Procedures

Weight Loss Surgery

Surgery is an option for patients with severe obesity (BMI  equal to or greater than 40 kg/m² or BMI equal to or greater than  35 kg/m² with significant risk factors). Prior to using that option, other non-invasive methods of treatment must have been tried without success.

Two types of procedures have been proven to be effective:

• those restricting gastric volume like banded gastroplasty, and
• those, like the "Roux-en-Y Gastric Bypass", affecting digestion in addition to restricting food intake.

Types of Surgery

There are several types of restrictive and malabsorptive procedures. Each one carries its own benefits and risks.

The restrictive procedures include:
- the Adjustable gastric banding (AGB) and
- the Vertical banded gastroplasty (VBG).

The malabsorptive procedures include
- the Roux-en-Y gastric bypass (RGB) and
- the Biliopancreatic Diversion (BPD).

The BPD is used less frequently because of increased risks. The Roux-en-Y gastric bypass is the most widely performed weight-loss procedure in the United States.

At Echelon Bariatric, we specialize in the Laparoscopic Approach.
 

Laparoscopic Roux-En-Y Gastric Bypass

The Roux-en-Y Gastric By-Pass designed for the treatment of Morbid Obesity has proven over the years to be beneficial for its restrictive effect as well as its malabsorptive potential. It accomplishes a dual function by decreasing the size of the stomach to just about a 50cc capacity gastric pouch, and by reducing the surface of absorption of the small bowels.

The procedure can be performed by the open technique thru a full thickness midline abdominal incision, as well as by the Laparoscopic approach. With the latter, the abdomen is accessed thru 5 small ports or incisions of 1-2 cm each, placed above the umbilicus and 2 each on the right and the left side of the abdominal wall. The belly is insufflated, in order to provide adequate working space. The surgeon’s vision is facilitated by a light source provided thru a scope, which is mounted to a camera. The operative field is therefore reproduced to a video screen.

The procedure will be carried out with several specific instruments designed for that purpose, including some stapling devices, reinforced by special suture techniques.

The stomach is shortened, and the small bowel course rearranged for the goal in perspective.

The advantages of the Laparoscopic technique are multiple.

• It is foremost better tolerated, even on less healthy patients, with no significant alteration of their vital functions.

• The fluid shift usually associated with open surgery is non existent. Therefore the fluid balance is well maintained, and there is no need for excessive fluid replacement.

• Very little pain and discomfort is reported. Therefore the need for post-operative narcotics is significantly reduced.

• The recovery is hastened, as supported by a short hospital stay, a quick resumption of normal activities, decreasing the loss of workdays.

• The scope of complications is markedly reduced, since the surrounding organs are less likely affected. The vision is also much greater.

• The incidence and the magnitude of wound complications are down.

The weight loss is as impressive, and much more appreciated, since it does take place with the feeling that you have not miss a beat.

The Risks

In medicine, even the simplest procedure is associated with risks. At Echelon Bariatric of South Jersey, your education is our first priority. The Surgeon and the members of the TEAM will take extra time to discuss every single aspect of your care, by providing advanced information and answering all your questions, in order for you to make an informed decision.

After the Procedure

Compliance to your dietary adjustments and integration of a proper exercise program are crucial to the success of your experience. Weight loss surgery requires lifelong medical surveillance with special attention to your nutrition.