OPERATIVE PROCEDURE

OPERATIVE PROCEDURE





Gastrostomy tube
Q: Which procedure do you prefer to use?

A: Open vertical gastro- plasty, Silastic ring banded, Roux-en-Y Gastric By-Pass.

Q: Do you offer more than one type?

A: One type is done. There are three variations.

  1. Open
  2. Open with Panniculectomy
  3. Laparoscopic
Q: Is the surgery chosen for me reversible?

A: Yes; however there would be the potential for total weight regain.

Q: Do you separate the unused stomach?

A: Yes.

Q: How small will my stomach be after surgery?

A: The size of your thumb.

Q How much small bowel is by-passed?

A: 3 feet.

Q: Does this procedure include a Silastic ring?

A: A Silastic ring is used for both open and laparoscopic procedures.

Q: Do you have a policy for gallbladders?

A: Yes; all gallbladders are removed.

Q: Do you regularly use a gastrostomy tube?

A: Yes.

Q: How is the skin closed after surgery?

A: By a non-visible dissolving suture.

Q: How long does the operation take?

A: One and one-half to three hours. The procedure is longer by about two hours if a panniculectomy is also done.

Q: Are any other procedures done at the time of surgery?

A: The lower abdominal fat pad (Pannus) is removed in 20% of patients, gallbladder removal is common. An occasional umbilical hernia is repaired.

Q: Is further cosmetic surgery required?

A: About 5% of patients elect to have plastic surgery. The amount of loose skin depends on the total weight lost and the person''s age.

Q: How is pain relieved?

A: By intravenous, patient-controlled pain medication. This is usually needed for thirty-six to forty-eight hours.

Q: Does narrowing (stenosis) of the intestinal connections occur following obesity surgery?

A: Narrowing is sometimes experienced in the immediate post operative period due to persistent swelling at the site of the bowel healing. It usually resolves as healing progresses.

Q: Is stretching of the narrow part of the bowel required?

A: Stretching is required in a small number of patients. Most of these patients will require only one outpatient treatment.

Q: What is the long term success of this clinic''s patients?

A: 95% of patients lose greater that 50% of their excess weight and maintain this benefit.
85% of patients lose greater that 75% of their excess weight.
20% of patients achieve their "ideal weight".

Q: Is there a "dumping" with this particular surgery?

A: Yes, sugars, either natural or artificial are likely to cause symptoms. Some spicy foods may cause discomfort. It has been observed that eating too quickly can sometimes cause marked pain.

Q: How does the Silastic Ring Gastroplasty and Roux-en Y Gastric by-pass work?

A: The surgery provides a small stomach pouch that limits the amount one can eat by by-passing the major portion of the stomach. The feeling of fullness originates in the small pouch.

The ring prevents some food from passing through the small pouch into the intestine too quickly. This prolongs comfort and improves digestion.

The by-passed small bowel limits the absorption of certain foods especially sugars and fats. If sugars are present in the diet, the person will experience unpleasant symptoms.

PANNICULECTOMY (TUMMY TUCK)

The stretching of fat stores in the lower half of the abdomen cause a sagging of the skin (pannus).

The removal of this "apron" is able to be done at the same time as the Gastric by-pass in most patients.

A person who continues to smoke prior to surgery is not a candidate for this surgery. There is an additional charge for this procedure as it is not covered by insurance.

The weight of skin and fat removed varies in relation to the patient''s initial size. There is a moderate increase in the risk of infection with this added surgery.