What Tests Are Needed Before Surgery?
At Illawarra Institute of Obesity Surgery, we like to make your surgery as safe and predictable as possible. We routinely perform a blood test on all patients before surgery- This includes a full blood count, blood group, cholesterol levels, kidney, liver and thyroid function, and a diabetes screening test. Depending on your medical history, a chest X-ray or an ECG may also be required.
Sometimes a referral to another specialist such as an endocrinologist, cardiologist, or respiratory physician may be made. This will be determined at your initial consultation with our surgeons. If you already have other specialists involved in your care, we will correspond with them.
What If I Have Heartburn Or Reflux?
Heartburn occurs when stomach acid refluxes back into the oesophagus and burns its sensitive lining. Obesity itself is a risk factor for this. Another common reason to have heartburn is if you have a hiatus hernia- a common condition in obesity. A hiatus hernia occurs when the normal opening in the diaphragm for the oesophagus becomes stretched and enlarged, allowing the upper part of the stomach to slide up into the chest. This causes the one-way valve between the oesophagus and stomach to become faulty.
We routinely look for and repair a hiatus hernia if one is found during your weight loss surgery (at no additional cost) – as a result it is usually possible to get rid of your heartburn completely. Many of our patients who have suffered from years of heartburn requiring medication to control and have had their symptoms alleviated as soon as they awake from surgery, and no longer need medication.
Do I Need A Referral From A General Practitioner?
Yes. A referral from a GP is a requirement under Medicare. We would also like to keep your GP informed about your management plan and subsequent progress.
Will All Of My Aftercare Be Performed At Illawarra Institute Of Obesity Surgery Or Will I Be Referred To Outside Practitioners?
As one of Sydney’s leading weight loss clinics, Illawarra Institute of Obesity Surgery directly employs all of the staff involved with your aftercare. You will not be referred away to see external dieticians, psychologists, or aftercare doctors. We feel it is our responsibility to provide all the aftercare needs of patients undergoing weight loss surgery. Furthermore, all of our practitioners are well trained and highly experienced in weight loss surgery, and know how to help you get the most out of your band or sleeve.
How Many Weight Lossweight Loss Procedures Have Our Surgeons At Illawarra Institute Of Obesity Surgery Performed?
Our surgeons have performed approximately 3000 bariatric (weight loss) procedures since becoming involved with weight loss surgery in 2004. This includes gastric banding surgery, sleeve gastrectomy surgery, revisional surgery, conversion from one weight loss procedure to another, and surgery on teenagers, older patients, and those with extreme obesity. He generally carries out between 8 and 12 weight loss procedures a week. Whilst weight loss surgery now forms the majority of his work, he continues to perform other types of advanced laparoscopic surgery on the abdomen, including anti-reflux surgery, gallbladder surgery, and hernia surgery.
Is Weight Loss Surgery Considered As Cosmetic Surgery By Medicare?
No- weight loss surgery has always been considered by Medicare as a genuine health intervention. Every surgical procedure that is supported by Medicare is listed in a large directory called the ‘MBS’ and each has its own unique Item Number. Weight loss surgery is no different- the Item Numbers for Gastric Banding and the Sleeve Gastrectomy are 31569 and 31575 respectively, meaning that Medicare will partially cover the costs involved. Furthermore, health funds will cover the hospital fees associated with any procedure that has an Item Number, including weight loss surgery (note that health funds usually offer different levels of access depending on your monthly premium). As is common with most procedures, there is usually an out-of-pocket gap that the patient must pay as the rebates from Medicare and Health funds are not sufficient to cover all the costs. For weight loss surgery, this gap is $5950, however the true total cost when bed stay fees, theatre fees, equipment and prosthesis charges, etc are considered is between $16,000- $18,000, which demonstrates the real and valuable contribution that Medicare and health funds make toward the cost of weight loss surgery. By contrast, cosmetic procedures do not have an Item Number, and do not attract any support from health funds or Medicare.
