Obesity is a major health issue that contributes to the development of many life-threatening or disabling health conditions. While bariatric surgery has been around for well over 60 years, it has progressed from an experimental, unconventional procedure to a safe, standard of care treatment for morbid obesity. The concept of a simple weight-loss-surgery is outdated, and is now seen as life-changing metabolic surgery.
Bariatric surgery in Southwest Virginia
LewisGale Medical Center offers a comprehensive bariatric and weight loss surgical program that includes an individualized treatment plan, pre-surgery preparation, post-surgery education, and long term follow-up care. Our multidisciplinary team consists of a bariatric surgeon, dietician, psychologist, nurses, and other clinical members who are here to support you through your entire journey.
Bariatric surgery can often have positive, benefits on numerous medical conditions, previously controlled and managed but never cured such as diabetes, high blood pressure, acid reflux, high cholesterol, arthritis, and obstructive sleep apnea. After surgery, patients can often lower or discontinue medications and treatments for these medical conditions. With less weight, a patient’s heart and lungs do not have to work as hard, improving overall quality of life.
Bariatric surgery is not for everyone, but if your BMI is over 40 and you have the above conditions, your life could be changed forever. We are here for you.
To learn more about our minimally invasive bariatric surgery options, please call (540) 772-3620
What to expect pre- and post-surgery
Your weight loss journey begins with you, under the supervision of a physician, first trying to lose weight by other means. If unsuccessful, then we consider surgery. All patients go through several months of preoperative classes and training. This will include visits with your surgeon, nursing staff, bariatric dietitians, and trained psychologists. During this process, all patients are expected to lose weight. Patients will receive medical clearance appropriate to their health.
Patients remain on a liquid diet for two weeks prior to surgery, and four weeks afterwards. The anticipated hospital stay is one day, overnight. Patients are usually walking within hours of surgery, sipping on ice chips. The next morning we will resume the liquid diet which consists of protein shakes and non-caloric liquids. Patients are typically discharged that first post-operative day in the late afternoon.
The first follow up visit will be 7-10 days later. Follow up visits will continue at 4 weeks, 6 weeks, 3 months, 6 months, and yearly. Patient will be encouraged to eat well, exercise regularly, take their vitamins properly, and follow up long term.
Our surgical treatments
With the multitude of surgery options available, customized plans are designed to inspire the best possible results. All surgical treatments are performed laparoscopically using minimally-invasive procedures that result in shorter hospital stays, faster recovering, and less pain.
- Gastric bypass
- Gastric sleeve
- Adjustable gastric banding
The gastric bypass remains the gold standard in modern weight loss surgery. It comes in many forms, but the Roux-en-Y is by far the most common and well-studied. In this operation, the surgeon cuts the stomach, completely dividing it, forming it into a one-ounce pouch. The small bowel is divided and the roux limb is brought up and connected to this pouch. Food therefore bypasses the remainder of the stomach and the first portion of the small bowel. The proximal cut end of the small bowel is then connected to the roux limb forming a ‘Y’. This allows all the digestive juices from the stomach, liver, and pancreas to meet up with the food and digest it.
Patients lose an average of 75% of their excess weight in the first year. Acid reflux is cured immediately and diabetes resolution is about 90%. All the weight-related comorbidities resolve as weight is lost.
The operation, as all the others, is done laparoscopically. Pain is minimal and goes away quickly. Patients typically stay one day (overnight) in the hospital and may return to normal activities and work usually within a week or two.
The Vertical Sleeve Gastrectomy, or Gastric Sleeve, is a newer operation that has gained popularity and commonly performed today. Laparoscopically, the stomach is divided with staplers in a vertical fashion to create a tube-shaped organ. The pressure within the tube is fairly high and food moves through it quickly. The remainder of the stomach is removed through one of the small incisions, and the operation is complete. There are no devices to manage, and no bowel connections to be made. The operation is relatively simple and its effect is profound. These patients lose all sense of hunger and practically have to remind themselves to eat or they will forget. And when they do eat, they get satisfied very quickly and stop eating.
Patients on average will lose 60-70% of their excess weight in the first year, and if they maintain the right habits, will keep that weight off. Diabetes resolution is very high. Other weight-related comorbidities resolve with weight loss. Some motivation is required as patients need to eat and drink properly even without the sense of hunger or other motivations to do so. Acid reflux may worsen, so careful patient selection is important.
Bariatric revision surgery
Although bariatric operations are somewhat standardized today, this was not always the case. Sometimes it is necessary to convert one operation to another, or more commonly, revise an operation due to complications or unforeseen circumstances. This type of surgery can be quite complicated, and experience is necessary to achieve the best outcomes.
Gastric banding has been around for a long time and has gone through many revisions over the years. A small device is placed in the abdomen and wrapped around the top of the stomach. It is sutured in place and connected to a tube, which is connected to a port. The port is sutured to the abdominal muscles, underneath the skin, and accessed with a needle. With small injections of saline, made over time, the band can be tightened or loosened. The intended effect is to provide patients with a sense of satiety (satisfaction) eating small meals. If patients eat small meals consistently, along with progressive exercise, they will slowly lose weight over time.
The band does not restrict patients from eating larger meals or snacking slowly throughout the day, and it does not help patient choose their foods wisely. It takes extreme motivation and discipline to make the band work. While gastric banding is performed laparoscopically, gastric bypass and sleeve procedures are performed more commonly as today’s gold standards.
Life after bariatric surgery
Life after bariatric surgery is not easy. Far from it, but well worth it. The first few weeks after surgery, patients are adjusting to their new stomach anatomy and have to remain on a carefully controlled liquid diet. Their activity quickly advances back to normal. They may take a week or two off from work, but there is very minimal pain after a few days and there are no restrictions in activity for the motivated patient.
After a few weeks, we advance the diet to soft foods, which may include tuna salad, egg salad, lunch meat, eggs, cheese, and yogurt. Over the next few months we advance to normal foods – mostly meat, small amounts of cooked vegetables, and very little else. Patients are encouraged to eat their small meals slowly and regularly, even though they are not hungry, and minimize snacking. Exercise is also encouraged.
Patients who do this faithfully will lose about two-thirds to three-fourths of their excess weight in the first year after surgery. Along with this weight loss comes resolution of medical conditions such as diabetes, hypertension, acid reflux, and obstructive sleep apnea. Quality of life improves and patient satisfaction is excellent.
Vitamins and minerals
After surgery, we’ll also recommend a regimen of vitamin supplements. Types and dosage instructions will be provided in your own personal notebook.
Liquid diet recommendations
You’ll also receive written instructions for your pre- and post-surgery liquid diet.
Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.
Your BMI Score is:
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