Frequently Asked Questions

1.-Tell me about my operation and my anesthesia?

If your operation is scheduled for the morning, you will be admitted to the hospital the night before. If your operation is scheduled for the afternoon, you will be admitted to the hospital that same morning.

The operation is performed under general anesthesia associated or not to an epidural anesthesia. in Weight Loss Mexico Center Hospital formed by doctors who take care of the postoperative pain when regular measures don't reach the desired pain relief. The goal is: minimum or no pain.

2.-Is the operation open or laparoscopic?

The operation is laparoscopic. Dr. Daniel Huacuz feeling that the incidence of complications is much smaller with Laparoscopic DS mostly and suturing precision. As the hospital stay is for 5 days .After the patients take radio logics test.

3.-What is the stomach capacity before and after the operation?

Before the operation you may fill your stomach up to 1,500 ml of fluids or the same volume of solids. A resting and empty stomach has a third of half of such capacity. After the operation you will have a new, slim and long stomach, the size of a banana, which will be able to receive around 100-150 ml of food (3,5 to 5 ounces). As the time goes by you will develop a capacity to fill it several times and the final eating volume may be 200 ml in average at the end of a meal. This will not happen immediately after the operation but after several months or a year. It is a combination of stomach emptying with stomach stretching that allows such amount of food. In the beginning the small stomach, with less peristalsis (movements) and slower emptying gives you the early satiety and fullness sensation.

4.-What is the length of the alimentary limb and the common ileal limb?

The length of the alimentary limb varies from 175 to 185 cm , the common limb varies from 75 to 65 cm and the stomach and duodenum are anastomosed always at 250 cm from the ileocecal valve (large intestine). These variations depend on the BMIs of the patients. For patients above 50 kg/m2 the common channel is made with 65 cm and below 50 kg/m2 it is made with 75 cm . The common channel length is discussed with every patient in order to have explained the benefits of a shorter common channel and its consequent nutritional problems as well. Some patients take the chance of not loosing all the weight they want but avoiding nutritional problems with a shorter common channel. We have been measuring this total length in order to match with the weight loss values in the future and believe this is better than doing standard lengths.

5.-How about cholecystectomy and appendectomy along with the DS?

Dr Huacuz don’t perform cholecystectomy, appendicectomy during the DS/BPD There is no evidence that DS leads to a higher incidence of appendicitis. Incidental appendectomy increases the postoperative infection rate so he does not routinely perform this procedures.

6.-Is that right that I will have diarrhea and foul smelling gases and stools?

Yes, you will have them if you start eating greasy and fatty foods. As this operation is a mal absorptive procedure, diarrhea occurs in such conditions. There are patients, however, who may eat fat and won't have diarrhea but this is not the rule. Foul smelling gases also are a problem for the fat eaters.

7.-What kind of complications may occur and how often they happen?

Complications may be major or minor. The major ones include disruption of the suture lines with leakage of the gastrointestinal contents. This is related to three major causes: sutures under tension, poor blood supply to the sutured areas and bad surgical technique. with these factors, over-sewing the stapling lines, maintaining the sutured areas loose, tensionless, and doing a good job, it is rare to occur suture dehiscence. In Dr. Huacuz patients, this type of complication is rare. He has had no leakages in over 100 DS patients and no deaths in this series.

The most common minor complication is seroma, or light yellow greasy fluid collected under the skin provoking drainages in the post operative period. The Doctor may leave a fine rubber drain under the skin for a couple of days and these collections happen with lower frequency. Incisional hernias never occur. In laparoscopic procedures Dr. Huacuz recommends the use of binders for 3 months after the operation. Infection is rare. He uses routine anticoagulation. Other complications are also infrequent.

8.-Am I too big for the DS operation?

Probably not. Dr. Huacuz routinely operates on very large people, his largest being over 700 pounds. Patients having BMI's of over 70 are common. You may think you will be Dr. huacuz largest patient, but chances are that you won't be. The hospital is equipped with special bariatric beds for the larger patients that will accommodate the bigger patients easily.

9.-Medicines which may be needed or should be used in the postoperative period:

For the first 60 days after your operation, you should take Omepresol 20 mg (or other Proton Pump inhibitor) or H2 blockers once a day for a period of 2 months. Examples: Prilosec, Prevacid, Tagemet, Nexium etc. These work best if taken in the morning on an empty stomach.

You should AVOID any NSAID such as aspirin... these can irritate the lining of the stomach.

Avoid the "time release" version of medicines. With your reduced absorbsion rates, the medicines may not be utilized well.

In case of diarrhea .Start with Calcium carbonate, one teaspoon 4 times a day in ½ glass of water. If it persists add Imodium, 1 tablet 3 times a day. You may combine one of the previous medicines with Tiorfan (Racecadotril) or Questran (Colestiramin). Don't forget that diarrhea happens with the use of fatty meals. Avoid fat before taking the medication. It may be enough. Get in touch with your private doctor or me if symptoms persist.

In case of foul smelling gases or stools, use Flagyl (Metronidazol) 400 mg 3 times a day for a week. Don't repeat the use of this drug without checking with your doctor. Warning: side effects may occur. If you are using fatty foods it may not work.

You may use also Devrom, Innermint , Beano, Symethicone, Lactobacillus or similar. These medications usually help decrease the smell.

Continue with your preoperative medications until your private doctor discontinue them. Don't forget to break the tablet or pill in pieces before swallowing.

10.-It is a good idea to follow a nutritionist taking care of your diet and nutrient supplements.

The way you eat is going to change after the operation. here are some short term and longer term ideas for your diet. Your short term goal is to eat SOFT food for two weeks while your stomach heals. Your long term goal is to get at least 90 grams of protein a day.
REMEMBER: For the first 60 days after your operation, you should take Omepresol 20 mg (or other Proton Pump inhibitor) or H2 blockers once a day for a period of 2 months. Examples: Prilosec, Prevacid, Tagemet, Nexium etc. These work best if taken in the morning on an empty stomach.