How Can I Find Out If My Health Fund Will Cover My Hospital Costs?
Contact your health fund and quote the Item Number for either the Gastric Band (31569) or the Sleeve Gastrectomy (31575) or the Gastric Bypass (31572). Sometimes it can seem a little difficult to get a straight answer! Patients often report being told that they will be covered up to the ‘Scheduled Fee’ or that ‘if Medicare will pay 75% then the health fund will pay 25%’, or ‘if the procedure has been recommended by a doctor for health reasons it will be covered’ etc. All of these responses mean that you are covered, and therefore your gap will be $5950(if you are still not sure, we can run a health fund check for you). Depending on your level of cover, sometimes a patient might be told they are only covered as a private patient in a public hospital- Don’t worry- if this affects you, our surgeons can perform your procedure in a public hospital as his private patient. There is no difference in the quality of the surgery or the aftercare, and your gap will remain $5950. If you are not covered at all because your level of cover is only basic, or covers ‘extras only’, then you have one of 2 options: either upgrade your cover and wait 12 months, or enter our program as an uninsured patient (conditions apply, call for a quote).
I Have ‘Top Cover’- Why Do I Still Need To Pay A Gap?
Unfortunately the full costs involved in providing quality medical care are not adequately covered by the Gap cover fee arrangement. Irrespective of your level of cover, most common surgical procedures performed in the private health system involve a gap payment. Weight loss surgery has even more costs, as multiple professionals are involved in your care such as dieticians and psychologists, and care by your surgeon needs to be lifelong. Although a gap is payable, at least you can feel confident in the knowledge that the anaesthetist and assistant surgeon fees, and all of your standard aftercare is included, and there will not be any further charges at any stage by Illawarra Institute of Obesity Surgery.
Will I Be In A Lot Of Pain?
Because both procedures are performed using laparoscopic (keyhole) surgery, pain after surgery is greatly reduced. However a sensation of chest tightness, a stitch feeling in the upper abdominal area (especially on the left side, up under the rib cage) and an ache in the left shoulder tip is quite normal, and will usually resolve in most patients within 3-5 days. This discomfort is generally not limiting however, and you will still be able to sit out comfortably and walk. You will be provided with adequate analgesia, both in hospital and after discharge, to make sure you are comfortable.
How Long Do I Have To Stay In The Hospital?
The vast majority of patients feel well enough to be discharged within 24 hours of the procedure- this usually means staying overnight in hospital. However everyone heals at different rates and surgery can vary in its complexity depending on a patient’s past medical history. You will be allowed home when you feel ready- no-one is ever pushed out of hospital.
How Many Incisions Will Be Needed?
The Gastric Band procedure involves 4 small incisions- the main one is hidden within the umbilicus (belly button) and is usually invisible, whilst the other 3 incisions are only 5mm long and are deliberately placed within your natural skin lines to minimise any visible scarring. The Sleeve Gastrectomy procedure involves 5 small incisions across the upper abdomen ranging in size between 5mm and 3cm. (the umbilicus is also used for one of these to minimise visible scars).The Gastric Bypass procedure involves a series of 6 small incisions between 5 and 10mm in length made on the abdomen. All skin wounds are closed with hidden absorbable sutures that do not need to be removed. All you will see when the dressings are removed is a neat line.
Will I Have A Surgical Drain, Nasogastric Tube, Or Urinary Catheter After The Surgery?
No. Surgical drains, nasogastric tubes and urinary catheters are not routinely used by our surgeons for gastric band or sleeve gastrectomy surgery. An intravenous drip in your arm is usually the only thing that you will have when you wake up. This is removed as soon as you are drinking enough fluids.
How Will I Feel When I Wake Up In The Recovery Room?
