of stay). Contact us for more information.
12 ¿How is the postoperative period to something like gastric bypass?
Early in the first postoperative day, the water is the beginning and advance to the food supplement rich in protein. The diet for the first 2 weeks is a food supplement rich in protein broth, crystal lite, Gatorade and many different liquids. The goal during the first two weeks is a shot of 45 grams of protein. The third week includes soft foods like mashed potatoes, yogurt, cottage cheese and mashed food for children. The fourth week marks the return of small volumes of regular food and soft at least Fobi Pouch has been released. (In this case the soft and pureed meals, will continue until the sixth week).
During this time we need to be encouraged to start a lifestyle change subject to good nutrition and exercises that will be important for the patient’s remaining life. The experience that each patient comfort after surgery varies depending upon the individual. Some patients are pleased with returning to a work schedule within a limited number of days, some patients are out of work for about two weeks. There are exceptions of long and short term, anyway a good rule is to avoid excessive fatigue or tiredness until your energy level again have the right to work. You can resume driving demand by the patient who feels he can do so responsibly.
