The operation is just the first step! The most important thing the patient has to realize is that there must be adjustment to the new way of eating. At first you try little sips of water but after a day you can start on other liquids. Well mashed or vitaminized food is started 2 to 3 days after surgery.
The first thing to get used to is the full feeling that may come on after eating just a few teaspoonfuls of semisolid food! This is great. And is the whole idea of the operation.
This means the operation is working and you can look forward to losing lots of weight. You are no longer hungry and you can now forget about food and your stomach till the next mealtime. Your friends or family may be quite shocked to see how little you are eating even though you are happy. Explain to them what has happened to your stomach so they will understand and not try to force you to eat more than you can fit in.
Weight loss after surgery reaches a peak between 12 to 24 months after surgery with the patient shedding between 50 to 70% of excess weight. Generally it begins with losing 5 to 15 kgs in the first week after surgery and then 1 to 2 kgs per week for the next 12 months. In the second year weight loss is between 0.5 to 1.0 kg per week.
Complications with Surgery
These include operative, post–operative and long–term complications. The immediate operative mortality rate for vertical banded gastroplasty is a mere .05% (recorded in a large series involving 3000 patients). Early post–operative complications include wound infection, dehiscence, leaks from the staple line, stomal anastomosis, marginal ulcers, pulmonary embolism and deep venous thrombosis. The most unwanted complications like staple line leak and pulmonary embolism were found to be 0.2%.
Long–term complications include regurgitation, staple line failure, stomal anastomosis which happens to approximately 7 to 10% of the patients. Reversal of gastroplasty is advocated in these cases. Reversal can be achieved laparo–scopically by removing the ethibond stitches or mesh, as the case may be.
