Why have a surgical procedure to lose weight?

If a person is more than 100 pounds overweight, dieting may be a failure. Other methods, such as wiring the jaws shut, diet pills, the gastric balloon, etc., also fail most people. Bariatric surgery has been successful in approximately 60 to 80 percent of patients, depending on the type of surgery and the patient population selected.
 
What is bariatric surgery?

“Bariatric” means weight. Bariatric surgery is a method to lose weight involving major surgery. There are several categories of procedures performed: gastroplasty, gastric bypass, biliarypancreatic bypass, and intestinal bypass (this last is no longer used regularly). All are major surgical procedures entailing all the normal risks of surgery.
 
Who is a candidate for bariatric surgery?

To be accepted for weight loss surgery, you need to meet certain criteria. You must:

• Be between 18 and 65 years old
• Be either severely obese (100 pounds or more overweight, with a BMI of 40 or more) OR obese with associated complications (a BMI of 35 or more, with a condition such as diabetes, high blood pressure and heart disease)
• Have tried unsuccessfully to lose weight through a structured, medical weight loss program that included diet, exercise and lifestyle changes
• Be experiencing personal or occupational problems due to obesity
• Undergo a psychological evaluation and counseling to determine that you are emotionally healthy enough to understand the ramifications of your decision
• Be willing and able to commit to long-term medical follow-up, as well as the rigorous, lifelong changes in eating, exercise and lifestyle habits that will be necessary to meet and maintain your weight loss and health goals after surgery

What is gastric bypass surgery?

Gastric bypass surgeries are combination procedures that use both restriction and malabsorption to achieve weight loss. They are the most common types of weight loss surgery performed. The most frequently performed type of gastric bypass is called the Roux-en-Y gastric bypass, which the procedure most often performed at FVRH.

In Roux-en-Y gastric bypass, staples are used to permanently close off part of the stomach. This leaves only a small pouch for the food you eat. Additionally, a Y-shaped piece derived from an upper portion of the small intestine is then attached to this small stomach pouch. As a result, food from your stomach pouch bypasses the intitial sections of the intestine, which normally would absorb calories and nutrients after eating.

Gastric bypass surgery can be performed using a traditional open technique or through laparoscopic surgery, depending on your circumstances and the decision of your surgeon. The traditional open technique involves an incision in the abdomen that allows the surgeon to view and access  your stomach and intestine. Laparscopic surgery uses smaller incisions and a small video camera that projects views of your stomach and intestine onto a monitor in the operating room. Both methods are routinely performed. Your surgeon will decide which is appropriate for you.

What is the laparoscopic adjustable banding system?

This adjustable and reversible surgical weight loss option consists of a silicone band that is placed around the upper part of the stomach. This creates a much smaller stomach pouch. The band also slows the passage of food from the stomach into the intestine. This allows you to feel full for a much longer time after eating.

Inflating the balloon with the saline solution further restricts the opening through which food passes. This reduces the amount you can eat and slows the passage of food. You feel full longer after eating.

Deflating the balloon by removing some of the saline solution increases the opening through which food passes. This can be helpful if you develop certain problems, like regurgitation of food.

The laparoscopic adjustable banding system is placed through small incisions or punctures in the abdomen. Each opening is usually less than half an inch in length. A miniature video camera is passed through one of these openings, allowing the surgeon to view your stomach on a monitor in the operating room. The rest of the surgical instruments are passed through the other tiny openings.