The most important step in weight loss surgery is getting all of the information you need about the various surgical options. Ultimately, Dr. Scott and other physicians are your best resource for information about the procedure they will recommend to you. When you ask a question, make sure you understand the answer. Do not hesitate to ask for a clearer explanation given in simpler language. The decision to have a weight loss surgical procedure may take several visits to their office and consultation with more than one doctor. Ask Dr. Scott or Ginger Deems for names of other patients who have had similar procedures and who are willing to discuss their experiences, good and bad, with you.
You may choose to research weight loss surgery on your own via the Internet or through your local library. As with any search for medical information, be sure that your sources are responsible recognized experts in the field you are investigating. An excellent resource for weight loss surgery is the American Society for Bariatric Surgery (www.asbs.org) or www.bariatricedge.com.
Although the results of weight loss surgery can be drastic, there are potential risks and complications. Before making your decision, you should be well informed. These steps are necessary if you are to give what is called "informed consent" for the procedure. Informed consent is a legal term meaning that a patient agrees that they have received and understood enough information about a procedure's benefits and risks to allow them to make a decision that is right for them. Dr. Scott will require you to sign a consent form before performing your procedure. Before you sign a consent form, you should have a solid understanding of what is about to take place. You should know what you would need to do to live well after the operation. And you should be aware of the signs or symptoms of complications to look for which may occur after your surgery.
For the last decade, laparoscopic procedures have been used in a variety of general surgeries. Many people mistakenly believe that these techniques are still "experimental." In fact, laparoscopy has become the predominant technique in some areas of surgery and has been used for weight loss surgery for several years. Although few bariatric surgeons perform laparoscopic weight loss surgeries, more are offering patients this less invasive surgical option whenever possible.
When a laparoscopic operation is performed, a small video camera is inserted into the abdomen. The surgeon views the procedure on a separate video monitor. Most laparoscopic surgeons believe this gives them better visualization and access to key anatomical structures. We are proud to offer the most advanced and integrated operating suites available today to perform your surgery with increased clarity and precision. We were the first site in the Southeast to offer high-definition laparoscopy technology.
The camera and surgical instruments are inserted through small incisions made in the abdominal wall. This approach is considered less invasive because it replaces the need for one long incision to open the abdomen. A recent study shows that patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels. Other realized benefits with laparoscopy have been fewer wound complications such as infection or hernia, and patients returning more quickly to pre-surgical levels of activity.
Laparoscopic procedures for weight loss surgery employ the same principles as their "open" counterparts and produce similar excess weight loss. We generally begin all of our procedures laparoscopically with the intent of completing the operation with the less invasive approach, but ultimately we will perform the safest operation even if that requires a large incision. The American Society for Bariatric Surgery recommends that laparoscopic weight loss surgery should only be performed by surgeons who are experienced in both laparoscopic and open bariatric procedures. Dr. Scott has completed a prestigious fellowship in Advanced Laparoscopy and Bariatrics and remains active in teaching others laparoscopic technique.
In recent years, better clinical understanding of procedures combining restrictive and malabsorptive approaches has increased the choices of effective weight loss surgery for thousands of patients. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat.
According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for weight loss surgery. It is one of the most frequently performed weight loss procedures in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the small intestine, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the "Y" shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.
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Laparoscopic Adjustable Gastric Banding is a restrictive surgery where a silastic band is used to section off a part of the stomach, creating a pouch. Because the stomach pouch is so small, the amount of food one can eat is limited. Food continues to be digested through the normal digestive and absorption process. The patient must eat small, sensible meals but the band helps the patient achieve this goal.
In this procedure, a band is placed around the uppermost part of the stomach, separating the stomach into one small and one large portion, slowing the emptying of food, and thus creating a feeling of fullness. In this procedure, the band can be adjusted to increase or decrease restriction by changing the amount of fluid within the band using an adjustment port that is left hidden beneath the skin.
Advantages
Lowest mortality and complication rateDisadvantages
More information is available at www.lap-band.com
There are several other weight loss surgery options available but we feel that the Roux-n-Y Gastric Bypass and the Lap-Band are the two safest and most established options and therefore we do not routinely offer any other options. Listed below are animations of some alternative and we can facilitate educating you more on these options on an individual basis by contacting our office.
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| Vertical Banded Gastroplasty | Biliopancreatic Diversion | Distal RNY Gastric Bypass | Duodenal Switch |