Surgeon accidentally cutting the liver?

[Rainy Days 73]

Everyone seems to go on a liquid diet to shrink the liver so it doesn't get in the way during surgery. So, how frequently does a liver get cut? And what are the consequences?

About 15 years ago I had my gallbladder taken out and the surgeon nicked my liver. Because of that I had to stay overnight in the hospital when it was suppose to be a day surgery. I ended up fine. But maybe I was super lucky?

Has anyone had that complication during weight loss surgery?

[Inner Surfer Girl 12,015]

I didn't have complications but know from these boards that it has happened. The best thing to do is choose a skilled surgeon and do everything you are asked to do to prepare for surgery.

The good thing, according to my surgeon, is that if something like that were to happen while you are in surgery you have a surgeon right there who can fix it.

[kmorri 1,689]

What I've heard is if when they first start the surgery, and get the first look at your liver and if it's too big, the surgeon may decide that surgery is too risky and may decide to not take the risk and cancel the surgery. I don't know how often that happens but that is surely not a risk I want to take. After all the time and effort I have in preparing for this surgery I'm going to be doing everything my surgeon tells me to do regarding pre-op.......

Luckily my 2 week pre-op diet sounds pretty simple to me (I haven't started it yet)....Mine is one Protein drink and two small "lean and green" meals per day.... the lean and green meal will consist of a lean meat like chicken or fish and a non-starchy veggie. So at least I'll be able to have some real food.

[Rainy Days 73]

oh, what a great point kmorri! I hadn't thought about the surgeon just deciding to not go through with the surgery at all. That would be really horrible! When I had my gallbladder out, it was an urgent surgery so there was no pre-op diet or anything. And I guess cutting the liver was a reasonable risk in that situation.

Your pre-op diet sounds good. I meet with my NUT today and I'm going to ask about what my pre-op diet would look like.

[Inner Surfer Girl 12,015]

oh, what a great point kmorri! I hadn't thought about the surgeon just deciding to not go through with the surgery at all. That would be really horrible! When I had my gallbladder out, it was an urgent surgery so there was no pre-op diet or anything. And I guess cutting the liver was a reasonable risk in that situation.

Your pre-op diet sounds good. I meet with my NUT today and I'm going to ask about what my pre-op diet would look like.

My surgeon said that if he went in and the liver was too large he would just close me up and not do the surgery. That was plenty of incentive to follow directions for me.

[photoman06 16]

Hi,

Yes I am also under the belief that if you do not do you liver shrinkage diet correctly the surgeon can refuse to carry out your operation I have been told that they used to ask for 1 week for liver shrinkage but that was not enough so 2 weeks are the norm but my surgeon has said that if you can manage 3 weeks all the better as the liver will shrink sown all the more and if that gives him more room and is safer in the long term it's worth doing and that is my plan and mine starts on the 30th April for 3 weeks on liquids only

Michael.

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[Rainy Days 73]

hahaha! I don't want anyone to misunderstand my question. I wasn't at all suggesting that a person shouldn't follow their doctor's pre-op diet. I just wanted to know if people had done the diet and still ended up getting their liver cut. It was a good point that a surgeon might stop the surgery if they feel the liver hasn't shrunk enough.

My NUT told me about my pre-op diet today and she also affirmed that the surgeon would stop the surgery if the liver seemed to be a problem. My pre-op diet is 10 days with 1 weight watcher frozen meal and 3 Protein shakes a day. Sadly, that falls over the 4th of July, so no BBQ for me!

[PaulaB72 49]

oh, what a great point kmorri! I hadn't thought about the surgeon just deciding to not go through with the surgery at all. That would be really horrible! When I had my gallbladder out, it was an urgent surgery so there was no pre-op diet or anything. And I guess cutting the liver was a reasonable risk in that situation.

Your pre-op diet sounds good. I meet with my NUT today and I'm going to ask about what my pre-op diet would look like.

My surgeon said that if he went in and the liver was too large he would just close me up and not do the surgery. That was plenty of incentive to follow directions for me.

Same here.

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[mmazzo 26]

Wow....you all get actual food in your pre-op diet?!?! For 2 weeks prior, my surgeon puts you on Clear Liquids with the exception of they want you to drink enough Protein to meet your daily requirements (80-100g for women). He swears that if I can just get through the first four days, those are the worst. LOL

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[kmorri 1,689]

@@mmazzo Yes there seems to be a big difference in pre-op requirements between surgeons. With most any diet after the first 4 days it gets easier. Good luck!

[Heather I 500]

Two things on this. I used to be a court reporter and took down testimony in civil litigation for over 20 years. I did about a dozen fatal RNY lawsuits where the surgeon "nicked" the liver and the patient bled out and died. Granted, the technique has certainly been refined over the years, and physicians learned a lot about performing the surgery, but the liver-shrink diet is a really big deal and needs to be taken seriously. When they say it can be too large to perform surgery, they mean it. They WILL cancel it.

I actually just had my surgeon meeting yesterday before we submit the docs to BCBS and book a date, and I asked about the diet, how much it shrinks the liver. He said he wasn't aware of any before/after studies of how much it shrinks, but he said if I'm not compliant and it's too big to work in there, the surgery is cancelled.

Anecdotally, I asked if he could take out my gallbladder while in there since I hear that has a high probability of needing to come out after weight loss. He said they don't do that at the same time for a couple reasons. One, your GB may never need to be removed, so that's another surgery site hampering recovery time. Two, the GB is wedged near vital organs, and when it's surrounded by fat, it's very dangerous to be noodling around in there trying to take it out. My doctor prefers to take it out after weight loss (if necessary,) when he can move around in there.

He also said if he goes in there and sees the GB is in bad shape, he cancels the bariatric surgery and goes ahead told to the GB first, then reschedules the bariatric surgery.

Ahhhhh!

[photoman06 16]

Hi Heather I

Thanks for your valuable information

Michael

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[Kooky1 96]

My doctor essentially requires a ketogenic diet. Must stay below 30 grams of carbs per day.

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[tgun25 29]

My program calls for me to follow a strict Atkins style diet and no more than 20g of carbs. I've already been following a low carb diet for the past couple of months so I don't anticipate any issues. I'll follow it to the T so I can ensure myself with the best chance of success.

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Edited April 26, 2016 by tgun25

[beggingtobehealthy 97]

Wow....you all get actual food in your pre-op diet?!?! For 2 weeks prior, my surgeon puts you on Clear liquids with the exception of they want you to drink enough Protein to meet your daily requirements (80-100g for women). He swears that if I can just get through the first four days, those are the worst. LOL

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The first 4-5 are the worst. This is my last day and I have been doing it since last Tuesday and I don't feel hungry at all

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