Although you will be awake in the recovery room, it is common to still feel a little drowsy. Our anaesthetists are here to ensure your comfort- and may use a variety of medication to make sure you are not in pain. Occasionally this may include a Patient Controlled Analgesia (PCA) or a self-administered pain management system. In addition, our surgeons routinely infiltrate all skin wounds with long acting local anaesthetic prior to making the incisions (this technique is called ‘pre-emptive analgesia’ and works by blocking the nerves before they are stimulated). Because your procedure is performed laparoscopically, any initial discomfort quickly passes, and virtually all patients feel completely awake, alert and able to have a normal conversation within an hour or two.
How Soon Will I Be Able To Walk?
As soon as you feel up to it. In fact we encourage you to get up and walk about the ward that afternoon- it helps avoid problems like blood clots and chest infection. On leaving the hospital, you should be able to care for all your personal needs, but may need a little help with shopping, lifting and transport for the first few days.
How Soon Can I Drive?
It is illegal to drive within 24 hours of a General Anaesthetic- therefore it is important that you arrange for someone to pick you up from hospital. Most patients feel ready to drive again after 3 days- however for your own safety; you should not drive until you have stopped taking any strong pain medications, and feel comfortable that you can break in a hurry.
What Is Done To Minimize The Risk Of Blood Clots (DVT Or PE)?
All patients receive a number of treatment measures to reduce the risk of blood clots- these include being given injections of heparin during and after surgery, special leg stockings (TEDS), and the sequential calf compressing device (SCD) whilst on the operating table. As a result of these measures we have never had a single patient develop a deep venous thrombosis at Illawarra Institute of Obesity Surgery.
Any patient who is at high risk of a blood clot (such as a history of blood clots or clotting disorders) may be asked to continue heparin (Clexane) injections for 10 days after the surgery in addition to the other measures. This can be done at home, and we will show you how.
Early mobilization is another major preventive measure- that’s why we will strongly encourage you to get moving and out of bed as soon as possible after the operation to restore normal blood flow in the legs. You should aim to do at least 10 short walks (of between 2 and 5 minutes) each day in the first 2 weeks after surgery.
What Should I Bring With Me To The Hospital?
A hospital representative will call you the evening before your admission and advise you on everything you need to know. Generally only a few things are required- personal toiletries and clothing for your stay that are easy to put on and take off. Don’t forget to bring any X-rays and other important medical documents that may be relevant to your surgery.
Will I Need Plastic Surgery For The Surplus Skin When I Have Lost A Lot Of Weight?
This happens very rarely. The skin has an amazing ability to remodel and shrink, it just needs time. As a rule, plastic surgery should not be considered for at least a year or two after the operation, as your skin usually continues to contract long after you have reached your goal weight. Most patients find that skin trimming surgery is not needed. Regular exercise and keeping well hydrated also helps remould your skin. If excess skin does persist, we can refer you to a plastic surgeon for an opinion.
A safe, non-surgical way of reducing excess skin is Thermage. Much like using an ultrasound probe over the skin, Thermage delivers radiofrequency energy to stimulate collagen remodelling. A single treatment is often sufficient, and it is particularly well suited to treating skin laxity under the arms, inner thighs, and abdomen. As well as being non-invasive, it is generally far less expensive than cosmetic surgery.
Click here to read more about Thermage.
How Long Will It Take To Recover After Surgery?
Patients having the gastric band generally recover more quickly than sleeve patients in the first few days after surgery, however by 2 weeks this difference has disappeared and both groups feel they have adequately recovered and are back at work. Gentle exercise such as walking can be restarted straight away, but you should wait 4 weeks before resuming swimming or more vigorous activities such as the gym or boot camp.
Patients recovering from gastric bypass surgery are encouraged to get out of bed and start walking by the next day. The hospital stay for patients who undergo the Roux-en-Y procedure is usually two to four days. Most patients are able to return to work in two to three weeks.
How Much Weight Will I Lose?
Our aim is to help patients lose between 60% and 100% of their excess weight (that is, the number of extra kilograms you are carrying over a BMI of 25). The final goal weight you reach depends on several factors including your build, body composition, sex and age. It also depends on how successful you have been in changing your dietary behaviours, lifestyle, and physical activity levels after surgery.
