In preparation for surgery, it’s standard practice to conduct a comprehensive preoperative assessment of patients to identify risks and plan for necessary precautions. Detailed examinations are crucial to uncover and address any potential health deficiencies or conditions prior to surgery, which may even warrant postponement of the procedure if needed.

The preoperative evaluations include pulmonary assessments through chest X-rays and function tests, possibly involving a pulmonologist’s consultation. Cardiac health is examined via ECG, echocardiography, and cardiology consultations, with additional tests like stress ECG, Holter monitoring, or angiography when indicated. Psychiatric evaluation is also essential, including a review of the patient’s medication history, substance use, and existing psychiatric conditions, supported by a psychiatric consultation. Surgical and internal medicine reviews are performed through abdominopelvic and doppler ultrasonography, alongside a review of any previous abdominal surgeries and ongoing medical treatments. Endoscopic examinations of the gastrointestinal tract and comprehensive laboratory testing are conducted to evaluate organ functions and bleeding parameters.

Patient medications, including blood thinners, antihypertensive, antidiabetic, and psychiatric drugs, must be carefully reviewed. Some medications may need to be paused or substituted during the surgery and promptly resumed postoperatively.

For patients with comorbidities like cardiovascular events, respiratory infections, neurological or psychiatric conditions, hypertension, diabetes, and sleep apnea, interdisciplinary reviews are necessary. Specialists’ evaluations and recommendations should be integrated into the surgical plan.

Finally, high-risk patients require hospitalization and stabilization before undergoing surgery to ensure the safest possible operative outcome.

Post-surgery, patients are assessed by the anesthesia team and, once cleared, are moved to their rooms for further monitoring as they recover from anesthesia. Typically, intensive care observation is not required post-surgery, with exceptions for special conditions such as sleep apnea. Six hours post-operation, patients are permitted to start drinking water and are encouraged to stand and take short walks to aid recovery. On the following day, walking frequency is increased and supplemented with breathing exercises. The initiation of a liquid diet, including items like seedless soup and compote, follows the passing of gas, during which the drain is also removed. A three-night hospital stay allows for the close observation of the patient’s clinical condition and early detection of any potential complications, with discharge planned for the fourth day.

Before leaving the hospital, patients and their relatives receive comprehensive dietary guidelines from a dietitian, along with detailed instructions on medication management and important post-operative care considerations.

After surgery, patients receive comprehensive dietary guidance from a dietitian. They are informed about appropriate early postoperative foods, the pace and frequency of consumption, and foods to avoid to ensure optimal recovery.

A one-month nutritional plan is provided, focusing not on rapid weight loss but on the safe healing of the surgical site and the protection of the suture line from strain due to improper eating habits.

By the end of the first month, patients typically resume a normal diet in terms of consistency. Detailed advice on foods to avoid is given to promote a healthy lifestyle and controlled weight loss. The dietitian closely monitors the patient’s adjustment to the new diet and weight loss progress on a monthly basis.

In the initial month following surgery, patients are prescribed stomach protectors, multivitamins, and pain relievers as necessary. Post the first month, these medications are tapered off in a controlled manner.

Medications taken prior to surgery are reintroduced. If there is an improvement in conditions associated with obesity, such as hypertension or hypercholesterolemia, the respective medications may be discontinued or adjusted under the guidance and recommendation of the consulting physician.

All surgical interventions carry inherent risks and potential complications, which vary by procedure. Scientifically, the frequency and manageability of these complications are of paramount importance.

In laparoscopic bariatric surgery, possible complications include bleeding at incision sites, wound-related issues such as infections and poor healing, specific problems like bleeding and leaks due to compromised surgical site integrity, and structural complications within the stomach such as strictures or torsion. Additionally, there may be postoperative complications not directly related to the surgery site, including lung or urinary tract infections and cardiac issues, as well as long-term effects like atypical weight loss or gain and nutritional deficiencies.

These complications have a wide incidence range, from 1% to as rare as 1 in 100,000. Key to successful outcomes is the early detection and treatment of any preventable issues. This includes identifying and mitigating risk factors prior to surgery, such as comorbidities, smoking, alcohol use, and other variables that can affect wound healing or anesthesia reactions. Proactively managing these risks can significantly reduce complication rates. Postoperative strategies, like early mobilization, respiratory exercises, diligent aftercare, and prompt medical intervention, are critical to a smooth recovery.

The adage ‘Early diagnosis saves lives’ is universally applicable in medicine and underscores the importance of timely intervention in surgical complications. Failure to promptly identify and manage a complication can lead to severe consequences. Thus, continuous patient education, regular check-ins, and close post-surgical monitoring are essential. The surgical team’s expertise is the cornerstone of managing and preventing complications effectively.