📖 7 minute read

Surgery day looms large in the weeks before it arrives. For most people it passes much faster than expected, and knowing what actually happens on the day makes the whole thing feel a lot less daunting.

Every programme is a little different, but most bariatric surgery days follow a similar shape.

The night before

You’ll have specific instructions about when to stop eating and drinking. For most programmes it’s nothing to eat after midnight, and nothing to drink including water from around two to four hours before your arrival time. Follow this precisely. The nil-by-mouth rules exist to prevent aspiration during anaesthetic. That’s a serious risk and the rules are there for a reason.

Sort everything out the evening before. If you haven’t already sorted your hospital bag, do it tonight. Loose comfortable clothing for going home, any medications your team has told you to take with a small sip of water, your paperwork. Doing it calmly the night before means surgery morning doesn’t involve rummaging around in a panic.

Arriving at the hospital

You’ll be asked to arrive a few hours before your operation is scheduled. Expect:

• Paperwork and checks. Consent forms if not completed at pre-assessment, confirmation of your name and operation, allergy checks.
• Meeting your anaesthetist. They’ll assess you and talk through the anaesthetic before you go to theatre. If you’re anxious about nausea after anaesthetic, which is common after bariatric surgery, mention it here. There’s medication for it.
• Pre-op preparation. You’ll change into a hospital gown, have a cannula placed, and get compression stockings fitted to reduce DVT risk. Blood pressure, oxygen levels, and other observations will be taken.
• Some waiting. Theatre lists run late. Bring something to do.

If you’re having NHS surgery or going through a large private hospital, your named nurse or healthcare assistant will be your main point of contact while you wait. It’s worth having someone with you for that bit if you can. It makes the waiting considerably easier.

Going to theatre

When it’s time, you’ll be walked or wheeled through to the anaesthetic room. Your team will confirm your details again. This is protocol, not because anyone has forgotten who you are. The anaesthetist will give you the sedative through your cannula. Most people describe going under general anaesthetic as a very rapid fade. Not alarming. Just quick.

From your point of view, surgery is essentially instantaneous. You close your eyes in the anaesthetic room and you open them in recovery.

Waking up in recovery

You’ll wake in the recovery room with nursing staff keeping a close eye on you. You may feel groggy, nauseous, cold, or some combination of all three. Pain is usually well managed at this point because you’re still receiving post-operative analgesia.

Common things to expect:

• Dry mouth and a strong desire to drink. You’ll get small sips of water or ice chips once it’s safe.
• Shoulder or neck pain. This is referred pain from the CO2 gas used in laparoscopic surgery. It can be surprisingly uncomfortable but resolves within a day or two. A lot of people aren’t warned about this and it catches them off guard.
• Feeling cold despite blankets. Very normal after surgery and anaesthetic.
• Nausea. Tell staff if it’s significant. Anti-nausea medication can be given, and you shouldn’t just sit there suffering with it.

Once you’re stable you’ll be moved to the ward. What happens in those first 72 hours is worth reading about before you go in, so none of it comes as a shock.

Your first night

Bariatric surgery in the UK is typically a one-night hospital stay. You’ll be encouraged to get up and move gently within a few hours of getting to the ward. This significantly reduces DVT risk and helps shift the gas pain from the surgery. Your first fluids will be very small amounts of water or clear liquid.

Pain should be manageable with medication. If it isn’t, tell your nurses. You’re not expected to be stoic about this. Managing pain properly in those early days matters more than people realise, because if you’re not comfortable enough to move around, recovery slows down.

Going home

Discharge varies by programme. Before you leave you’ll get written instructions covering what to eat and drink in the first days, warning signs to watch for, wound care, medication, and who to contact if something doesn’t seem right. Read these before you leave. Ask if anything is unclear. Don’t assume you’ll remember everything once you’re tired and back at home.

Have someone drive you home. Make sure your recovery environment is sorted before you go. Sleep setup, fluids within easy reach, anything you’ll need in the first couple of days. Getting comfortable enough to sleep after surgery takes a bit of thought, and it’s much easier if you’ve planned for it beforehand rather than figuring it out at midnight.

One more thing worth knowing before your date arrives. Nausea in the early days after surgery is common, and knowing what to do when it hits makes it a lot less frightening than being caught off guard by it.

Surgery day feels enormous right now, but the anticipation is usually the worst part. Once you’re in the system and things are moving, most people find it goes much faster than expected and they feel considerably calmer than they thought they would.