Bariatric Surgery

Kevin Huguet MDFor millions of people around the world, chronic obesity is simply a part of their everyday existence. It affects nearly every aspect of their lives, from their ability to perform basic tasks such as shopping and driving to how they perceive themselves and measure their own worth. Aside from the psychological and physical hardships created by excess weight, the risk of serious health conditions such as high blood pressure, diabetes, heart disease, and certain types of cancer.

Bariatric surgery, or weight loss surgery, offers hope to those who suffer from chronic obesity. While some people are able to lose massive amounts of weight through diet and exercise, many others find it difficult to achieve lasting results through these more traditional means of weight loss. Bariatric surgery allows overweight people to regain control over their health and, by extension, their lives. Post-bariatric patients who remain committed to their new, healthy lifestyles find themselves at significantly lower risk of disease. Perhaps just as importantly, many people who experience massive weight loss feel better about themselves, their appearance, and their futures.

Shaping A Better Future Through Bariatric Surgery

Sleeve GastrectomyFor some individuals struggling to lose weight, no amount of dieting, exercise or lifestyle modification can significantly impact severe obesity. It is a reality that can lead to frustration, depression, and in many cases, serious health issues. Fortunately, weight loss through bariatric surgery may be an effective option where other approaches have failed. Determining whether you may be a candidate for bariatric surgery is a process that requires a serious and honest discussion with your doctor and your family. It is a decision that should not be taken lightly. Within the following pages you will learn more about the choices in bariatric surgery, how they will impact your body and your lifestyle, and what you will need to do to take control of your weight and your life.

This procedure involves surgery on the stomach only (a restrictive procedure) and does not involve the intestine (which would make it malabsorptive). It basically consists of making a stomach that originally looked like a pouch into a long tube or “sleeve.” The sleeve gastrectomy procedure removes approximately 2/3 of the stomach, which provides for quicker satiety (sense of fullness) and decreased appetite. The smaller stomach sleeve restricts food intake by allowing only a small amount of food to be consumed in a single sitting.

  • A small sleeve (or narrow tube) is created with a surgical stapler along the inside curve of the stomach, from the pylorus of the stomach up to the esophagus.
  • After the creation of the sleeve is completed, the remainder of the stomach is removed.
  • The valve at the outlet of the stomach remains and provides for the normal process of stomach-emptying to continue, which in turn allows for the feeling of fullness.
  • Incisions are typically closed with absorbable sutures (stitches that do not need to be manually removed)

Procedural Considerations

Pros

  • Does not require the implantation of a foreign body, such as a silastic ring used in gastric banding.
  • The procedure both mechanically decreases the size of the stomach and also decreases the secretion of the hormone, ghrelin, which is responsible for the feeling of fullness, by removing the part of the stomach that produces this hormone.
  • There is no malabsorption.
  • There are no anastomoses or rerouting of the intestinal tract.
  • Fewer vitamin deficiencies when compared to gastric bypass.
  • Less long-term maintenance than gastric banding because no band fill is needed.
  • No vitamin or mineral deficiencies due to malabsorption.
  • More weight loss than Adjustable Gastric Banding.
Cons

  • Potentially slower weight loss than Roux-en-Y Gastric Bypass or Duodenal Switch.
  • Not as much clinical data available when compared to gastric bypass and adjustable gastric banding.
  • Potential for gastric leaks due to stapled resection of the stomach (less than 1%).
This procedure utilizes an adjustable band that is placed at the top of the stomach to create a small pouch. With its reduced size, this pouch provides a sense of satiety after a very small meal. The opening to the rest of the digestive tract is adjustable through an epidermal port. Weight loss is slower than alternative weight loss procedures, but with appropriate aftercare and routine band adjustments, it has been shown to ultimately result in comparable long-term weight loss three or four years after surgery.

  • A band is placed around the top of the stomach, creating a small pouch that limits food intake.
  • Additionally, a small port is affixed inside the body that allows the band to be adjusted later to make the pouch smaller or larger.
  • Internal incisions are typically closed with absorbable sutures (stitches that do not need to be manually removed) while external incisions are closed with sutures, steri-strips or staples; based on surgeon preference.

Procedure Considerations

Pros

  • No resection of the stomach.
  • No vitamin or mineral deficiencies due to malabsorption.
  • There are no anastomoses or rerouting of the intestinal tract.
  • No protein-calorie malabsorption.
Cons

  • Less weight loss than Gastric Bypass and Sleeve Gastrectomy.
  • Risk of slippage or band erosion, which may result in re-operation.
  • Risk of mechanical failure, due to port or tubing leakage.
  • Routine follow-up adjustments required.
  • Requires the implantation of a foreign body.

More Lap Band Information

Among morbidly obese individuals, massive weight loss has been clinically proven to lower the risk of obesity-related diseases and early death. In 2011, the American Heart Association released a statement that, for certain candidates, the benefits of bariatric surgery significantly outweigh the risks. In addition to health-related benefits, many patients experience dramatically improved self-esteem and newfound abilities to participate in activities that often prove difficult for overweight people, including hiking, swimming, and other types of sports.
Any surgical procedure carries with it some degree of risk, and the possibility of serious complications is higher in cases of major surgeries such as gastric bypass. These risks include infection, pulmonary embolism, bleeding, and ulcers. It should also be noted that, while gastric banding procedures are reversible, gastric bypass surgery involves the permanent alteration of the patient’s anatomy. Furthermore, in some rare cases, people who undergo bariatric surgery simply fail to lose substantial weight, even when they commit to making the appropriate lifestyle changes.

The surest way to reduce the risks associated with weight loss surgery is to seek out an experienced bariatric surgeon with an established record of success.

It is important that people who undergo bariatric surgery understand that massive weight loss requires a lifelong commitment to healthy eating, portion control, and regular exercise. Bariatric surgery is an important means of promoting weight loss, but cannot, in and of itself, produce the life-saving results that many morbidly obese people are seeking. Life after bariatric surgery can be difficult, emotionally and physically; most people need substantial support from family, friends, and professionals to succeed. Many of those who do succeed, however, succeed gloriously, reducing their BMI to healthier levels and often ridding themselves of comorbidities such as Type 2 diabetes.
The cost of bariatric surgery depends on many factors, such as the procedure chosen, geographical location, the experience of the surgeon, and the amount of coverage, if any, provided by the patient’s insurance plan. The exact cost of a patient’s surgery is determined during the pre-surgery consultation.

Choosing a Bariatric Surgeon

When choosing to undergo any major surgery, you should be as certain as possible that the surgeon you are entrusting with your health is deserving of the responsibility. Be sure to ask about the surgeon’s background, record of success, and approach to aftercare. Before you proceed with surgery, it is essential that you feel comfortable with your choice of surgeon.

Dr. Huguet, Jenne, Deane and everyone else at Bay Surgical Specialists for the excellent care during my Gastric Sleeve Surgery. Without them, Deane, Ava I would have been unable to navigate the system. I am grateful for this chance to begin a new healthy lifestyle. I would not have this opportunity if not for your team.

For more weight loss information, contact:

Bay Bariatric Surgery
960 7th Ave N
St. Petersburg, FL 33705 USA
Phone: (727) 755-0007
Fax: (727) 825-1357

The physicians of Bay Surgical Specialists offer the most advanced surgical procedures and the highest quality of care. Contact us and schedule an appointment today by calling (727) 456-8882.