Weight Loss Surgery/Bariatric Surgery
Bariatric surgery is the clinical term for several different procedures. The procedures use one of three approaches to help patients lose weight and improve or resolve co-morbid conditions.
Emerson’s bariatric surgeons use a minimally invasive technique, whereby several 1/4–1/2 inch incisions are created and long-handled instruments are used. This technique is associated with faster recovery, less pain and less scarring. Read our frequently asked questions.
Instead of open surgery, our surgeons use a minimally invasive technique to make several small incisions.
During these procedures, the surgeon reroutes the small intestine so that food skips a portion of it. The small intestine absorbs calories and nutrients from food, and avoiding part of the intestines means that many calories and nutrients are not absorbed.
During this restrictive surgical procedure, two medical devices are implanted in the patient: a silicone band and an injection port. The silicone band is placed around the upper part of the stomach and molds the stomach into two connected chambers. The injection port is attached to the abdominal wall, underneath the skin. The port is connected to the band with soft, thin tubing. The band is adjustable. Adjustments are made by your healthcare professional using a needle to inject saline solution into your band through the port in our office. Adding saline increases the amount of restriction provided by the band, helping patients feel full sooner and with less food.
At Emerson, we offer two types of adjustable gastric bands: Lap Band.
Vertical Sleeve Gastrectomy
The procedure consists of a laparoscopic partial gastrectomy in which the majority of the greater curvature of the stomach is reoved and a tubular stomach is created. This procedure generates weight loss solely through gastric restriction. Five year intermediate-term outcomes show the VSG to be a safe and effective stand alone procedure for surgical weight loss, but long-term outcomes are still unknown.
The disease of morbid obesity interferes with basic physical functions such as breathing or walking. Long-term implications of the disease include shorter life expectancy, serious health consequences in the form of weight-related conditions such as type 2 diabetes and heart disease, and a lower quality of life with fewer economic and social opportunities.
Obesity is a serious disease with symptoms that build slowly over an extended period of time. The National Institutes of Health defines morbid obesity as:
- Being 100 pounds or more above your ideal body weight
- Or, having a Body Mass Index (BMI) of 40 or greater
- Or, having a BMI of 35 or greater and one or more co-morbid condition
The presence of obesity increases the risk of a number of medical conditions, including cancer. A co-morbid condition is a health condition related to a primary disease such as obesity. There are many health conditions related to morbid obesity, but some of the most common are:
- Type 2 diabetes, which can lead to heart disease, kidney failure, blindness, amputation of the feet or legs and nerve damage
- Coronary heart disease, such as hardening of the arteries, heart attack and angina
- Obstructive sleep apnea has been associated with high blood pressure
These conditions occur more frequently in people with morbid obesity. Mortality rates from many of these conditions are also higher among people with morbid obesity.
Results of five-year follow-up
The below chart compares the long-term effectiveness of three different obesity treatments: diet and exercise, weight loss medications and bariatric surgery.
Bariatric surgery clearly has the best weight loss outcome compared to the other two treatments: 50–70% of people were able to lose at least 50% of the excess weight and keep it off for five years.*
After five years, only 2–5% of the people who dieted and exercised had maintained a weight loss of at least 10%. People who had taken weight loss medications were not able to maintain any weight loss.
|TREATMENT ||WEIGHT LOSS (% OF PATIENTS)|
|Diet and Exercise**
- * Bariatricedge.com
- ** Success measured as a loss of 10% of initial body weight.
- *** Weight loss is not maintained once treatment ends.
- **** Success measured as a loss of 50% of excess body weight (equivalent to loss of approximately 20–25% of initial body weight).
Frequently Asked Questions
What is bariatric surgery?
Bariatric surgery is a procedure designed to make the stomach smaller so the patient feels satisfied with less food. It is intended for people who are 100 pounds or more overweight with a Body Mass Index (BMI) of 40 or greater, and who have not had success with other weight loss therapies such as a supervised weight loss trial, exercise, medications, etc. A person with a BMI of 35 or greater and one or more co-morbid conditions also may qualify for bariatric surgery.
What is Body Mass Index (BMI)?