The reason why we set a minimum goal of achieving 60% excess weight loss is because this level of weight loss will lead to maximal improvement in any weight-related co-morbidities. In general, most patients having the sleeve gastrectomy will reach their goal weight by 12 months, whilst most patients will get there by 18 months with the gastric band. This roughly equates to losing between 0.5kg-2kg per week, depending on your starting weight.
Why Are Frequent Clinic Visits Necessary After Surgery?
The Illawarra Institute of Obesity Surgery total care program has been carefully designed to allow you to get the most out of you band- both in terms of weight loss and freedom from problems. As you lose weight, the amount of fat around your stomach will shrink, and your band will need to be adjusted in size to maintain the same feeling of hunger control. These regular visits will also provide an opportunity to check your band is functioning properly, and assist you with dietary advice and band support. Once your goal weight has been reached (usually around 18 months after surgery) your follow-up appointments can then be scaled back to yearly once.
Regular check-ups are a normal and a very important part of gastric banding follow-up. It is totally unethical for gastric banding surgery to be offered by any surgeon or clinic without also providing a clear and comprehensive aftercare program.
Is There Any Difference Between The Cost Of The Gastric Band And The Sleeve Gastrectomy And The Gastric Bypass?
No. Both of these procedures have the same out of pocket cost of $5950 provided you have private health insurance. For patients without private health cover, we have formulated a special package that may be more affordable than you think- conditions apply, so call us for details.
Is There Anything Not Included In The Program Fee?
At Illawarra Institute of Obesity Surgery we pride ourselves on being upfront and transparent with our costing- Our program fee covers all the necessary components of your treatment including the anaesthetist, assistant surgeon, dietician appointments, psychologist appointments, band adjustments, and unlimited clinic check-ups. We feel regular and ongoing multidisciplinary aftercare is important following weight loss surgery, and will not charge you any further costs for this. Furthermore, we guarantee the quality of our surgery- if corrective surgery is ever required down the track you will not be charged any further out of pocket costs by us. However it is strongly advised that an appropriate level of health insurance be maintained to cover any hospital costs.
QUESTIONS RELATING TO THE GASTRIC BAND
Is Gastric Banding Always Performed By Laparoscopic (Keyhole) Surgery?
Yes. Nowadays it is extremely rare to require conventional open surgery to perform gastric banding- indeed our surgeons have never had to convert to a major incision during a gastric banding procedure, even in patients who have had multiple previous abdominal operations. The benefits of laparoscopic surgery include less discomfort, shorter hospital stay, earlier return to work, less abdominal adhesions, and reduced scarring.
Does The Gastric Band Limit Any Physical Activity?
No. After the initial recovery period you are free to do any physical activity you choose including aerobics, stretching and strenuous exercise.
Will I Be Vomiting Or Have Nausea After The Operation?
Nausea or regular vomiting is not a normal part of life with a band. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. However, it could also mean that your band is too tight, or that it has slipped- we are here to support you so you should never hesitate to contact us if this problem persists. Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch.
How Is The Band Adjusted?
Adjustments are performed in our clinic by our doctors and surgeons. Occasionally they are done under X-ray but this is seldom necessary. Local anaesthesia is available but is usually not needed as the fine needle is passed through the scar (which is usually numb) over the access-port. When saline is added, the band becomes tighter, and vice versa. The process usually only takes a few minutes, and most patients say it is virtually painless. Whilst adjustments may be performed at any time, the majority are needed in the first 18 months or so, as the fat around the stomach diminishes.
Do I Have To Be Careful With The Access Port Just Underneath My Skin?
There are no restrictions based on the access port. It is placed well under the skin, on the outer layer of the abdominal muscles. It is usually invisible, and may even be difficult for you to feel. Once the incisions have healed it should not cause discomfort or limit
your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.
