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Specialty Procedures:
- Types of Weight Loss Surgery
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Additional Information:
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Specialty Procedures:
Types of Weight Loss Surgery Performed at Brigham and Women's Hospital
Our surgeons perform two types of surgeries: adjustable gastric banding, also known as the Lap-Band®, and the Roux-en-Y gastric bypass, also know as just "gastric bypass." These surgeries have been endorsed by the National Institutes of Health as appropriate for the surgical treatment of obesity.
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Roux-en-Y Gastric Bypass
This operation is the most common procedure preformed by our surgeons. It combines creation of a small pouch at the top of the stomach and sewing the new pouch to a lower segment of small intestine. Food enters the small stomach pouch and immediately empties into the small intestine, thereby bypassing the majority of the stomach as well as the first several inches of the small intestine. This procedure causes patients to loose weight by two mechanisms. The first is by eating less food and the second is by absorbing less of the food that is eaten.
Laparoscopic Adjustable Banding (LAP-BAND)
The LAP-BAND is an Adjustable Gastric Banding System that induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed. The lap band is considered a "restrictive operation."
Surgeons usually use laparoscopic techniques (using small incisions and long-shafted instruments rather than a large incision), to implant an inflatable silicone band into the abdomen. Like a wristwatch, the band is fastened around the upper stomach to create a new, tiny stomach pouch that limits and controls the amount of food you eat. It also creates a small outlet that slows the emptying process into the stomach and the intestines. As a result, patients experience an earlier sensation of fullness and are satisfied with smaller amounts of food. In turn, this results in weight loss.
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Pre Operative Evaluation
Patients meet with a surgeon who specializes in "Bariatric Surgery." Bariatric surgery is surgery for treatment of morbid obesity. Surgeons who specialize in this field are experts in the pre-operative, surgical, and post-operative management of patients requiring obesity surgery. The surgeon will discuss both surgical and medical treatment options for weight loss, tell you if surgery is appropriate for you, and review the procedure as well as the risks and benefits of surgery. All patients being considered for surgery must meet with a Dietitian, Psychiatrist and Anesthesiologist prior to surgery. Some patients may also need additional tests prior to surgery such as an ultrasound of the gallbladder if it has not been removed; an ultrasound of the heart if there is a history of heart disease or use of weight loss medications such as fen/phen, fenfluramine, or Redux; a sleep study test if there is a history of difficulty with breathing while sleeping; a chest x-ray; and various blood tests. Additional tests may also be required depending on a patient's medical history.
Hospital Stay
Uncomplicated patients are routinely discharged on the third day after surgery and the vast majority of patients stay in the hospital for 5 days or less. During the hospital stay, the diet is advanced to include liquids and softer foods. At the time of discharge, patients are generally able to walk, care for themselves, and eat and drink.
Post Operative Course
Patients should expect to be out of work for 4 to 6 weeks. During this time, there is follow up with the surgeon as well as one of the dietitians. The first office visit with the surgeon will be about 7 to 10 days after your surgery. There is a specific diet which starts with liquids then progresses to certain solid foods such as egg beaters, cottage cheese, yogurt, and diced chicken and fish. It is strongly encouraged that patients attend our post-surgical support group, which meets twice a month. Laboratory tests are done to make sure there are no vitamin or mineral deficiencies or other concerns. The surgeon continues to see patients on a regular basis to monitor progress. Maximal weight loss occurs 12 to 15 months after surgery. After this period, it is recommended that there are annual follow-up visits with your surgeon.
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