Body Mass Index, is defined as an individual's body weight divided by the square of his or her height.
How do I know if I qualify for bariatric surgery?
Patients should have:
- 100 pounds or more of excess weight; or a BMI of 40 or greater
- A BMI of 35 or greater with one or more co-morbid condition
- Not successful in multiple attempts at a supervised weight loss trial
Other common guidelines include:
- Understanding the risks of bariatric surgery
- Committing to dietary and other lifestyle changes
- Undergoing a complete examination including multiple medical tests
- Absence of a drug/alcohol or uncontrolled psychological disorder
What is the difference between laparoscopic (minimally invasive) surgery and an open procedure?
Open surgery involves the surgeon creating a long incision to open the abdomen and operating with “traditional” medical instruments. Laparoscopic, or minimally invasive, surgery is an approach that allows the surgeon to perform the same procedure using several small incisions, a fiber-optic camera, video monitor and long-handled instruments. At Emerson, we only do minimally invasive surgical techniques for our surgical weight loss cases.
How successful is bariatric surgery?
Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more that 22,000 bariatric surgery patients showed:
- Improvement in or complete resolution of conditions including type 2 diabetes, hypertension and sleep apnea
- 61.2% reduction of excess weight
Do I qualify for insurance coverage for the surgery?
Because every insurance policy is unique, it's important that you thoroughly understand your Certificate of Coverage to know exactly what is and isn’t covered through your plan. We recommend that all of our patients call their insurance company to verify coverage for surgical weight loss at Emerson Hospital.
What is included in the qualifying process?
Quaifying for surgery is assessed by your treatment team. You will meet with a nutritionist, mental health practitioner, a physcians assistant and surgeon in sessions leading up to surgery. Each healthcare professional will help you prepare for the changes and challenges that lie ahead.
How long do I have to stay in the hospital?
It varies from person to person. Generally, the hospital stay can be one night for a gastric band and two nights for a laparoscopic gastric bypass and vertical sleeve gastrectomy.
After the surgery, what support will I receive in adjusting to new daily habits?
After surgery, you will continue to receive a personalized approach to help you adjust to your new habits and lifestyle, which will provide long-term success. Monthly support groups and scheduled individualized appointments with our mental health provider, dietitian, physician assistant and surgeon will be a major part of your long-term success.
Can I get pregnant after bariatric surgery?
Most doctors recommend that women wait at least eighteen months after the surgery before a pregnancy. Approximately 18–24 months postoperatively, your body should be fairly stable (from a weight and nutrition standpoint), and you should be able to carry a normally nourished fetus. Consult your surgeon as you plan for pregnancy.
What about postoperative pain and discomfort?
Many people think bariatric surgery will be followed by a long and painful recovery period; however, most patients report experiencing only discomfort and soreness rather than pain. Recovery does, however, vary from patient to patient.
How long is recovery?
As with any major surgery, there will be a recovery period. Remember that this is a necessary step, and the better care you take during recovery, the more quickly you’ll return to normal activity. Recovery time varies from patient to patient, but can average between 3–6 weeks.
What will my life be like after the surgery?
Bariatric surgery is not a quick fix. It’s an ongoing journey toward transforming your health through lifestyle changes. After surgery, you will feel satisfied with less food. Positive changes in your body, your weight and your health will occur, if you maintain the diet and exercise routines recommended by your bariatric program.
When can I go back to my normal activity level?
Your ability to resume pre-surgery levels of activity depends on your physical condition, the nature of the activity and the type of bariatric surgery you had. Many patients return to normal levels of activity within 3–6 of surgery.
How much exercise is needed after bariatric surgery?
Exercise is an important part of success after surgery. You may be encouraged to begin exercising, limited only by discomfort, about 3–4 weeks after surgery, after discussion with medical provider. The type of exercise depends on your overall condition, but the long-term goal is to get 30 minutes of exercise three or more days each week.
Is there any difficulty in taking medications?
Most pills or capsules are small enough to pass through the new stomach pouch. At first, your doctor may suggest that medications be taken in crushed or liquid form. As a general rule, ask your surgeon before taking any medication.