Can The Band Be Removed?
Yes. Although the gastric band is designed for long-term use, it is quite simple and quick to have it removed if desired (this will still involve a laparoscopic procedure and a general anaesthetic though). The stomach then generally returns to its original shape once the band is removed. This reversibility is a key advantage of the gastric band over other weight loss procedures, and appeals to many patients. If removed though, your hunger and appetite usually return to their previous level, and as a result you weight may then go back up.
Is It True That The Gastric Band Seems “Tighter” In The Morning?
Yes. This is a fairly common (and normal) feeling, especially for people with bands that are quite tight already, or just after an adjustment. During the daytime, the water distribution in the body moves with gravity toward the feet, but at night whilst sleeping this fluid is redistributed back to the rest of the body, including the stomach. When you wake up, the band feels tighter as your stomach wall has become slightly thicker. This is why many patients with a band don’t feel very hungry first thing in the morning. Some women have also noticed that the gastric band feels tighter during, or just before, menstruation as a result of fluid retention.
Will I Feel Hungry Or Deprived With The Band?
No. The band works by making you feel full and satisfied- in much the same way as you feel now after a meal, but achieves this with less food. Most patients say they actually enjoy their meals more. Taste is heightened, and food is now consumed for pleasure rather than to satisfy hunger. Bulk quantity consumption is replaced with quality eating.
Remember though that the band is a tool rather than a magic wand- you are still physically able to eat more than you need to if you ignore the feelings of fullness, and/or consume large amounts of liquid calories. We are here to help and guide you to allow you to get the most out of your band.
What Will Happen If I Become Unwell From Something Else?
One of the major advantages of the band is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline.
The band will allow you to comfortably drink plenty of fluids, so there should not be any risk of becoming dehydrated.
What About Pregnancy?
Becoming pregnant is often easier as you lose weight. Your menstrual cycle may become more regular, and reduced fertility due to Polycystic Ovary Syndrome improves. Pregnancy is also usually a lot easier after weight loss, and the risk of developing gestational diabetes and pre-eclampsia is reduced.
The adjustability of the gastric band is a key advantage over other weight-loss procedures for women who might become pregnant, as it can be loosened as the pregnancy progresses to allow sufficient calorie intake. After the pregnancy, the band may be made tighter again, and you can resume losing weight. At OClinic we have a number of patients who are pregnant, and are familiar to adjusting the band appropriately. We will correspond with your obstetrician and GP throughout.
Will I Need To Take Vitamin Supplements?
The gastric band does not cause malabsorption of nutrients- another advantage over other weight loss procedures. However we do recommend taking a daily multivitamin tablet to ensure you still receive your daily vitamin and mineral requirements given that you will be eating less.
What About Other Medication?
You will still be able to take prescribed medication. Large tablets may need to be broken in half or dissolved in water so they do not get stuck, however most of the common tablets for high blood pressure, diabetes, etc are fine.
What If I Go Out To Eat?
Eating out is no problem with a gastric band. Order only a small amount of food, such as an entree. Eat slowly, and don’t forget to chew well. Finish at the same time as your table companions. Never feel compelled to eat the same amount of food as the others.
Can I Still Enjoy A Glass Of Wine?
Gastric banding is all about achieving better quality of life- A glass of wine with a meal is for many people a quintessential part of living well, and there is no reason why you cannot continue to enjoy this. An occasional glass of wine or other alcoholic beverage is not considered harmful to weight loss. Moderation is the key- just be aware that alcohol contains a high number of calories.
Can I Eat Anything In Moderation?
The aim of the gastric band is not to reduce your range of food choices, just the quantity you need to feel full. Provided you chew well and eat slowly, band patients can eat almost anything. There is a couple of problem foods- fresh white bread and chewy steak can get stuck, and are probably best avoided. However wholemeal bread, toast, crackers, soft red meats, mince, chicken, fish, pasta, rice, salads, etc, are generally fine for most patients. Just ask our dieticians- we’re here to help.
