Bariatrics & Gastric Bypass
Surgical Options
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BAPTIST HEALTH has been designated
a Bariatric Surgery Center of Excellence by the American
Society for Bariatric Surgery. |
What Surgical Options Are Available?
Weight-loss surgery is also called bariatric or gastrointestinal
surgery. The treatment is an important health option for some people
with severe obesity — those who are 100 pounds more than their ideal
weight. Your doctor may also recommend obesity surgery treatment if you suffer
from a weight-related health problem, such as type-2 diabetes, heart disease, high blood pressure, degenerative joint disease or obstructive sleep apnea syndrome.
There are several different types of obesity surgery treatment procedures to help
you lose weight. For example, one method makes the stomach smaller
to restrict food intake. Another more common technique makes the
food reservoir about 1 ounce and creates controlled malabsorption
by bypassing a portion of the small intestine. With these methods,
the body absorbs fewer calories and nutrients from the digestive
system.
Surgical Procedures for Gastric Bypass
Morbidly obese patients have a very high risk of associated health
problems and early death; therefore the National Institutes of
Health (NIH) (http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_b.pdf)
has endorsed Roux-en-Y Gastric Bypass (RYGB) as effective in the
treatment of obesity. Most of the best hospitals for gastrointestinal surgery use this method. Depending on the circumstances, this surgery can be accomplished by an open or Laparoscopic technique.
Roux-en-Y Gastric Bypass (RYGB)
Roux-en-Y Gastric Bypass (RYGB) is a more complex operation, to
provide more consistent and successful weight loss. The small upper
pouch is completely separated from the distal stomach which is left
in place. A "Y" shaped segment of small bowel is attached
to the pouch with a narrow opening. This bypasses the mixing of
food and digestive juices from the distal stomach resulting in poorer
absorption of calories and nutrients. This both restricts food intake
and interferes with absorption resulting in more consistent weight
loss, but has a higher risk of complications or side effects. 80%
of patients lose at least half their excess weight with the RYGB
procedure.
The laparoscopic RYGB averages a 2-3 day hospitalization with a
return to full activity in 7-10 days. A liquid and soft diet high
in protein is suggested for 4 weeks after surgery, then the patient
is placed on a solid diet.
The Laparoscopic Approach to Obesity Surgery
Laparoscopic operations are performed through several small incisions
with the aide of a fiber optic video camera and special instruments
which can reduce the trauma and discomfort associated with a long
open incision. Hospitalization, post-op pain, and recovery time
is usually reduced compared to traditional surgery. Laparoscopic
obesity operations have only been performed since 1993. Therefore
the American Society of Bariatric Surgeons (http://www.asbs.org)
recommends choosing a surgeon who is experienced in both laproscopic
and open bariatric operations, and who understands the complexities
of surgical treatment of obesity.
You should be aware that any surgery may have complications, and
this is major surgery. Specific complications will be discussed
further with you, but it is possible that death may result and the
risk of death is approximately 1 in 300. You should therefore carefully
weigh the benefits versus the risks. You should consider whether
you have any alternative way to lose weight. Usually, if you are
100 lbs or more overweight, it is impossible to lose weight and
keep it off by any means. If you do not have surgery you will probably
continue to gain weight and develop other complications of obesity,
which may seriously affect your health and may shorten your life.
The decision to undergo the surgery should not be taken lightly
as it is intended to be permanent and for life. The changes which
it can produce in your life are generally very positive, but you
should fully consider all the implications.
You should be aware that certain medications may cause bleeding
during surgery and should not be taken after surgery, because they
may cause ulcers. These medications, if taken, should be stopped
at least 2 weeks before surgery. They are Aspirin, Motrin (Ibuprofen),
Aleve and any other non-steroidal anti-inflammatory drugs such as
Indocin, Clinoril, Naprosyn, and many others.
In addition, Cortisone, Hydro-Cortisone, Prednisone and other Steroids
also interfere with healing. Tylenol and prescription drugs such
as Darvocet are safe to take for pain relief. Please discuss any
other medications you may be taking with your physician prior to
surgery.
Designated as a Bariatric Surgery Center of Excellence, Baptist Health is one of the best hospitals for gastrointestinal surgery in Arkansas. For more information on the BAPTIST HEALTH program for Gastric
Bypass, call (501) 202-1791.