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Bariatric surgery involves specialized surgical procedures that assist patients who are morbidly obese with losing weight. In the United States, 60% of the population is either overweight or obese. Obesity can be a life threatening disease and contributes to 300,000 deaths each year. Obesity is now the second leading cause of preventable death after smoking. Obesity is associated with many other serious health conditions including: Diabetes, High Blood Pressure, Heart Disease, Stoke, Sleep Apnea, Gastroesophageal Reflux/Heartburn, Degenerative Joint Disease/Osteoarthritis, Depression, Cancer, Gallbladder Disease, Urinary Stress Incontinence, Skin Ulcers and High Cholesterol to name a few.

Only about 5% of people who are able to lose weight using conservative measures are able to keep that weight off long term. Most people regain the weight that they were able to lose and then some and end up weighing even more.

Regional Surgical Specialists is pleased to offer two surgical procedures that have met with dramatic success in assisting obese patients with losing weight and keeping it off long term. Doctors Bradshaw and Soosaar perform Laparoscopic Gastric Bypass and Laparoscopic Adjustable Gastric Banding procedures. We have partnered with Mission Hospitals to provide comprehensive care for the overweight or obese patient with services including a medical weight loss program, nutrition counseling, psychologic counseling and a surgical program for those patients who qualify.

Gastric Bypass procedures involve dividing the upper portion of your stomach and forming a smaller reservoir that can only hold one ounce of food. This smaller stomach actually restricts how much a patient can eat and thereby decreases the number of calories that a patient takes in, subsequently leading to weight loss. This small stomach pouch is then connected to a portion of your small intestine which is constructed into the shape of a “Y.” The portion of the intestine that is “bypassed” does not absorb nutrients and calories, leading to malabsorption and further weight loss. Accompanied by a strict diet and exercise program, most patients are able to lose approximately 60-75% of their excess weight in 18-24 months and keep it off.

Adjustable Gastric Banding procedures involve placement of an inflatable silicone band around the upper portion of the stomach that limits the amount of food you can eat at one time. The narrowing of the stomach outlet caused by the band then increases the amount of time it takes for the stomach to empty. This keeps you from getting hungry as soon as you would normally. Since you are eating less food and are not as hungry, you are able to lose weight. Accompanied by a strict diet and exercise program, most Gastric Band patients are able to lose approximately 50-60% of their excess weight over the course of a few years.

We perform BOTH Gastric Bypasses and Gastric Bands LAPAROSCOPICALLY for a number of reasons. Advantages of a minimally invasive, laparoscopic approach include: Reduced post-operative pain, Shorter hospital stay, Quicker return to work, Improved cosmetic result, Less chance of post-opertive infections and hernias and Less bleeding. Of course, all procedures carry a risk of having to make a longer incision, but our surgeons all have advanced laparoscopic skills that will allow you the best chance at having your operation performed in a minimally invasive fashion.

Advantages of Laparoscopic Gastric Bypass include: rapid initial weight loss, a higher total weight loss than with gastric banding, a long experience in the U.S., higher total average weight loss than reported with the Lap Band and a one time procedure. Disadvantages of the Laparoscopic Gastric Bypass include: dividing the stomach and bowel is required, which can lead to complications such as leakage, malabsorption can lead to nutritional deficiencies or anemia, “Dumping Syndrome” can occur, the procedure can be rendered less effective if the patient consistently overeats and stretches their stomach pouch, the lower stomach and upper portion of the small intestine can no longer be visualized by x-ray or endoscopy should a condition such as an ulcer, bleeding or malignancy arise and the procedure should not be considered reversible.

Advantages of the Laparoscopic Adjustable Gastric Band include: Food passes through the digestive tract in the normal order and allows for normal absorption, no division of the stomach or bowel with stapling or re-routing of the intestine, the band can be Adjusted to increase or decrease restriction, a lower complication rate and the Band is reversible. Disadvantages of the Gastric Band include: implanting a medical device, slower rate of weight loss than gastric bypass and less total average weight loss, regular follow up for band adjustments is crucial to patient success, access port twisting or leakage may require additional operations, effectiveness can be altered by band slippage and repeat operation may be required if a gastric perforation occurs.

Surgical therapy should be considered for patients who have a Body Mass Index (BMI) of greater than 40 or 35-40 with associated co-morbid health conditions. BMI is calculated by your body weight in kilograms divided by your height in meters squared. No patient is currently considered for surgery by our program who has a weight greater than 400 pounds, because the x-ray equipment used to evaluate our patients has a 400 pound limit. Gastric bypass procedures are offered to patients between the ages of 18 and 55. Gastric Bands are offered to patients over 18 years of age. The maximum acceptable BMI for a gastric bypass patient is 50 and for a gastric band patient is 60. All patients who are accepted for surgical treatment are required to undergo a dietary assessment, psychologic evaluation, medical testing, and must lose 5% of their initial presenting body weight in order to make their procedure more safe.

Bariatric surgery is an excellent option for those patients who are unable to lose weight effectively using conservative measures and who are 100% committed to a disciplined lifelong program of diet and exercise.

For further information about our Bariatric Surgery program, please visit our Mission Bariatrics website at: http://missionhospitals.org/.


Further information may be found at:

www.lap-band.com
http://www.morbid-obesity.info/
http://missionhospitals.org/news/stories/2005/bariatric-surgical-options.htm
http://www.asbs.org/html/about/patients.html

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