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 the operation if you suffer from a weight-related health problem, such as type 2 diabetes, heart disease, or high blood pressure, degenerative joint disease or obstructive sleep apnea syndrome.

There are several different types of surgical 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. 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.

For more information on the BAPTIST HEALTH program for Gastric Bypass, call (501) 202-1791.