Immediate Post-operative Period*
In this video, Dr. Marvin talks about what to expect after Endoscopic Sleeve Gastroplasty (ESG) surgery.
Recovery Room for 3 Hours Post-op: Patients will go first to the recovery room after the ESG procedure is complete. There he/she will be closely monitored while waking up from anesthesia. With assistance from a nurse the patient with begin walking around the room, and hallway. The patient is allowed to take liquids by mouth, to include sugar free, non-carbonated and low fat items. Once the patient is ambulatory and able to walk and drink liquid, the nurse will discharge the patient to a designated care giver. The hospital or surgery center will not release the patient without accompaniment over the age of 18. Our staff can assist with a nurse transport should a patient be traveling alone from out of town.
At Home – Week 1 (or Hotel)
Medications: All necessary previous medications should be taken at the prescribed intervals after returning from the hospital. Tablets will need to be crushed and capsules opened for the first week. Usually these are taken with water. Any medication that can be skipped should wait until 1 week post-op. Examples are: cholesterol medications, previous pain medications, muscle relaxants, special vitamins, etc. Absolutely necessary blood thinners such as aspirin, Plavix or Coumadin should be restarted 48 hours after surgery. If any signs of bleeding occur they should be discontinued and the patient should call the office immediately. Diabetes medications should be reduced to ½ dose, and blood sugar levels should be monitored every 6 hours if the patient is on any insulin. If you are on diabetes medication, make an appointment to see the prescribing physician within 2-3 weeks. Be sure to reference the medication page in your patient booklet for detailed instructions and adhere to any specific orders from Dr. Marvin for you. For questions you may contact the clinic coordinator, Kris at 713-993-7124 or firstname.lastname@example.org.
Activities: Patients can do their activities of daily living (ADL) such as going up steps, or taking care of themselves in the bathroom or shower.* The patient does not need special assistance from someone else.* He/she should not stay in bed; moving about and even light exercise are encouraged. The patients activity level is largely dependent on potential nausea they may experience. There are no lifting or activity restrictions with the ESG and exercise should not be disrupted or should begin right away for the maximum benefits of the procedure. Normal sexual activity can occur as soon as the patient feels comfortable enough.
Driving: A typical patient will be able to drive his/her car within 24 hours, following the effects of anesthesia to dissipate. Do not drive while taking a narcotic pain medication. (See medication precautions provided by the pharmacy.)
Return to Work: Patients are able to return to work as soon as the patient feels comfortable enough.
Diet:Dr. Marvin is requiring all ESG patient to undergo at least one nutrition consultation through PsyMed prior to the procedure. Click here for details.
Immediately following the ESG procedure the patient is on a clear liquid low sugar diet for 7 days. Do not attempt to take soft or solid foods yet as these could breakdown the upper connection sutures. Black Coffee is allowed without sugar and no creamer. Starting week 2 the patient is on a soft foods, low sugar, low fat diet for 3 weeks. (Anything you can mash up with a fork, avoid meat) Please see the ESG Post-Operative Diet page for a details. As always, contact the clinic if you are unsure. Also, avoid carbonated beverages until 1 month after surgery. Concentrated fruit juice, premixed protein drinks and all processed sugar (candy, pastries) should be avoided to avoid cramping, flushing and diarrhea which are the symptoms of the dumping syndrome.
Diet After One Month: Follow normal post op diet as outlines in the ESG Booklet.
APPOINTMENT 1 week Post-op
The clinic staff will preset your follow up appointment for 1 week after surgery. Dr. Marvin will do an examine see how you are doing and answer questions.
Medications: All previous medications should be resumed and can be taken normally (i.e. as whole pills or capsules. Diabetes medications should remain at ½ the previous dosage, and the patient should make an appointment to see the prescribing physician to alter the dose.
Diet: Warning: it is ABSOLUTELY ESSENTIAL NOT TO OVEREAT after the ESG procedure. The length of the suture line will be vulnerable to stretching and inhibiting the expected success. A revision may be required to tighten the stomach or move to the more invasive laparoscopic sleeve gastrectomy. At this point the patient can follow the regular prescribed diet provided.
Vitamins: A multivitamin with folic acid (folate) should be started one week after surgery. Although this can be chewable, it is not necessary. The patient should take some form of a multivitamin indefinitely.
Blood work, as described above, will be done prior to each visit. If any unpleasant symptoms occur that could be related to your Endoscopic Sleeve Gastroplasty operation call the office immediately. Please see the section on problems that can occur after the ESG. It is not uncommon to feel a left shoulder pain from the air used during the procedure, however, this should not last longer than 2-3 days.