Surgery for Weight Loss - Bariatric Weight Loss Surgery

The decision to move forward with weight loss surgery is not one to be taken lightly. The surgeons of Western Bariatric Institute perform multipe types of weight loss surgical procedures, which allows for our surgeons and patients to have options in determining the safest and most effective procedure for each person. It is the goal of our practice to provide patients and their families with the necessary information and tools to make an informed decision as to whether weight loss surgery is the right option for them.

Weight loss is defined as a decrease in body weight resulting from either diet and exercise or voluntary activities, or due to involuntary circumstances such as illness. However, many seriously overweight people may have difficulty losing weight by engaging in voluntary activities or even with medically supervised diets, exercise and behavior modification programs.

In some instances, they may already have health problems that have attributed to their weight problem. Weight loss surgery is an option for many to help lose their excess weight while also gaining back their health.

Weight loss surgery is commonly known as bariatric surgery and involves surgical procedures done on the stomach and/or intestines to help a person with extreme obesity lose weight. This is usually considered an option for persons who have a BMI over 40, or those with a BMI over 35 who are experiencing health problems such as Type II diabetes or heart disease (co-morbidities).

In certain situations, persons with a BMI of 30 � 34.9 may be eligible for surgery. Determination of qualification is done on a one-on-one basis with one of our qualified surgeons.

Am I a Candidate for Bariatric Weight Loss Surgery?

To be a candidate for surgery, the following guidelines must be met:

You are severely obese, with a Body Mass Index (BMI) of 40 or more or you have a BMI of 35 - 39.9 with serious medical conditions (co-morbidities) such as high blood cholesterol and triglycerides, hypertension, sleep apnea, Type II diabetes and other serious cardiopulmonary disorders. In addition, you may be eligible for surgery if you have a BMI of 30 - 34.9. Please speak with one of our surgeons if you are interested in learning more about this option.
You have tried other weight loss methods such as changes in eating habits, behavior, exercise and/or drug therapy and you are still seriously overweight.
You are restricted from performing routine daily activities related to work and family and your quality of life is seriously impaired due to your weight.
You understand the procedures as well as the risks and effects of surgery.
You are motivated to making a lifelong behavioral commitment that includes well-balanced eating and physical activities necessary to achieve and maintain the best results.

Please be advised that these are just general guidelines. It is always best to refer to your physician or surgeon for a specific evaluation and a determination of your candidacy for surgery.
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How Effective is Bariatric Weight Loss Surgery?

Both research and experience have proven bariatric surgery to be an effective tool in the reduction of excess weight. With any of the procedures available through Western Bariatric Institute, most patients have improvement or complete resolution of their health co-morbidities within months after surgery and lose an average of 69% - 82% of excess weight over the 12 � 54 month stage post-operatively (WebMD). In addition, 95% of people state that their quality of life has improved since surgery.

Our past patients are our best way to share the effectiveness of weight loss surgery. We invite you to view their before and after pictures and to see for yourself what a difference it has made in their lives.
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How Surgery Reduces Weight

Roux-En-Y Gastric Bypass is a procedure in which a small stomach pouch is created by the surgeon which allows patient�s to eat only a small meal at each sitting. The Lap-Band� and Realize gastric banding procedures involve placing an implantable adjustable gastric band around the stomach. The band serves as a way of restricting the size of the stomach, which again allows the patient only to eat small meals at each sitting. The size of the stomach is so drastically reduced by each of these procedures that it requires patients to severely reduce the amount that is eaten at each meal which lends itself to weight loss.

Vertical Sleeve Gastrectomy is a restrictive procedure where 85% or more of the stomach is removed without bypassing the intestines or causing any gastrointestinal malabsorption. With this procedure, the amount of food is restricted due to the reduced size of the stomach.

StomaphyX� is a revisionary procedure available for people who have previously undergone weight loss surgery and have a stretched pouch. The StomaphyX� is done intra-orally, meaning through the mouth, so that there are no incisions and fastens tissue in the gastrointestinal tract, decreasing the size of the pouch. By decreasing the pouch (stomach) size, food intake is limited which therefore promotes weight loss.
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Risks of Surgery

For people interested in weight loss surgery, it is important to ask what the pros and cons of each operation are as well as learn the risks associated with the surgery.

As with any surgery, weight loss or bariatric surgery patients face the same risks as they would face in any type of abdominal surgery. Individuals who are overweight usually have greater risks during an operation due to pre-existing co-morbidities (sleep apnea, high blood pressure, etc.). Thus, it is important to learn the potential risks and complications of bariatric surgery prior to moving forward.

