This is carried out by the multidisciplinary team that approved the indications for the intervention and by the general practitioner.
Detect complications from the surgical procedure:
- certain symptoms must result in urgent consultation with the surgeon of the multidisciplinary team
- symptoms appearing early: tachycardia, dyspnoea, abdominal pain, confusion or hyperthermia, even if there is no abdominal pain or tenderness
- symptoms that may appear late: abdominal pain, vomiting, dysphagia, incapacitating gastro-oesophageal reflux.
Prevent and screen for vitamin and nutritional deficiencies
- these can lead to serious neurological conditions
- following metabolic surgery, some nutritional supplementation is recommended for all patients (multivitamins, calcium, vitamin D, iron and vitamin B12 are most common)
- following restrictive surgery, it may be discussed if the results of the clinical and biological assessment warrant it.
Adapt any medicines and their dosage
- bariatric surgery can improve or control certain comorbidities, sometimes only a few days or weeks after the operation (diabetes in particular). These comorbidities must be reassessed early and their treatment adapted
- metabolic surgery can lead to changes in the metabolism of various medicines (antivitamin K, thyroid hormones, antiepileptic drugs, etc.), the dosage of which may require modification in the early post-operative period
- gastrotoxic medicines (aspirin, non-steroidal anti-inflammatory drugs, corticosteroids, etc.) must be avoided as far as possible.
Continue the education of the patient
- follow up diet and physical activity programmes commenced in the preoperative phase by checking, in particular, that they are adapting well to their new eating habits.
Assess the necessity of psychological or psychiatric follow-up
- follow-up recommended for patients who presented with eating disorders or other psychiatric pathologies before the operation.
- follow-up proposed on a case-by-case basis for other patients.
- weight loss can lead to psychological changes that may not be easy to manage. A period of adaptation to the change is often necessary, both for the patient and for their family, friends and colleagues.
If necessary, plan for reconstructive/body contouring surgery
This is possible 12 to 18 months after obesity surgery, when weight loss has stabilised and in the absence of malnutrition.