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Postoperative nausea and vomiting are common occurrences following bariatric surgery, occurring in up to 80% of patients and contributing to increased healthcare utilization and delays in discharge. This study aims to evaluate the impact of a high-protein liquid diet on postoperative nausea, vomiting, and length of stay after laparoscopic or robotic sleeve gastrectomy.
Patients with obesity or morbid obesity who are scheduled to undergoing robotic or laparoscopic sleeve gastrectomy will be screened at their preoperative visit. If they meet inclusion/exclusion criteria, they will be invited to participate in the study and written informed consent will be obtained. If the patient consents to participation, they will be randomized to either the control arm or intervention arm. All patients will undergo sleeve gastrectomy in a standard fashion, either laparoscopically or robotically, as discussed with their bariatric surgeon. Post-operative diet will be initiated 4 hours after surgery. The specific diet received will depend on which arm the patient is randomized into. Post-operative assessments will be completed at various time points for all patients. These include a Verbal Rating Scale of Nausea and Vomiting, Rhodes Index Survey, and Quality of Recover-15 Survey. All patients will track their oral intake on a spreadsheet which will be provided. Additional demographic and clinical data will be collected from the Electronic Medical Record. After hospital discharge, patients will follow up in the clinic one week and one month after surgery, per routine. After the one-month visit, the patient's study participation will be considered complete.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | Standard bariatric clear liquid diet to be started 4 hours after surgery | |
| Intervention | Experimental | Bariatric full liquid diet (clear liquid diet + protein shakes) to be started 4 hours after surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bariatric Full Liquid Diet | Dietary Supplement | Patient's will receive a Bariatric Full Liquid Diet (standard bariatric clear liquid diet + protein shakes) to be started 4 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative nausea and vomiting related delay in hospital discharge | Inability to be discharged from the hospital on postoperative day 1 due to postoperative nausea and vomiting. This will be measured by inability to maintain oral intake of 4-6 ounces an hour due to feeling of nausea or vomiting. | through hospital discharge, an average of two days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Length of Stay | Time from end of surgery to discharge from hospital | through hospital discharge, an average of two days after surgery |
| Severity of Postoperative Nausea and Vomiting | Patient reported severity based on surveys |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Talar Tatarian, MD | Contact | 215-955-0020 | talar.tatarian@jefferson.edu |
| Name | Affiliation | Role |
|---|---|---|
| Talar Tatarian, MD | Jefferson Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Thomas Jefferson University Hospital | Recruiting | Philadelphia | Pennsylvania | 19107 | United States |
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| ID | Term |
|---|---|
| D020250 | Postoperative Nausea and Vomiting |
| D009767 | Obesity, Morbid |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009325 | Nausea |
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| Baseline until 1 month after surgery |
| Patient Self-Reported Quality of Recovery | Patient reported quality of recovery based on survey | Baseline until 1 month after surgery |
| Hospital Antiemetic Usage | Total amount and type of antiemetic medication received while in the hospital | through hospital discharge, an average of two days after surgery |
| Cost of Hospital Stay | Total cost of hospital stay after surgery (including initial admission and any readmissions, ED visits, if applicable) | Up to 30 days after surgery |
| Weight Loss | Percent excess weight loss (EWL) and total weight loss (TWL) 1 week and 1 month after surgery | Up to 30 days after surgery |
| 30-Day Events | Complications, ED Visits, Readmissions | Up to 30 days after surgery |
| Jefferson Methodist Hospital | Recruiting | Philadelphia | Pennsylvania | 19148 | United States |
|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D014839 | Vomiting |
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |