Dr Michael Hii answers some of your questions regarding bariatric surgery.
Does exercise affect healing at three to four weeks post surgery, even if you are feeling completely fine and eating normally.
Healing after surgery is a process that varies between individuals. There is a significant amount of healing that needs to occur on the inside of your abdomen following bariatric surgery, as in most procedures, the stomach has been divided and needs to heal. In some patients there can also be a join between the stomach and other parts of the bowel. In addition to this, there are incisions made through the skin and muscle wall, where instruments are inserted to perform the surgery. These wounds require healing also.
In general post-surgical care, we recommend that patients can commence gentle activity as soon as they arrive home. This can include walking and other gentle motions but no vigorous exercise and no heavy lifting (for most patients this means objects greater than 10kg).
Gentle exercise helps to improve healing and certainly helps to reduce the risk of complications such as post-operative pneumonia or clots in the leg veins.
The main reason we recommend that patients avoid heavy lifting for one month after surgery, is due to the risk of developing hernias. Hernias are persisting defects, where holes were made through the muscle for surgery. In the long term, this can result in the protrusion of intra-abdominal organs through the muscle, below the skin.
Therefore, we recommend that patients undertake gentle mobilisation and activity after surgery, slowly building this up over a month or two. Heavy lifting should be avoided early on but by two months post surgery most patients are back to their normal level of activity. In fact, we encourage patients to engage in more activity after the surgery, once they are healed.
Does the chance of developing gallstones increase after a single anastomosis gastric bypass.
Gallstone disease is very common in the Western World. Taking all other factors out of consideration, approximately one in six people will develop gallstones at some stage in their life. In most patients, the development of gallstones is actually no problem and many patients have no symptoms at all. A small percentage of patients (1 – 2%) will develop symptoms and in these patients gallstone disease can become a problem.
One complication of gallstone disease is pain, this can be a major impediment on the person’s life and substantially reduce their quality of life. The second most common complication is infection of the gallbladder. If left untreated, this can be a life threatening infection. Rare complications of gallstone disease include infection of the bile ducts and pancreatitis (or inflammation of the pancreas).
For patients who have gallstones but no symptoms, we usually follow a watch and wait approach. For patients who are symptomatic, the standard treatment is removal of the stones and the entire gallbladder. Currently, there is no mechanism for removing the stones without taking out the gallbladder and there are no medications that can dissolve gallstones.
In patients following obesity surgery, some different considerations apply and in some patients, even with asymptomatic gallstones, it may be important to take out the gallbladder.
Gallstones form due to an imbalance of the salts within the gallbladder. Risk factors for this include a family history, a fatty diet and rapid weight loss. This last factor means that patients following any form of weight loss surgery are at a higher risk of developing gallstone disease.
In our practice, we think it is important for patients to undergo an ultrasound looking for gallstones approximately one year post surgery and we arrange this for you. If required, treatment will be discussed.
In conclusion, the risk of developing gallstones does increase after single anastomosis gastric bypass, however it increases after all types of obesity surgery. In some cases, these stones do not require treatment but all patients following bariatric surgery should seek their surgeon’s advice.