Be aware that liquids and soft foods that are high in calories including chocolate, ice cream, milk shakes, soft-drinks, etc slip past the band very easily, and do not provide the same sense of satisfaction that solid foods do. Your weight loss may be greatly reduced or cancelled if you regularly consume these types of foods. We encourage you to eat real solid food, which will provide the best results.
Will I Be Constipated?
No. However you may notice some reduction in the volume of your stools, which is normal after a
decrease in food intake because you are eating less. It is important to maintain adequate fibre intake, and our dieticians will assist you in this. We recommend taking soluble fibre such as Benefibre in the liquid phase after surgery to help maintain normal bowel movements. If difficulties do arise, just let us know.
Will I Still Be Able To Eat Whilst Flying In A Plane?
As the band is filled with saline rather than air, it shouldn’t change in size with altitude. However in practice a few little bubbles often get inside the band, and these may expand temporarily. It’s usually not enough to be noticeable, but sometimes the band can feel a bit tighter whilst flying. Either way everything returns to its normal size once the plane descends. Airline travel in general becomes more comfortable however as fitting into seats, overcoming jet-lag, and moving about the airport carrying luggage becomes far easier.
QUESTIONS ABOUT THE SLEEVE GASTRECTOMY
What Is The Main Difference Between The Sleeve Gastrectomy And The Gastric Band?
Whilst they both help control hunger and portion size, the Band uses a ring-shaped implanted device to do this, whilst the Sleeve involves removing part of the stomach to make it smaller.
How Long Has The Sleeve Been Around?
The sleeve has been performed worldwide over the past 6 years. It was initially developed as the first part of another weight loss operation called the ‘Duodenal Switch’. High risk patients would have the sleeve part performed as a first stage operation, and then return for a second operation at a later date to complete the duodenal switch, in the belief that this staged strategy would lower their chance of complications. When it was observed that many of these first stage patients lost large amounts of weight without requiring the additional stage, the Sleeve Gastrectomy became a stand-alone weight loss procedure. Since then it has been further refined and studied, and has now become the fastest growing type of weight loss procedure in Australia and around the world.
Could There Be Any Long Term Dangers Of Having Part Of The Stomach Removed?
Whilst the sleeve operation for obesity is still relatively new, similar operations that involve the removal of part or all of the stomach have been performed for over 100 years for conditions such as cancer, benign lesions, and stomach ulcers. We have learnt from these operations that a person can survive perfectly well without part of their stomach. Because the lower part of the stomach (the Antrum) is kept during the Sleeve Gastrectomy procedure, vitamin B12 absorption is maintained, and Iron, Calcium and folate levels remain unaffected. There is no risk of malabsorption with the Sleeve, and every nutrient that is consumed will travel through the gastrointestinal tract normally. A single daily multivitamin is recommended however as you will be eating less food. It’s also a good idea to check that your essential vitamin and element levels remain normal by having an annual blood test.
Could The Stomach Sleeve Stretch Over Time?
Yes- the stomach does have a tendency to stretch, particularly if a person regularly tries to eat more than can be comfortably held. This is a longer term problem rather than something that is seen in the first few years. It is important that a person having the sleeve gastrectomy respects their new smaller stomach and avoids overeating. As with all weight loss procedures, there is a need to complement the surgery with changes in eating behaviours, lifestyle, and exercise levels. The chances of the sleeve stretching are greatly reduced when a patient works with their sleeve as a tool, maintains regular contact with the clinic, and makes a genuine attempt to improve diet and lifestyle. However, in the event of a significant increase in the stomach capacity over time, there are a number of rescue procedures that have been proposed to make the stomach smaller again. These include re-sleeving the stomach, using sutures to reduce the stomach, placing a Gastric Band around the top, or converting to a Gastric Bypass procedure. The relative merit of these various approaches is currently under study.
Is The Sleeve Reversible?
