Bariatric Surgery - Comprehensive Obesity Management Program (COMP)
Roux-en-Y gastric bypass and adjustable gastric banding are the most commonly performed weight loss surgical procedures. Sleeve Gastrectomy is a new, promising option. The preparation for surgery may take between three to six months to complete, depending on the patient's insurance.
Weight loss surgery should be considered if:
- Patients have a BMI greater than 40.
- Patients have a BMI between 35 and 39 with significant obesity-related conditions such as: diabetes, hypertension or sleep apnea
- Calculate your BMI (links to BMI calculator)
Surgery FactIn the last five years, the number of weight loss surgeries has increased to about 225,000 per year.
Laparoscopic Roux-en-Y Gastric Bypass
- Most common weight loss operation performed in the U.S.
- Offers the best weight loss
- Provides restriction and malabsorption
- Requires close follow-up to prevent nutritional deficiencies
Laparoscopic Sleeve Gastrectomy
- Majority of the stomach is completely removed. Remaining stomach is a long tube.
- Restrictive procedure, decreases amount of food consumed
- Preservation of normal anatomy
Laparoscopic Adjustable Gastric Banding
- Less invasive procedure introduced to the US in 2001
- Overall weight loss is less versus the gastric bypass; risk of complication is reduced.
- Requires multiple band adjustments
- Gastric bypass surgery is a major operation that seals off most of the stomach to decrease food intake and rearrange small intestines to reduce the calories that the body can absorb.
- Bariatric surgery may be performed using laparoscopic techniques through several very small incisions.
Benefits of Laparoscopic Technique
- Decreased wound infection rates
- Decreased abdominal wall hernia rates
- Decreased potential for pneumonia
- Decreased pain
- Quicker recovery
Weight Loss Surgery Risks
- Approximately 10-20 percent of weight loss surgery patients develop gallstones. Not all patient will develop symptoms. Gallstones can be prevented with supplemental bile salts taken for the first six months after surgery.
- Nearly 30 percent of patients develop nutritional deficiencies, such as anemia or osteoporosis. Deficiencies can be avoided if vitamin and mineral intakes are maintained.
- About 5 percent of weight loss surgery patients require follow-up operations to correct complications, like abdominal hernias or breakdown of the staple line.
- Gastric bypass surgery may cause "dumping syndrome," when stomach contents move too rapidly through small intestine. Symptoms include nausea, weakness, sweating, diarrhea and inability to eat sweets without becoming weak and sweaty.
- Blood clot formation
Long Term Risks
- Dumping Syndrome
- Internal Hernia
- Nutritional Deficiencies
- Weight Regain - if not retaining lifestyle changes