| Frequently Asked Questions |
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What procedures are performed at the Center for Surgical Weight Loss & Wellness? We perform both the Laparoscopic Gastric Bypass Roux-En-Y and the Laparoscopic Adjustable Gastric Banding (LapBand) procedures.
- How do I know if I qualify for weight loss surgery?
- Define the centimeters of intestine bypassed in Gastric Bypass Roux en Y cases
- What determines the size of the gastric pouch 15ml, 30ml, 60ml? Do doctors play with those numbers in different situations?
- I have panic disorder and anxiety. I am seeing a counselor and am taking meds. Does this affect if I can have the surgery done?
- Many of the pre op and post op classes and seminars are held in group format. Is there any accommodation to go through individual sessions?
- In gastric bypass cases, how do you check for anastamotic leaks?
- How long does the surgery take?
- Can I still have laparoscopic weight loss surgery if I have had previous abdominal surgery?
- Does having a heart condition, pacemaker, and heart medications cause a greater risk for having this kind of surgery? Would I still be a candidate?
- What if I have Chron’s disease or Irritable Bowel Syndrome; can I still have the surgery?
- If my support person and I both decided to undergo weight loss surgery, could we do it at the same time?
- Can BMI be too high to do the procedure laparoscopically? If so, what is the cut off?
- In gastric bypass, what happens to the stomach remnant?
- What kind of vitamins do you have to take after weight loss surgery?
- Would you have the procedure reversed when you reach normal weight?
- Is it more difficult to do laparoscopic or open surgery?
- What types of dietary changes can I expect after bariatric surgery?
- Can these procedures cause too much weight loss? How does the body know when to stop?
- Which insurance companies cover this procedure?
- What kinds of risks for surgery are associated with higher BMI?
- How long do I have to stay in the hospital for Weight Loss Surgery?
- How soon can I get back to work?
- What types of risks are associated with weight loss surgery?
- Is the appendix removed at the time of surgery? Why or why not?
- Is the gallbladder removed at the time of surgery? Why or why not?
- How is pain managed in the hospital post-op?
- What is dumping syndrome?
- Can I get pregnant after surgery?
- When can I start exercising?
- Will I experience hair loss after weight loss surgery
How do I know if I qualify for weight loss surgery?
You must:
• have a body mass index (BMI) of 40 or greater, for at least 5 years,
• have a BMI of 35 to 39, with significant medical complications of obesity (high blood pressure, sleep apnea, diabetes mellitus, osteoarthritis, gastroesophageal reflux/ heartburn, etc.)
• be between the ages of 21 and 65. Each case requires individual consideration.
• verify a documented attempt at weight loss programs, including medically supervised programs
• demonstrate a low probability of success with conventional treatment modalities
• have acceptable risk for surgery, as determined by preoperative medical, surgical, and psychological evaluation
• demonstrate motivation to participate in and comply with all phases of treatment and long-term follow up
Define the centimeters of intestine bypassed in Gastric Bypass Roux en Y cases:
• BMI < 50 = 75 cm
• BMI > 50 = 100 cm
What determines the size of the gastric pouch 15ml, 30ml, 60ml? Do doctors play with those number in different situations?
Several different techniques are used in the gastric bypass procedure, and surgeons have different rationales why certain gastric pouch sizes may be used.
I have panic disorder and anxiety. I am seeing a counselor and am taking meds. Does this affect if I can have the surgery done?
All patients in our program will be asked to undergo an independent psychological evaluation by our psychologists/psychiatrists where these issues will be discussed and a recommendation regarding surgery will be made. Ultimately, the decision to proceed with surgery will be up to your surgeon.
Many of the pre op and post op classes and seminars are held in group format. Is there any accommodation to go through individual sessions?
No. Patients benefit from the shared group experience, and learn best with others who are in the same stages of their weight loss surgery preparation and recovery.
In gastric bypass cases, how do you check for anastamotic leaks?
While in the operating room, a test is typically done to check for leaks before the surgery is completed. Additionally, the following day, you will be asked to swallow a small amount of contrast dye while in the radiology suite to again visualize if there are any leaks. When the test is shown to be normal, you will begin a clear liquid diet of water, sugar free gelatin, and fat free broth.
How long does the surgery take?
• Laparoscopic Gastric Bypass: Average operation time usually takes 2 to 3 hours.
• LapBand Procedure: Average operation time usually takes 1 to 2 hours.
Actual surgical time may be more or less based on your body composition, BMI, history of previous abdominal surgery, and other factors. Your individual case will be discussed with you at your surgical consultation.
Can I still have laparoscopic weight loss surgery if I have had previous abdominal surgery?
Your personal surgical history and the technique to be used will be discussed with you at the time of your surgical consultation.
Does having a heart condition, pacemaker, and heart medications cause a greater risk for having this kind of surgery? Would I still be a candidate?
Your personal medical history will be evaluated and discussed individually with you at the time of your surgical consultation.
What if I have Chron’s disease or Irritable Bowel Syndrome; can I still have the surgery?
Specific disease states would be evaluated on a case-by-case basis.
If my support person and I both decided to undergo weight loss surgery, could we do it at the same time?
No. One should support the other through at least the first two months after surgery.
Can BMI be too high to do the procedure laparoscopically? If so, what is the cut off?
Yes. The laparoscopic technique uses several small incisions and long reaching instruments to reach deep inside the abdominal cavity. When BMI exceeds 50, or in patients with a large distribution of body fat in the upper abdomen, the instruments may not be long enough to perform a laparoscopic surgery. The surgeon will discuss this with you at your initial consultation.