No- because part of the stomach is removed from the body, the sleeve operation cannot be reversed. Many patients are actually attracted to the sleeve because of this, as they feel it represents a more permanent solution to their weight problem.
How Quickly Is The Weight Lost With A Sleeve?
Generally weight is lost more quickly after the sleeve- at approximately 1-2kg per week. Most patients reach their goal weight within 9-12 months.
Do The Staples Used In The Sleeve Cause Any Problems?
No, the staples are completely safe. The staples used in the sleeve procedure are the same as those used in a variety of other common procedures such as operations on the colon and lung, and have been used for over 50 years. Indeed, they are essential to the sleeve procedure- it would not be possible to perform the sleeve procedure without surgical stapler technology.
Will The Staples Activate Airport Security Metal Detectors?
No. The staples used in the sleeve procedure are way too small to activate airport and security metal detectors. They can barely be seen on a medical X-ray.
Will I Be Able To Get Enough Nutrition If I Fall Pregnant After The Sleeve?
Yes- although the sleeve will only accommodate about a cup of food at each meal, the easy way to increase your calorie intake during pregnancy is by having more frequent meals- between 4- 6 per day. This will ensure you have enough nutrition during pregnancy. Our dieticians will advise and help you with this.
QUESTIONS ABOUT THE GASTRIC BYPASS
What Is Gastric Bypass Surgery?
Gastric Bypass surgery is a restrictive/malabsorptive surgical procedure. It is restrictive in the sense that it “restricts” how much food the stomach can hold and is “malabsorptive” in that it affects how food and calories are absorbed into the bloodstream. This combination surgery has the highest success rate for amount of weight lost.
How Is The Surgery Performed?
The surgeon makes the stomach smaller by creating a small stomach pouch by stapling along the upper part of the stomach. A new opening from this pouch is created as well. The small intestine is then cut into two sections. The lower section of intestine is attached to the opening in the stomach pouch creating what is referred to as the “roux limb”. The upper section of the small intestine which carries digestive juices from the remaining portion of the stomach is attached at the distal end of the roux limb. The roux limb enables food to bypass the lower stomach, duodenum, and a portion of the small intestine.
How Much Weight Will I Lose?
Studies have shown that gastric bypass patients can lose up to 90 percent of their excess body weight. 75% of patients will lose 75-80% of their excess body weight after surgery.
What Can I Expect After The Surgery When I Eat?
You will only be able to eat a few ounces of food at a time. You will not be able to drink and eat at the same time as your new stomach will not be able to hold both. You will also have to concentrate on eating slower and chewing your food thoroughly. You wil also have to avoid certain sugary foods as these can lead to “dumping syndrome”.
What Is Dumping Syndrome?
Dumping syndrome happens when the food you eat passes too quickly through your new GI tract causing diarrhea, shakes, sweats, and other unpleasant symptoms. Dumping syndrome can be avoided by not eating sugary foods such as candy, juices, sodas, and other foods high in simple sugars.
What Are The Advantages Of Gastric Bypass Surgery?
Advantages of Gastric Bypass Surgery includes:
- Quick and dramatic weight loss
- Continued weight loss for 18-24 months post surgery
- Many patients maintain a weight loss of 60-70% of excess weight 10 years post-op
- Improved health problems associated with severe obesity such as Diabetes, high blood pressure, arthritis , asthma and sleep apnea.
- Many patients are able to stop taking medications for diabetes and hypertension as a result of the weight loss.
Improved mobility and quality of life and self esteem.
What Are The Disadvantages Of Gastric Bypass Surgery?
Disadvantages of Gastric Bypass Surgery include:
- Major surgery with serious risks
- Malnourishment and anemia may occur requiring lifelong vitamin and mineral supplementation.
- Requires permanent lifelong changes to patient’s diet and lifestyle
- Increased risk of gallstones due to rapid weight loss
- Dumping syndrome: nausea, reflux, diarrhea can occur after ingesting high sugar foods