Helping You Prepare for Surgery
Why Should I Consider Weight Loss Surgery?Patients who have weight loss surgery are able to lose—and keep off, on average—around 50 to 70 percent of their excess body weight. Patients can also experience a significant decrease in weight-related illnesses, including, in many cases, remission from type 2 diabetes.
Combining bariatric surgery with personal dedication and hard work can give patients:
- Added energy to participate in daily life
- More years to be with friends and family
- Improved self-image and confidence
- Enhanced physical conditioning and endurance for sports and other activities
- Control over health and health care spending
Which Bariatric Surgery is Right for Me?Not all bariatric procedures are the same. Your surgeon will work with you to determine which procedure best suits your needs and goals.
We encourage you to attend one of our free educational surgical weight loss seminars to understand the differences between the procedures we offer: gastric bypass, gastric sleeve and gastric banding.
- Gastric Bypass (Roux-en-Y): A small stomach pouch about the size of an egg is created. The remainder of the patient's stomach is completely divided from the pouch and a portion of the small intestine is bypassed. The new pouch allows the patient to feel full after only a small amount of food, helping patients to eat less and lose weight.
- Sleeve Gastrectomy (Gastric Sleeve): The left side of the stomach is surgically removed, leaving the pylorus intact. This results in a new stomach that is roughly the size and shape of a banana, restricting the amount of food a person can eat at one time.
- Adjustable Gastric Band: This surgery involves the placement of an adjustable silicone elastic band on the upper part of the stomach, typically using a laparoscopic technique. While the rate of weight loss with the adjustable band is slower than with other bariatric procedures, its minimally invasive nature helps reduce postoperative pain, length of stay and recovery time.
What are the Risks of Bariatric Surgery?As with any surgical procedure, there are risks involved with bariatric surgery, including bleeding, infection, blood clots or death. Each type of weight loss surgery has its own specific risks, which your bariatric surgeon can discuss with you. The safety of bariatric surgery improves each year. It is now safer than gallbladder surgery. Spectrum Health bariatric surgeons have an excellent record of quality and successful operations.
Will My Surgery be Laparoscopic?More than 90 percent of the surgeries we perform are laparoscopic. Our bariatric surgeons are able to use small incisions, tiny tools and flexible video equipment to avoid making a large incision in the abdomen. Laparoscopic operations carry the same risk as an open operation, but the benefits include less discomfort, shorter hospital stay, earlier return to work and reduced scarring.
While rare, there are surgeries that start laparoscopically but are converted to open procedures after the surgery begins. This decision is made when the surgeon determines that proceeding laparoscopically will result in a less satisfactory outcome than an open approach.
Will I Have a lot of Pain?While post-surgical pain is to be expected, every attempt is made to control pain so you can become active early in recovery. This helps avoid problems and speeds recovery. Sometimes several drugs are used together to help manage post-surgical pain. While in the hospital, a Patient Controlled Analgesia (PCA) may be ordered by your physician so you can give yourself a dose of pain medicine on demand. Your surgeon will discuss other pain management options with you.
How Much Weight Can I Expect to Lose?In a typical patient, bariatric surgery can cause a 50 to 70 percent reduction, on average, in excess body weight over three years. If you are willing to commit to lifestyle changes, including diet and exercise, you should be very pleased with your results. More importantly, bariatric surgery is a conduit to a healthier life.
Besides Weight Loss, Are There Any Other Benefits of Weight Loss Surgery?Extreme obesity often negatively affects quality of life. Several studies have shown substantial improvement in quality of life after bariatric surgery.
The comprehensive Spectrum Health surgical weight loss program can help you leave behind:
- High blood pressure
- Heart and circulatory problems
- Osteoarthritis and other joint problems
- Sleep apnea and respiratory problems
- Medications and frequent doctor visits
There is also good evidence from scientific research that weight loss surgery may significantly prolong life.
Evidence continues to mount that bariatric surgery can help eliminate type 2 diabetes, a dangerous and potentially deadly disease. Surgery leads to a large improvement in insulin sensitivity (a two- to threefold increase) and can offer lasting remission. In fact, more than 50 percent of patients who undergo bariatric surgery experience long-lasting remission from type 2 diabetes.
