Weight Loss Surgery Options:For years, weight
Weight Loss Surgery Options:
For years, weight loss surgery has been a safe and effective treatment option for those suffering from morbid obesity. It is especially effective for those who have not experienced long-term weight loss success through other means such as diet and exercise. Also referred to as bariatric surgery, it has been instrumental in the fight against morbid obesity and the diseases that come with excess weight.
How Does Bariatric Surgery Work?
Bariatric surgery is the clinical term for many procedures including gastric bypass, gastric banding and gastric sleeve. Each of these procedures has their benefits and risks, however no matter which procedure is right for you, weight loss is only a secondary effect of bariatric surgery. The primary goal is health. When a person is morbidly obese, which is broadly defined as being 100 or more pounds overweight, having a BMI of 40 or more or having a BMI of 35 or more with one or more obesity related diseases, they can suffer from serious and fatal diseases. If left untreated, these “co-morbidities” often wipe years off the life of an obese person. Co-morbidities can include:
- High Blood Pressure or Hypertension
- High Cholesterol
- Sleep Apnea
- Certain forms of cancer
- Type-2 Diabetes
All of these diseases are serious enough to consider bariatric surgery as a viable alternative. Below you’ll find a description of the three procedures we offer at our practice:
Gastric bypass (Roux-en-Y) combines both restriction and malabsorption to make the patient feel fuller sooner and restrict the number of calories being absorbed into the body. During the procedure, Dr. Gornichec will create a smaller stomach pouch by cutting away a portion of the existing stomach to restrict the amount of food that it can hold. He will then attach a Y-shaped portion of the small intestine directly to the newly formed pouch. By doing this, it allows the food that the patient eats to skip a large portion of the small intestine, where most of the calories and nutrients are absorbed. As a result of these adjustments, the patient will feel fuller sooner and caloric intake will be restricted, accounting for the significant weight loss that can be expected after gastric bypass surgery.
Excess Weight Loss
A patient may expect to lose up to 70% of his or her excess body weight. Results vary between patients.
Health Benefits of Gastric Bypass:
Studies found that gastric bypass:
– Resolved type-2 diabetes in over 80% of patients
– Resolved high blood pressure in over 75% of patients
– Improved high cholesterol in 95% of patients
Each patient’s recovery time will vary, and based on the level of the patient’s health, the final determination of recovery time will be made after surgery. Ideally, patients will be able to leave the hospital after 2 days and return to work after about 3 weeks depending on recovery.
Possible side effects of Gastric Bypass:
– After surgery, if high fat, high sugar foods are consumed, a condition known as dumping syndrome can occur. Generally it isn’t considered a health risk, but it is unpleasant and includes vomiting, nausea, weakness, sweating, faintness, and diarrhea.
– Because of the malabsorptive qualities of the procedure, patients cannot absorb sufficient nutrients through food alone. The patient will need to start a lifetime of supplementation – Generally a daily multivitamin and calcium and sometimes vitamin B12 and/or iron.
– The stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are problems after surgery such as ulcers, bleeding, or malignancy.
Gastric banding, also known as Lap-Band® and Realize® Band is a purely restrictive surgical procedure that works by allowing less food to enter the main stomach pouch. Using up to five small entry points in the abdomen (about ¼ to ½ inch each), Dr. Gornichec will implant a silicone band and an injection port . The silicone band is placed around the upper part of the stomach and allows us to mold the stomach into two connected chambers. The injection port is attached to the abdominal wall, underneath the skin. The port is connected to the band with soft, thin tubing.
The band is adjustable and the procedure is fully reversible. Adjustments to the band serve as a mechanism to control the amount of restriction and weight loss. Adjustments are made in our office using a needle to inject saline solution into the band through the injection port. Adding saline into the band increases the amount of restriction provided by the band which in turn helps patients feel fuller sooner and with less food. This leads to weight loss.
Excess Weight Loss
Gastric banding patients typically lost 47% of their excess weight but weight loss in each patient varies.
Studies found that gastric banding:
– Resolved type-2 diabetes in over 45% of patients
– Resolved high blood pressure in over 38% of patients
– Improved high cholesterol in over 75% of patients
Because of the nature of the surgery, recovery times tend to be shorter than those of gastric bypass procedures. Our office team will advise you when to return to work and when you are able to resume normal activities.
Possible Side Effects of Gastric Banding
– Gastric banding is only the first step in your weight loss journey. Although you will feel fuller sooner, you will still have the desire to eat. A specific diet and exercise regimen, as provided by our office, must be followed to achieve success.
– Gastric banding requires several office visits and adjustments after surgery. Since the band is adjustable, it will take some trial and error to find the ideal level of restriction. This means that even after reaching and maintaining your target weight, you may still need to come into our office for further adjustments.
Gastric Sleeve / Sleeve Gastrectomy
The gastric sleeve, also known as the sleeve gastrectomy is a restrictive bariatric procedure in which Dr. Gornichec creates a small, sleeve-shaped stomach about the size and shape of a banana. It is larger than the stomach pouch created during Roux-en-Y bypass (about 30% of the size of a regular stomach) and consequently allows more food to pass through. Because the intestine is not rerouted, there is no malabsorption and there are fewer food restrictions.
Until recently, the gastric sleeve has been used as the first of a two-part procedure and has been considered the most effective treatment option for bariatric surgery patients with a BMI of 60 or higher. The second part of the treatment can be gastric bypass.
Recently however, with the excellent success rates of the gastric sleeve surgery alone, it has widely been adopted as a standalone procedure.
Excess Weight Loss
Gastric sleeve patients typically lost 60% of their excess weight although individual results may vary.
Studies found that the gastric sleeve procedure:
– Resolved type-2 diabetes in over 75% of patients
– Resolved high blood pressure in over 70% of patients
– Improved high cholesterol in over 80% of patients
A Note on Risks:
Bariatric Surgery is major surgery however we believe that the risks of doing nothing far outweigh the risks of surgery. As medicine has advanced, the risks of bariatric surgery have fallen. In the hands of a very experienced surgeon such as Dr. Gornichec, bariatric surgery is indeed a very safe and effective alternative to living with morbid obesity and its related diseases.