Are You a Candidate for Weight Loss Roux-en-Y (Gastric-Bypass) Surgery?

Have you tried every diet, diet pill, exercise program known to man? Did you lose weight at the beginning and then gain it back (and then some) a short time later?

Remember when you could wear regular shoes and tie them? Get on the floor and play with the kids? Wear brand name clothes like everyone else? Sit comfortably in a seat at the movie theater? Walk up a flight of stairs without getting winded?

If you have answered yes to these questions, then you are one of 14 million Americans who are seriously overweight.

If you are 100 pounds or more overweight, then you are considered morbidly obese and run a risk of developing serious health problems such as diabetes, heart disease, high blood pressure or even a stroke. In addition, the physical and emotional complications make it difficult for you to enjoy life to its fullest.

A good way to determine whether you are a candidate for weight loss surgery is to take a look at your Body Mass Index (BMI). BMI is found by dividing a person´s weight in kilograms by height in meters squared (BMI=kg/m2). Click here to calculate your body mass index.

If you have...

• a body mass index over 40 or a body mass of 35 or greater with serious obesity-related health problems such as diabetes, high blood pressure, high cholesterol, sleep apnea, or gastric reflux, and are between the ages of 18 and 60
• between the ages of 18 and 60
• have been involved with a physician supervised weight loss program (diet and exercise) for at least 6 months within the past two years

...then you are a candidate for weight loss surgery.

What are Your Surgical Options at Guadalupe Regional Medical Center?

There are two weight loss surgeries available at Guadalupe Regional Medical Center. They are the Roux-en-Y Gastric Bypass and the Adjustable Gastric Banding (LAP-BAND®). These are the most commonly performed procedures in the United States, and both have very good track records. In addition, both procedures can be performed laparoscopically.

What is Laparoscopy and How is it Beneficial?

For the patient, weight loss surgery has been enhanced by the laparoscopic techniques. With the use of laparoscopy, the operation is performed through tiny incisions with special miniturized instruments and the use of a sophisticated technologically advanced camera to guide the surgeon.

The benefits of the laparoscopic technique:

• Smaller incisions
• Reduced pain after surgery
• Shortened medical center stay
• Shortened recovery time
• Reduced risk of infection

There are several types of weight loss surgeries. Because of the benefits of laparoscopic techniques, both the Roux-en-Y gastric-bypass and the LAP-BAND® are the surgical procedures of choice in Guadalupe Regional Medical Center's Bariatric Surgery Program. The laparoscopic approach is attempted in nearly 100% of weight loss surgeries performed at Guadalupe Regional Medical Center. However, when medically necessary the "open" surgical approach, requiring a major incision from the breast-bone to the bellybutton is performed.

How Does the Gastric Bypass Surgery Promote Weight Loss?

The Roux-en-Y gastric-bypass procedure involves modifying the stomach so that only a small amount of food can be eaten at one time. A small pouch is created at the top of the stomach effectively shrinking the volume of the stomach from a gallon to two ounces.

Next, a Y-shaped section is attached to the pouch to allow food to bypass the small intestine. The pouch is sealed shut with a line of staples.

As gastric-bypass implies, food is routed past much of the stomach, and the first part of the small intestine. Patients lose weight because this small pouch restricts the amount of food that can be eaten and the bypassed portion of the intestine decreases the calorie absorption.

What are the risks of the Roux-en-Y Gastric bypass Procedure?

Nationally, the mortality rate for this surgery is less than one percent. In about 10 to 15 percent of cases, complications occur. These include:

• Loosening of the line of staples to create the stomach pouch, pouch stretching, or leakage
• Wound infection-greatly reduced risk with laparoscopic procedures
• A tissue tear at the site of the incision, also called a hernia-also greatly reduced with a laparoscopic procedure
• Development of gallstones
• Blood clots–usually avoided by early and continued walking after surgery
• Vitamin deficiencies-usually prevented by taking daily vitamin supplements for life

If you fit the profile, you must also be willing to make a formal commitment to the surgery and to yourself; follow the restrictions and restraints of the surgery and the surgeon’s recommendations; and have sufficient motivation to make the necessary changes in eating habits and exercise.

What are the Benefits of Weight Loss Surgery?

The medical and emotional benefits of the procedure begin almost immediately after surgery, and the cosmetic benefits soon follow.

Over time, the benefits may include:

• Significant sustained weight loss
• Control or resolution of diabetes
• Lower blood pressure
• Lower cholesterol
• Relief from sleep apnea and acid reflux
• Decreased osteoarthritis pain and improved mobility
• Improved mood and self-esteem

If you fit the profile, you must also be willing to make a formal commitment to the surgery and to yourself; follow the restrictions and restraints of the surgery and the surgeon´s recommendations; and have sufficient motivation to make the necessary changes in eating habits and exercise.

How Does the LAP-BAND® Promote Weight Loss?

The LAP-BAND® System consists of an adjustable silicone band filled with saline liquid connected to a tube that leads to an access port implanted beneath the skin. The surgeon places the adjustable band around the upper part of the stomach. This is usually done via the laparoscopic approach, involving only a few small incisions in the abdomen. The silicone ring around the upper part of the stomach creates a new small stomach pouch above the band. This restricts the amount of food a person can hold in the stomach. The band also controls the size of the outlet leading from the upper stomach to the lower stomach, helping patients feel full sooner and longer. Unlike the Roux-en-Y Gastric Bypass procedure, the LAP-BAND® does not involve cutting or re-routing of the stomach or intestine.

What are the Risks of the LAP-BAND® Procedure?

Nationally, the mortality rate for this surgery is less than one percent. Possible complications include:

• Band erosion
• Band slippage
• Port malfunction and/or replacement
• Wound infection
• Development of gallstones
• Blood clots – usually avoided by early and continued walking after surgery
• Vitamin deficiencies – usually prevented by taking daily vitamin supplements for life

Who Would not be a Good Candidate for Weight Loss Surgery?

Persons with the following situations may not be a good candidate for the LAP-BAND® System:

• Numerous and unstable health conditions that would make someone a poor candidate for any surgery
• Lack of commitment to the dietary and exercise recommendations
• Mentally or emotionally unstable
• End Stage Cirrhosis of the liver
• Drug or Alcohol addiction

Persons with the following situations may not be a good candidate for the Roux-en-Y Gastric Bypass:

• Certain medical conditions such as Lupus or any other chronic inflammatory disease
• Allergy to materials in the LAP-BAND® System

What Lifestyle Changes Must I Make After Weight Loss Surgery?

Surgery alone will not ensure long-term success. In order to get down to a healthy weight, you must

• adjust your eating habits and exercise patterns
• take vitamin supplements daily-for life, and
• comply with recommended lifelong behavioral changes