BARIATRIC SURGERY

 

WEIGHT LOSS SURGERY

Weight loss surgery is one option for a limited number of patients with severe obesity. It is generally reserved for patients with whom efforts at medical therapy have failed and who have either a BMI of 35 - 40 and suffer from complications of obesity or a BMI of more than 40 (100 pounds or more overweight). Roux-en Y gastric bypass is a tool to assist motivated patients. This surgery is part of an integrated program that includes diet, physical activity and behavioral and social support prior to and after surgery.

Patients medically appropriate for and desiring surgery will receive extensive pre-operative education regarding this permanent re-arrangement of their digestive system. In order to obtain the safest lasting weight loss, it is critically important for potential surgical patients to learn how to utilize their new "tool" and recognize the signs of potential nutritional deficiencies and other complications.

Weight loss operations achieve their results through two methods. The first is restriction. The small stomach pouch severely limits the amount of food that can be eaten at any one time without inducing vomiting. The patient has a sensation of fullness with a limited volume of food. The second method is malabsorption. The bypassed portion of the small intestine does not participate in the absorption of nutrients from food. The remaining shorter length of small intestine is not capable of absorbing all of the nutrients efficiently. Following roux-en Y bypass, patients eat less, still feel full and absorb less of what they eat. Calories expended are greater than calories consumed and the patient loses weight.

WILL I BE HOSPITALIZED?

Gastric bypass requires hospitalization for an average of four to six days, depending on each patient's response to recovery.

HOW DO I PREPARE FOR SURGERY AND WHAT HAPPENS THE DAY OF SURGERY?

As most patients are admitted to the hospital the day of surgery, the majority of preparation occurs at home the day prior to the operation. Your surgeon will discuss the specific pre-operative instructions with you. In general, you may be on a liquid diet the day before your operation, may be given instructions for a bowel cleansing procedure and may require an adjustment in your medications. You will be asked to refrain from eating and drinking after midnight the night before your operation.

WILL I HAVE PAIN AFTER SURGERY?

Despite many advances in medicine, pain still occurs with any operation. Your surgical team will do their best to alleviate your pain. For the first few days after operation, you will receive pain relief medications with an intravenous system. Once you are able to tolerate medications by mouth, your pain relief medication will be changed to a by-mouth preparation that you will also have available when you are discharged to home. For most patients, the pain level rapidly decreases over the first two days while in the hospital. Most patients are taking few doses of pain relief.

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