Who is Eligible for Bariatric Surgery?Patients who are 100 or more pounds overweight and haven’t been successful at losing weight through diet, exercise and behavior modification may be eligible for bariatric surgery.
Body mass index (BMI) is another important consideration. Surgical weight loss candidates usually have a BMI of 40 or higher, or a BMI of at least 35 as well as other obesity-related health conditions, such as:
- High cholesterol
- Arthritis or degenerative joint disease
- Sleep apnea
Is There a Difference in the Outcome of Weight Loss Surgery Between Men and Women?
Both men and women generally respond well to bariatric surgery. In general, men lose weight slightly faster than women do because they have more muscle mass, an indicator of a higher metabolism.
Is Weight Loss Surgery Recommended for Elderly or Teenagers?
We evaluate patients on an individual basis to determine whether the benefits of surgery outweigh the risks. Generally accepted guidelines from the American Society for Bariatric Surgery and the National Institutes of Health indicate surgery only for those 18 years of age and older.
What if I have had Previous Weight Loss Surgery and I'm Now Having Problems?
The first place to start is by contacting your original surgeon. He or she is most familiar with your medical history and can make recommendations based on knowledge of your surgery and anatomy. If you have contacted your original surgeon and feel you need a second opinion, or if you are unable to locate your original surgeon, feel free to contact our office for a consultation. Our surgeons can perform revisions on previous bariatric surgeries.
What can I do to get Ready for Bariatric Surgery?
- The first step is to register for a free surgical weight loss seminar, where you will be presented with more information about the process and have a chance to ask questions.
- Select a primary care physician if you don't already have one, and establish a relationship with him or her. Work with your physician to ensure that your routine health maintenance testing (such as Pap smears for women and prostate screening for men) is current.
- Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
- Bring a list of your medications with dose and schedule, as well as any relevant medical data or test results.
- Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.
What Tests are Done Before Surgery?To avoid complications, an accurate assessment of your physical and psychological health is needed before surgery. Certain basic tests are done prior to surgery:
- Dietary assessment
- Psychological evaluation
- Lab tests (such as blood or urine)
- Gallbladder ultrasound to look for gallstones
- Pulmonary function testing
- Sleep studies
- GI evaluation
- Cardiology evaluation
How can I Minimize the Risk of Deep Vein Thrombosis (DVT) and Pulmonary Embolism?
Because a DVT can originate on the operating table, therapy begins before a patient goes to the operating room. Generally, patients are treated with leg compression stockings and given a blood thinner prior to surgery. Both of these therapies continue throughout your hospitalization. After surgery, you will be encouraged to move and get out of bed as soon as possible to restore normal blood flow in your legs.
What if I have Other Serious Medical Problems that Make Surgery Risky?
Medical problems such as serious heart or lung problems can increase the risk of any surgery. On the other hand, if these problems are related to the patient's weight, they also increase the need for surgery. Severe medical problems may not dissuade the surgeon from recommending gastric bypass surgery if it is otherwise appropriate, but those conditions will make a patient's risk higher than average. Interventions to help minimize the risk may be recommended before surgery.
How Long will I be in the Hospital?
Although it can vary, the hospital stay (excluding the day of surgery) can be one to two days for a laparoscopic approach and three to four days for an open gastric bypass.
How Big will My Stomach Pouch Really be in the Long Run?
In the Roux-en-Y gastric bypass, the stomach pouch is created at 1 ounce or less in size (15 to 20 cc). In the first few months it is rather stiff due to natural surgical inflammation. About 6 to 12 months after surgery, the stomach pouch expands. Many patients end up with a meal capacity of 6 to 8 ounces.
What Do I Need to do to be Successful after Surgery?The basic rules are simple and easy to follow:
- Before surgery, our dietitian will provide you with special dietary guidelines to begin after surgery. You will need to follow these guidelines closely. Our bariatric surgeons begin patients with liquid diets, moving to semi-solid foods. Solid foods can eventually be tolerated without risk to the surgical procedure performed.
- When able to eat solids, eat three to four meals per day, no more. Protein in the form of lean meats (chicken, turkey, fish) and other low-fat sources should be eaten first. Foods should be cooked without fat and seasoned to taste.
- Never eat between meals.
- Drink 2 quarts (64 oz.) or more of water each day.
- Exercise aerobically every day for at least 30 minutes (one-mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added three to four days per week, as instructed by your doctor.