Potential risks of bariatric surgery may include the following:

Pneumonia
Abscess
Wound Infection
Urinary Tract Infection
Hemorrhage
Transfusions
Bowel Obstruction
Leakage of Bowel Connections
Obstruction of the Stomach Outlet
Chronic Nutritional Problems
Protein Deficiency
Vitamin and Mineral Deficiency

The possible side effects may include the following:

Nausea
Food Intolerance including red meats, sugar and milk products
Other side effects include transient hair loss and loss of muscle mass

For more information regarding the risks, please refer to your surgeon.
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Types of Weight Loss Procedures

Weight loss surgery should be treated as a tool to assist patients to make lifelong changes in their dietary and physical activity habits. Each procedure has its own pros and cons and should be discussed fully with your surgeon. It is imperative for patients to have an in-depth understanding of the procedures prior to surgery. Remember to discuss your specific case with your surgeon and ask about the advantages and disadvantages of each procedure to learn what may be best for you.

The procedures that the surgeons at Western Bariatric Institute perform are the Roux-En-Y Gastric Bypass (RYGB), The Lap-Band� Adjustable Gastric Banding Procedure, The Realize� Gastric Banding Procedure, Vertical Sleeve Gastrectomy and StomaphyX�.
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Roux-en-Y Gastric Bypass (RYGB)

The Roux-en-Y gastric bypass procedure has been the gold standard for surgical weight loss intervention for many years in the United States. In fact, it was back in 1991 that the National Institutes of Health first recommended Roux-en-Y gastric bypass surgery for patients who had a Body Mass Index over 35 and suffered from any obesity related health condition, or people who had a Body Mass Index over 40, regardless of health. Roux-en-Y gastric bypass has a long and distinguished track record in the United States among many bariatric surgical interventions that have come and gone over the decades. Numerous large, multi-institutional and long-term studies demonstrate that Roux-en-Y gastric bypass surgery improves health, creates the condition for dramatic long-term durable weight loss, and results in improved life expectancy in population studies. How Is Laparoscopic Roux-en-Y Gastric Bypass Performed? In most cases, the procedure can be performed by an experienced Western Bariatric Institute surgeon in around one hour. The procedure involves making five small skin incisions, each of which is approximately 1 cm in length. A small camera, called a laparoscope, is inserted into the abdomen, and the surgeon works to create a small stomach pouch from the larger stomach body, or stomach remnant, as it is called. A portion of the small intestine is then brought up and connected to the small stomach pouch with a small opening made through which food can travel to be digested. This procedure results in a sensation of satiety or fullness after eating only a small meal, and patients generally feel full after eating small meals over the course of their lifetime. Most patients stay in the hospital one to two nights, recover quickly and return to work within one to two weeks after surgery.

Roux-en-Y Gastric Bypass is Durable and Effective For the Long Term.

Roux-en-Y gastric bypass has been the most widely performed bariatric procedure in the United States for many years. Many long-term studies now demonstrate that the procedure is a durable and effective aid to long-term weight loss, health, and improved longevity. Most patients experience rapid weight loss immediately after surgery and continue to lose weight over the next 18 to 24 months. Most studies, and the extensive data at Western Bariatric Institute, show that over 95% of people succeed in significant weight loss and health improvement. Numerous studies indicate that heart problems, lung problems, diabetes, hypertension, obstructive sleep apnea and painful musculoskeletal problems improve in a high fraction of patients who have undergone Roux-en-Y gastric bypass.

Who Is A Candidate for the Roux-en-Y Procedure?

Western Bariatric Institute offers the laparoscopic Roux-en-Y gastric bypass to patients who meet the criteria established by the National Institutes of Health and the American Society for Bariatric and Metabolic Surgery. Namely, patients are candidates if they have a Body Mass Index over 35 and suffer from any health condition related to obesity. Anyone with a BMI over 40, regardless of health conditions, is a candidate. Some people are not candidates for the Roux-en-Y gastric bypass due to other medical concerns and this should be discussed with your surgeon�
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Lap-Band� Adjustable Gastric Band

In 2000, Inamed Corporation won FDA approval for the Lap-Band� System, an adjustable gastric band that is placed on the upper stomach in a minimally invasive outpatient procedure. The Lap-Band� System has proven to be very effective for the long term treatment of obesity in many studies that go back ten to fifteen years.

How is the Lap-Band� Surgery Performed?

In most cases, the procedure can be performed by an experienced bariatric surgeon in around forty minutes in an outpatient setting. The procedure involves the laparoscopic placement of an implantable adjustable gastric band and access port system under the skin, all done laparoscopically with five small incisions while the patient is under anesthesia. During laparoscopy, a small camera is inserted into the abdomen and the Band is carefully placed around the upper stomach. The Lap-Band� is made of a specially designed soft material and it acts like a snug, soft belt around the stomach. It serves to restrict the size of the stomach and patients feel full and satisfied after eating very small meals. Most patients do not require an overnight hospital stay. With experienced hands, serious complications are very rare, but in some cases, the band may need to be repositioned in the future.

