After bariatric procedures, the main complication your surgeon will be looking out for is a leak, depending on the surgery you had done this can occur in the stomach or in the intestines. Although leaks are not common it is important to detect one sooner rather than later so that it can be addressed immediately. A leak detected on time can be resolved even without further surgery.
For a Gastric Sleeve, we perform a total of three tests throughout the whole process, to be certain that no leaks have occurred:
- Hydropneumatic test (air pressure test)
- Blue Methylene test
- Barium Swallow X-Ray
The initial test, the Hydropneumatic test, is done inside the OR after the sleeve has been completed, before closing. It consists of submerging the stomach in a saline solution and applying air pressure to see if any bubbles form as a result of a leak. This test is used for all bariatric surgeries that we perform.
Blue methylene testing is set up during the surgery; placing a drain that will be taken out before you go home unless there has been a complication. The day after surgery, the patient drinks a small amount of blue dye, which will then come out through the urine, confirming that there are no leaks and everything is flowing as it should. The blue dye will continue to taint your urine for a few days, but that’s nothing to worry about.
On your third day, a Barium Swallow X-Ray is done, where the patient drinks a thick solution that contains barium (a contrast solution), its flow will be observed through an X-Ray. Making sure that the solution does not leak out of the stomach.
The Duodenal Switch and the Gastric Bypass follow the same testing process done after the Gastric Sleeve, the only difference is what is being observed during the Barium Swallow X-Ray. For the DS, the doctors will be able to see not only your stomach but the duodenum as well, and for the Gastric Bypass, it provides a view of both of the anastomoses (referring to the connections that were done to the stomach and intestines).
These 3 tests are vital for leak detection, since only doing the hydropneumatic test, which is normally offered in most clinics, leaves a lot of room for doubt and doesn’t fully discard the possibility of a leak. 97% of leaks happen during the first 48 hours, which is why at Mexicali Bariatric Center we have our patients stay for 72 hours at the hospital after their surgery, to make sure they are ready to go back home without a complication.