REHABILITATION AFTER BARIATRIC SURGERY

Rehabilitation of patients after bariatric surgery, performed in the Metabolic Surgery Center, gives excellent long-term results for maintaining normal body weight and overall health.

Rehabilitation period after bariatric surgery

In the Kyiv Metabolic Surgery Center, rehabilitation starts with the first day after bariatric procedures of all types and involves two principal periods: early and late. The team of our doctors is permanently staying in touch with patients: while staying in the inpatient department, after discharge, when recovery and adaptation takes place, and later, during whole patient’s life.

The rehabilitation period typically lasts one week (up to 10 days in some cases). An average stay in the inpatient department lasts 2-3 days.

Features of the inpatient period:

Patient stays under continuous therapeutic care and monitoring by our healthcare team (surgeon, cardiologist, endocrinologist and, when necessary, psychologist) after surgery. Overall health is usually is satisfactory. Mild nausea, as a result of anesthesia or temporary swelling, where sutures are located, may disturb in some cases. Mostly, the body copes with this trouble instantly, or it is resolved by means of the specific medication and disappears quickly. Pain is typically mild and perceived as 3-4 point on the 10-point scale, and, for this reason, the need for strong painkillers is rare.
Within a few hours after surgery the patients, already operated, get out of bed for the first time. Early intensification promotes faster wound healing and recovery of the overall body tone. Owing to laparoscopic surgery techniques, used during gastrectomy or gastric bypass, wound surfaces have minimal area and, in most cases, securely stick together in less than one day. Postoperative wound are closed with an antibacterial patch, needed to be replaced every other day. The bariatr.com team uses disposable high-quality tools designed for separating and suturing tissues from the American manufacturer – Medtronic, the global leader. It makes for instant and painless scarring of surgical incisions on internal organs. The risk of wound dehiscence is minimal, so patients may not restrict themselves in physical activity.
Since the first hour of the postoperative period, it’s recommended to frequently drink small amounts of fluid. We recommend the avoidance of eating during the first day, however since the second day, patients receive sip feeds, purposely designed for such instances. Liquid mixtures, balanced in protein amounts, nutrients and vitamins are called in such manner. They should be sipped 5-6 times a day, not more than 10 ml at a time.
A similar diet will remain unchanged throughout the rehabilitation period. The number of meals should comprise 4-5, and portions should be small (40-50 ml), not to stretch the stomach. It’s crucial, as weigh loss surgery leads to weight loss due to the reduction in the stomach capacity.

The bariatr.com team cares not only about the quality of medical services provided, but also about the comfortable environment for a stay in the clinic. Single VIP wards with all conveniences, kitchenette and an extra bed for attendants are available to you, as well as cozy semiprivate and triple wards. The last option is commonly chosen by extroverts, as well as patients, who need emotional support not only from healthcare professionals and relatives, but also from colleagues in the disease. Oftentimes, patients start making friendship and they keep on communicating after discharge from the inpatient department.

The in-home rehabilitation period starts at the time of discharge from the inpatient department.

Features of the inpatient period:

A patient gets the targeted long-term weight loss program before homecoming, designed personally for him/her. It’s a mandatory to strictly adhere to these recommendations not only during rehabilitation, but also throughout life for weight loss surgery to be effective over the long term.
We provide our patients with specially designed bariatric ware capable of resolving practical issues concerning meals at home. Such a ware will help to determine the optimal portion size, proportion of groceries acceptable in a particular diet, as well as will come in handy while measuring the optimal daily water intake.
When deemed necessary, a patient can easily change a patch independently during the first two days at home, because wounds are small – up to 2-3 cm. Doctors clarify how to do it properly: you only need to debride wounds and the nearby skin using antiseptic, dry a little and gently cover with a new patch. The frequency of bandage change – every other day. It’s allowed to take shower, by the way, as little as 24 hours after bariatric surgery.
Complications involving the site of suture placement may rarely develop in this period. Although the incidence of such complications is low, if symptoms do occur, a surgeon should be consulted immediately. Dangerous signs are the following:
1. Development of the pain.
2. Erythema and swelling of the skin encircling wounds.
3. Elevation of the body temperature up to 38°C.
4. Smelly dark liquid discharge from the wound.
5. A rapid heart rate up to 120 beats/min and higher.
The diet is gradually broadened: as early as during the first week, patient will be able of consuming pureed foods, soft foods to be added since the second week, solid foods – from the end of the third.
You can get back to your desk job optionally as early as in 3 days after discharge from the clinic.
A sick leave can account for 2-4 weeks in certain instances, depending on the procedure type and the professional activity.
Doctors allow for starting exercises a little while after surgery. Gentle exercises, such as walking, cycling and swimming are recommended as initial. The duration and intensity of aerobic (cardio) exercises should be increased to 150 minutes per week. With a doctor's permission, you can attend a gym, do resistance exercises (strength training), use light weights, pull up and do squats – all of those things assist in strengthening muscles and tighten loose skin.

Let us introduce the doctor

Andrian Ostapovych Reiti

PhD in Medical Science, Chief Surgeon at the Metabolic Surgery Center

Hands-on experience

Completed the internship in Vienna in the subject area Laparoscopic Surgery;
Took the in-depth course aimed at improving skills in laparoscopic surgery in Glasgow, Scotland;
Incumbent member of the Association of Bariatric Surgeons of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO);
Accredited consultant of the World Obesity Federation (WOF);
Consultant on obesity treatment strategy in Nigeria;
Educator at the Medical Academy of Postgraduate Education holding the course of laparoscopic surgery;
Co-organizer and lecturer of international workshops and webinars on obesity;
Co-organizer of the International Multidisciplinary Forum on Obesity Treatment;
Author of more than 25 scientific articles, published in local and foreign specialized periodicals.

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