How do you lose weight from this surgery?
The surgery reduces the amount of food you can eat at one sitting. Because the pouch is so much smaller, you eat less food and feel satisfied more quickly. Your appitite is also reduced.
What types of surgeries are there?
These are the 3 most popular surgical procedures.
1.Gastric Bypass also called the Roux-En-Y or RNY
This operation reduces the size of the stomach and its capacity by creating a pouch at the top of the stomach. This pouch is connected directly to the small intestine, bypassing the lower stomach and the first portion of the intestinal tract. Besides restricting the volume of the stomach and the capacity to hold food, this procedure also reduces the absorption of calories. Having the food enter the lower part of the intestine prematurally may also allow you to feel full sooner. Weight loss is generally greater with this procedure than with the vertical banded gastoplasty, but also carries more risk of nutritional deficiencies.
2 Vertical Banded Gastroplasty or VBG
This procedure also creates a small pouch in the stomach with a restricted outlet that is sometimes reinforced with a ring. The outlet from the pouch is about the size of a dime, which delays the passage of food and reinforces the feeling of fullness. An advantage of this procedure is that it preserves the continuity of the digestive tract and lessons the risks of nutrient deficiencies. The Fobi Pouch Sugery comes under this heading.
3 The Duodenal Switch
The DS procedure reduces the stomach along the greater curvature, effectively restricting its capacity while maintaining its normal functionality. Unlike the BPD and the RNY procedures, which employ a gastric pouch and gastric pyloric valve, the DS keeps the pyloric valve intact- a main benefit of which is the elimination of dumping syndrome, marginal ulcers, stoma closures and blockages. Unlike the BPD and the RNY, the DS keeps portion of the duodenum in the food tract of the small intestine, enabling more normal absorption of many nutrients, including calcium iron and vitamin B-12
Who qualifies for weight loss surgery?
Candidates for surgery are usually at least 100lbs over their ideal body weight. Another measure of obesity is the body mass index (BMI) The body mass index is your height in Kg divided by the square of your height in meters. Generally a body mass of 40 or higher qulaifies for surgery, or 35 and above with certain health problems called co-morbidities. You must also have tried to lose weight in the past by more conventional methods and be of "sound" mind understanding the severity of this surgery.
What are the benefits of weight loss surgery?
Most patients lose weight rapidldy for 18-24 months after sugery. Some patients may then regain some of their weight, although few will regain it all. Sugery also improves most obesity related health problems, such as diabetes.
What are the risks?
WLS is considered major surgery and had the same risks as other surgical procedures. Some of the more specific risks are abdominable hernias that require further surgery, blood clots , wound infections, breakdown of the staple line and streched stomach pouches. Rapid weight loss increases the risk of gallstones. This can be prevented by taking bile salts for six months after surgery. Nutritional deficiencies may occur but can be avoided if vitamin and mineral suppliments are taken. There is a one in 200 chance of WLS resulting in death. Much the same odds as any major surgical procedure.
Will I have to exercise?
Exercise is very important after WLS. Many doctors insist on implementing positive physical changes even before operating. It aids in losing weight faster and heps tone skin and muscles after the weight loss.
Is surgery covered by provincial medical?
Roux-En -Y and VBG are at this time fully covered by provincial medical. The lap band is not covered at this time and estimates of out of pocket expenses range from 12,000-15,000 dollars. In the US it is up to the individual insurance companies. Most will cover WLS if it is deemed medically necessary.
What is the difference between open and lap sugery?
The difference is in the size of the incision. Traditional or open is one where there is an abdominable incision 4-12 inches long. Lap surgery is done by making five or six small "port" incisions about 1/4 to 1/2 inch each. A laparoscope is inserted into the incision and is connected to a video camera and shows up on a monitor. The entire operation is performed inside the abdomen after gas is used to expand the abdominable cavity. Recovery is generally quicker with the Lap version.
What is a diet history?
Some doctors require a detailed diet history. This is because surgery is a drastic choice and should only be used when traditonal treatments have failed. There are supervised methods such as Weight Watchers and Jenny Craig, as well as self supervised methods such as SLim Fast, low carb, Atkins etc Doctor supervised Meridian and other prescibed methods. A documented history of weight loss attempts is always helpful.
Can I lose too much weight?
With the possible exception of the rare patient who developes obstruction of the stomach outlet, it is unlikely that you will lose too much weight. On the other hand, snacking on high calorie liquids can put weight on readily.
Will my skin sag?
Because of the large amount of fat between the skin and the true body, the skin is bound to sag as fat is removed by the slow gradual burning in everday life. The skin of younger bypass patients who have not been obese for long periods of time recovers more rapidly than others.
What happens to the unused portion of the stomach?
It remains in place and it's ability to function remains intact. The muscles may lose some of their contractile power but each cell is still there and capable of functioning in the likely event that it should be called upon.
Can the stomach be hooked up again?
It IS possible, but doing so would result in regaining most of the lost weight.
Can you become deficient in some vitamins after surgery due to lack of absorption?
You need to take vitamin and mineral suppliments the rest of your life. This is known and understood prior to surgery.
Can you become protein deficient?
One of the most important issues for the bariatric patient is eating a diet adaquate in protein. Protein builds and maintains body tissues and is necessary for metabolic functions. You MUST consume good sources of protein to avoid protein nutrition related complications. Good protein sources are considered "complete" as they contain all the essential amino acids. Complete proteins are primarily of animal origin (eg egg, fish, poultry, milk, cheese and meat) while grains and vegetables are 'incomplete".
