Surgery

Now you’re ready for surgery!

Our Surgical Program Coordinators will submit your pre-surgical work-up to your insurance company for prior authorization. Upon insurance approval, you will be contacted to select your surgery date. We offer weight loss procedures at Wilshire Surgery Center.

While scheduling your surgery, you will also schedule two additional visits. These two visits will occur directly before and after your surgery. Your pre-surgical appointment will provide you with information, prescriptions and recommendations to help better prepare you for your upcoming procedure. Your post-op appointment with Dr. Emma Patterson will be your first progress check-up and will take place approximately 3-4 weeks after surgery.

Meanwhile, there are a few things you can get familiar with in the immediate days preceding your surgery.

What to expect for your upcoming surgery:

The following is information before band, bypass and sleeve procedures. You can consider this your “surgery checklist”.

Preparing for surgery:

• Have labs drawn 2-4 weeks before the surgery date
• Fill all prescriptions prior to surgery
• Purchase vitamin supplements for after surgery
  • For the first 3 weeks after surgery, only multivitamins are sufficient
  • Vitamins need to be chewable, gummy or liquid for these 3 weeks
  • After the first 3 weeks, take all recommended supplements
• Purchase protein drinks for after surgery
• Avoid all non-steroidal anti-inflammatory (NSAIDS) medications in the 7 days prior to surgery (they can increase your risk of bleeding). If you are unsure of what constitutes as NSAID, please ask someone from our team.
• Only liquid diet the day before your surgery.
• Examples: protein shakes, Propel, Gatorade, low-fat milk, juice, water, Jell-o and broth
• Drink plenty of water in the days before surgery, so urine is light in color. It is important you are well hydrated for surgery.
• Do not shave your abdomen – it may increase your risk of infection.

The night before surgery:

• Do not eat or drink anything after midnight before surgery
• For diabetics: if you use insulin, take half your regular evening dose the night prior to the surgery
• Use one of the 2% CHG rinse cloths to wipe your abdomen

The morning of surgery:

• Use the 2% CHG rinse cloth to clean your abdomen
• Take all of your regular medication with a small sip of water, except diuretics, MAOIs or herbal preparations (unless otherwise told by your surgeon)
• For diabetics: if you take diabetic medication by mouth, do not take these the morning of your surgery
  • No insulin the morning of the surgery
• Wear comfortable clothes – do not bring valuable jewelry or money
• Bring your identification and insurance card
• If you have sleep apnea: bring your CPAP

For the surgery:

• Once you check in, the nurse will bring you to the operating room. The anesthesiologist will give you medicine to help you relax and sleep. Once asleep, the anesthesiologist will gently place a tube in your throat to help you breathe during the procedure. You will not feel any pain.

Just after the surgery, in the recovery room:

• You will awake in the recovery room and be cared for by a recovery nurse, who will monitor you closely. Medications will be given as needed for pain and nausea. Once you are stable, you’ll be transferred to a hospital room; if you’re in a surgery center, you will remain in the same post-operative room.

Staying and recovering in the hospital:

• Medication will be given to treat your pain and nausea as needed
• Once fully awake, you’ll start slowly drinking liquids
• You’ll be encouraged to get up and walk around once you’re able to, and without experiencing any abdominal discomfort
• We’ll do deep breathing exercises with your intentive spirometer, which keeps your body well-oxygenated

Discharge criteria for leaving the hospital:

• Pain can be controlled with medications, given by mouth
• Ability to tolerate liquids – at least 1 ounce every 15 minutes for at least 2 hours
• Able to move around independently
• Vital signs are normal (heart rate, blood pressure, breathing rate and temperature)

Following this, you’ll be scheduled for a follow-up visit three weeks from discharge. Call our office to schedule this if you don’t have an appointment.

Preparing the Skin Before Surgery

Preparing or “prepping” the skin before surgery can reduce the risk of infection at the site of surgery. One step our center takes is choosing disposable cloths moistened with a rinse-free, 2% Chlorhexidine Gluconate (CHG) antiseptic solution. The steps below outline the prepping process and should be followed carefully before your surgery:

Prep the skin at both of the following times:

1. Night before surgery (after your shower, if you’re taking one at this time)
2. Morning of surgery (again, after a shower, if you’re taking one at this time)

Directions:

1. Shower or bathe at least one hour before prepping the skin for the first time (not any sooner)
2. Once you begin applying, your skin should be completely dry and cool. If you have sensitive skin, CHG may cause skin irritation, such as temporary itching and/or redness; showering or shaving immediately before applying may enhance these effects.
3. Prep the abdominal area. Avoid contact with eyes, ears and mouth. Use one cloth in the evening and the other in the morning before surgery.
4. Allow the area to dry for one minute. Do not rinse. It is normal for the skin to have a temporary “tacky” feel for several minutes after the antiseptic solution is applied.
5. CHG works best when left on the skin; do not rinse it off once applied. If you do need to shower after applying, make sure the water is not hot (warm is okay).

Other notes:

• Once you’ve started prepping with the 2% CHG cloth, do not shower, bathe or apply lotions, moisturizers or makeup. Reason being, water and ingredients commonly found in personal care products can reduce the antiseptic effects of CHG.
• Shaving should be suspended 2 days before surgery on ALL areas of the body (including face, legs, underarms)
• If itching or redness persists, rinse the affected areas and discontinue use

Medicine to take/NOT to take on day of surgery

There is a long and comprehensive list of medicines which are permissible and forbidden on the day of your surgery.

You can read this list here.

If you have any questions, please contact our team immediately.

Following surgery, you’ll be put on a strict diet regiment. This is made to incorporate your dietary changes. You can read more about that in our Post-Surgery section.