At St. Francis eastside, bariatric surgery candidates have a range of weight loss surgery options, including Lap-Band surgery or Roux-en-Y gastric bypass surgery. Located in Greenville and convenient to areas throughout the Upstate, SC, St. Francis also offers a Surgical Weight Loss Program that provides nutritional and psychological counseling, exercise programs, pre- and post-surgical education and an ongoing support groups for candidates of bariatric surgery.
Bariatric surgery may be an option for those who are very obese and have tried unsuccessfully to lose weight on diet and exercise programs and are unlikely to lose weight successfully with non-surgical methods. In general, candidates for weight loss surgery:
Are at least 100 pounds overweight with a Body Mass Index (BMI) of 40 or above. Check your BMI now!
Have a BMI of 35 or more with two or more major health concerns, such as sleep apnea, type 2 diabetes, hypertension and heart disease.
Are non-smokers and do not abuse alcohol or drugs
Are 18-60 years of age
Have appropriate motivations and commitment to follow post-surgery guidelines
Bariatric surgery, also called weight loss surgery or gastric bypass surgery, is appropriate for those who are morbidly obese and have a substantial amount of weight to lose to become healthy. Bariatric surgeries lower the body's intake of calories by reducing the size of the stomach so that patients feel full faster, and by bypassing part of the stomach and small intestines so that the body absorbs fewer calories.
Before surgery, the stomach is approximately the size of your two fists, with the ability to expand and stretch. After surgery, the new pouch is approximately the size of a small Dixie cup and can only hold a few ounces of food at one time and cannot stretch.
Bariatric surgery can be performed in three main ways: gastric bypass surgery, adjustable gastric banding, or sleeve gastrectomy surgery. All of these can be performed laparoscopically, although not all patients are good candidates for laparoscopic gastric bypass surgery. Your surgeon will work with you to determine which weight loss surgery is best for you: Roux-en-Y gastric bypass, laparoscopic Roux-en-Y, adjustable laparoscopic gastric banding or sleeve gastrectomy.
Roux-en-Y Gastric Bypass
There are two basic steps to gastric bypass surgery. The first step makes your stomach smaller. The surgeon makes an incision in the abdomen to divide the stomach into a small upper section and a larger bottom section using staples that are similar to stitches. The top section of the stomach (called the pouch) will hold your food.
After the stomach has been divided, the surgeon connects a section of the small intestine to the pouch. When eating, the food now travels from the pouch through this new connection ("Roux limb"), bypassing the lower part of the stomach. The surgeon then reconnects the base of the Roux limb with the rest of the small intestines from the bottom of the stomach, forming a y-shape.
This y-connection allows food to mix with pancreatic fluid and bile, helping to absorb important vitamins and minerals, but you still may have poor absorption of certain nutrients after Roux-en-Y gastric bypass surgery.
Roux-en-Y gastric bypass surgery may also be done laparoscopically, using a camera placed in the abdomen. This less-invasive technique allows the surgeon to make smaller surgical cuts, which lowers the risk of large scars and hernias after the procedure.
First, small surgical cuts are made in your abdomen. The surgeon passes thin surgical instruments through these narrow openings. The surgeon also passes a camera through one of these small openings and watches through a lens and video monitor to do the surgery.
Not everyone is a candidate for the laparoscopic gastric bypass surgery. Your surgeon will determine the best and safest approach for you.
You may not be a good candidate for laparoscopic surgery if you have had past abdominal surgery, due to scar tissue, have significant heart and lung disease, and/or weigh more than 350 pounds.
adjustable laparoscopic gastric banding
The adjustable laparoscopic gastric banding procedure involves the placement of a band around the upper part of the stomach, creating a small pouch to hold food. The band limits the amount of food you can eat, and increases the time it takes the intestines to digest the food.
Your doctor can later adjust the band to allow food to pass more slowly or quickly through your digestive system. Possible complications associated with the Lap-Band weight loss surgery include nausea, vomiting, and gastroesophageal reflux.
Final weight loss with gastric banding is not as much as with gastric bypass surgery. However, it may be enough for many patients.
The sleeve gastrectomy is a restrictive procedure that limits the amount of food you eat by reducing the size of your stomach. During this procedure, a thin vertical sleeve of stomach is created using a stapling device. This sleeve will typically hold between 50-100 ml, about the size of a banana. The excised portion of the stomach is removed.
Note: If necessary, the surgeries can be performed open, meaning the surgeon creates a long incision to open the abdomen and operating with traditional medical instruments. For some patients, the laparoscopic technique cannot be used due to dense scar tissue from prior abdominal surgery.
Generally, the hospital stay (including the day of surgery) can be one to two days for a gastric band, two to three days for a laparoscopic gastric bypass, and five to seven days for an open gastric bypass. Your surgeon will help you decide which of these procedures is right for you.
If you are considering weight loss surgery options like Roux-en-Y gastric bypass surgery, Lap-Band surgery, or sleeve gastretomy speak with a Greenville or Upstate, SC area St. Francis physician to learn more, or visit www.gottolose.org.