The Lap-Band� is Adjustable:

After the Lap-Band� has been placed, patients follow up at regular intervals at Western Bariatric Institute for adjustments of the tightness of the band. In these simple office visits of ten minutes or so, a small amount of saline can be injected into the port under the skin to gently tighten the band and enhance the weight loss. For most patients, finding the appropriate tightness for their own personal band may take 3 � 4 fills and it is important for banding patients to work closely with the clinical staff of Western Bariatric Institute to find this spot.

Who is a Candidate for the Lap-Band�?

Western Bariatric Institute offers this procedure to patients who meet the criteria established by the National Institutes of Health and the American Society for Bariatric and Metabolic Surgery. Patients are considered candidates if they have a Body Mass Index (BMI) over 35 and suffer from any health condition related to obesity or have a BMI over 40. Additionally, people with a BMI between 30-35 may be considered for surgery if their weight is affecting their lives and their health. To learn more, please register for one of our free informational seminars by either clicking [here] or by calling (877) 985-6771.
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Realize� Adjustable Gastric Band

The Realize� Band was formerly known as the Swedish Band and was developed at Huddinge University Hospital in Sweden in 1985. Clinical trials for the Swedish Band began in 2003 in the United States and in 2007, the name was changed to the Realize� Band and the FDA approved the product for use with US patients. In the spring of 2008, Western Bariatric Institute began offering this procedure as an option for patients interested in gastric banding

How is the Realize� Band Surgery Performed?

The Realize Gastric Band consists of two medical devices that are surgically implanted at the same time during surgery. The first implant, the Realize Band, wraps completely around the upper part of the stomach and the second implant, the injection port, is attached to the abdominal wall underneath the skin. The injection port is used to add saline to the band after surgery to add restriction to the band. The band and port are connected by a soft, thin, hollow tubing. Gastric banding is done to limit food intake and slow the progress of food through the digestive system. The procedure is done laparoscopically via several small incisions in the abdomen and the procedure generally takes about 45 minutes to complete.

The Realize� Band is Adjustable

The Realize� adjustable gastric band comes in one size and is tailored to your individual needs throughout the adjustment process. Patients will return to Western Bariatric Institute for band adjustments after surgery and will work with one of our clinical providers to find the appropriate restriction level for their success. It is important to understand that the adjustment process is different for each person and for safety reasons must be done gradually. At each adjustment visit, a small amount of saline will be added until you are able to lose weight at a satisfactory rate without experiencing uncomfortable side effects. Remember to focus on losing a healthy 1 to 2 pounds per week and not the fill level of your band.

Who is a Candidate for the Realize� Adjustable Gastric Band?

How Do I Know Which Band is Right for Me?

Both adjustable gastric bands have proven track records for success and good outcomes. The choice for which band to use is something that you should research and then discuss with your surgeon. You will decide together which option is best for you.

Vertical Sleeve Gastrectomy

The surgeons of Western Bariatric Institute have recently added the Vertical Sleeve Gastrectomy as a surgical option for patients in our practice. The Sleeve Gastrectomy is a restrictive procedure that involves removing 85% or more of the stomach without re-routing the intestines.

How is the Vertical Sleeve Gastrectomy Performed?

With this procedure, restriction of the stomach is accomplished by dividing, stapling and removing more than 85% of the existing stomach. The remaining part of the stomach is long and narrow, much like a shirt sleeve. Since the intestines are not touched, the functioning of the stomach remains the same meaning that the nutritional elements of food can still be absorbed, but the volume of food that can be eaten is drastically reduced.

Who Is A Candidate for a Vertical Sleeve Gastrectomy?

With this procedure being relatively new and the long-term outcomes still being evaluated, the candidacy of patients for this surgery is done on a one-on-one basis with our surgeons. To learn more, please register for one of our free informational seminars by either clicking [here] or by calling (877) 985-6771.
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StomaphyX�

A new surgical option, the StomaphyX� is considered a revisionary procedure for patients who have previously undergone another form of weight loss surgery but have stretched out the size of their stomach pouch. Done intra-orally, meaning through the mouth with no incisions, this innovative procedure reduces the size of the stomach by fastening tissue to create folds in the gastrointestinal tract.

How is the StomaphyX� Performed?

With the patient under anesthesia, the flexible StomaphyX� device is gently lowered through your mouth into your stomach with the visual assistance of an endoscope video. A small section of the stomach wall is then suctioned up into the StomaphyX� device and fastened with a suture like fastener to create a fold called a �placation.� This is repeated 10 � 20 times until the overall size of the stomach has been reduced.

Who Is A Candidate for a StomaphyX�?

With the StomaphyX� procedure considered a revisionary surgery, it is recommended only for people who have previously undergone some type of weight loss surgery who have also experienced stretching of the original stomach pouch. Candidacy for this procedure is done through a one-on-one consultation with one of our four board certified surgeons. To learn more, please call our office at (775) 326-9125 and schedule a consultative appointment.
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