In gastric bypass, what happens to the stomach remnant?
The unused part of your stomach will remain in place. In addition, the unused portion’s ability to function remains intact.
What kind of vitamins do you have to take after weight loss surgery?
Generally speaking, everyone should take a multivitamin supplement daily. However, gastric bypass patients have additional needs related to the malabsorptive component of their surgery. Gastric bypass patients will need a specially formulated vitamin to maintain proper nutrient levels. The specific types of vitamins we recommend will be discussed at your pre- and post-operative nutrition classes.
Would you have the procedure reversed when you reach normal weight?
Surgical weight loss is merely a “tool” to assist you in achieving your weight loss goals. It does not change your underlying genetic or metabolic structure. If the procedure was reversed you will likely gain the weight back.
Is it more difficult to do laparoscopic or open surgery?
This depends on the surgeon’s experience with laparoscopy.
What types of dietary changes can I expect after bariatric surgery?
Patients are given the details of their dietary advancement during their preoperative and postoperative education classes. In short, patients will concentrate on protein rich foods, and eliminate fats and sugars from their diets. The average meal size should fit in the palm of your hand. This will be enough to give you a feeling of fullness and satisfaction. Exercise plays a key role in maximizing weight loss efforts and long term maintenance. Patients will need to drink large amounts of water throughout the day, not snack between meals, and take their vitamins daily. Doing this will maximize one’s weight loss goals.
Can these procedures cause too much weight loss? How does the body know when to stop?
The body will reach a new, metabolic baseline, where the body is functioning comfortably and effortlessly.
Which insurance companies cover this procedure?
You will need to obtain a copy of your current, insurance policy to determine if these procedures are covered. Insurance details can be difficult to navigate, and our insurance specialists will be happy to assist you in determining if these procedures are a covered benefit in your plan.
What kinds of risks for surgery are associated with higher BMI?
Patients with a BMI greater than 50 are at higher surgical risk.
How long do I have to stay in the hospital for Weight Loss Surgery?
• Laparoscopic Gastric Bypass: Our average length of hospital stay is 2 ½ days.
• Lap Band: Our average length of hospital stay is one day.
Discharge planning begins before your surgery as we begin to identify any needs that you may specifically have after surgery. Please take time to talk with our team about any concerns you have regarding your care at home.
How soon can I get back to work?
The laparoscopic technique affords patients the opportunity to return to work typically 2-3 weeks after surgery. Your surgeon’s office will be happy to complete a medical excuse and complete any short term disability papers for you following your surgery.
What types of risks are associated with weight loss surgery?
Both Laparoscopic Gastric Bypass and Laparoscopic Adjustable Gastric Banding (LapBand) are major operative procedures, and the complications associated with any major procedure, as well as with general anesthesia, can occur. There are certain procedure-specific complications that will be discussed with you at both our educational seminar as well as your surgical consultations.
Is the appendix removed at the time of surgery? Why or why not?
It is not removed. There is not an increased incidence of reported appendicitis after Laparoscopic Gastric Bypass Roux-En-Y.
Is the gallbladder removed at the time of surgery? Why or why not?
This issue is somewhat controversial and will be discussed in detail at our informational seminar.
How is pain managed in the hospital post-op?
Patients are taught how to use a P.C.A. or Patient-Controlled Analgesic pump in “Bariatric Boot Camp” before surgery. This device allows patients to control the delivery of their pain medication immediately after surgery until the next postoperative day when oral medications can be given.
What is dumping syndrome?
With the gastric bypass procedure, “dumping” is the condition that occurs when the stomach’s contents move too rapidly through the small intestine, this is typically caused by eating foods high in sugars or fats. Symptoms can include nausea, weakness, sweating, faintness, rapid heart rate, abdominal cramping, and diarrhea. This side effect encourages gastric bypass patients to positively adhere to a diet high in protein and to stay away from fats and sugars.
Can I get pregnant after surgery?
Although many women were not able to conceive previously due to their obesity, numerous bariatric patients become fertile again after their significant weight loss. However, a period of 12 to 15 months should go by before you try to get pregnant. This is because during the first 6-9 months after surgery, you will lose weight at a considerably fast rate, and sustaining the needs of a baby will be difficult at this time. If you are considering pregnancy after surgery, you should allow your body adequate time to adjust to your new weight prior to becoming pregnant.
When can I start exercising?
Walking is strongly encouraged to prevent several postoperative complications such as pneumonia and blood clots in the legs. Our program has provided specialized equipment to assist you in getting started after surgery. A few hours after surgery, you will get out of bed and begin walking. You will continue to build your walking stamina each day after surgery. Walking is an excellent form of exercise, and early after surgery will be continued daily until other strengthening and conditioning exercises can be added! Many of our patients are walking up to 1-2 miles each day at one month after surgery!
Will I experience hair loss after weight loss surgery?
Hair loss can occur with any rapid and significant weight loss. The best way to minimize hair loss is to improve intake of protein rich foods and minerals that enrich hair follicles. Hair loss is usually seen between 2-4 months after surgery. The best prevention is to follow the dietary instruction given both pre and post op and take the vitamin supplements so protein levels will be maintained throughout the weight loss experience. If hair is lost, most everyone is able to re-grow the hair once protein and mineral levels, and weight loss stabilizes.
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