Weight Loss Surgeries
Obesity remains a growing concern globally, affecting millions in America and posing a significant risk for various chronic conditions. While diet and exercise are commendable efforts to lose weight, such changes may seem like an uphill battle for individuals struggling with severe obesity. That’s not to mention the frustration and body image struggles that accompany slow progress and weight plateaus.
At RMC, we acknowledge that some patients require a more permanent solution for sustained weight loss. As part of our bariatric surgery program, we offer a range of interventions specifically designed to promote weight loss and improve overall health outcomes for patients with obesity. Our commitment to patient-centered care means we take the time to understand your specific health profile, lifestyle, and weight loss objectives, guiding you toward the most appropriate surgical option.
Exploring & Comparing Types of Bariatric Surgery
Bariatric Surgery (also known as metabolic surgery) comprises various surgical procedures to address obesity and weight-related health problems. Here are some of the bariatric surgeries available to shed excess weight.
Also known as Roux-en-Y gastric bypass, this is one of the most common bariatric procedures, achieving substantial long-term weight loss and improving obesity-related conditions such as type 2 diabetes, high blood pressure, and obstructive sleep apnea. The surgeon designs a stomach pouch that directs straight to your small intestine, bypassing a large portion of the stomach and the opening section of the small intestine and reducing the volume of food you can consume and retain.
Benefits:
- Most effective for long-term weight loss, often exceeding 60% excess body weight.
- Offers significant improvement in weight-related health conditions (e.g., type 2 diabetes, hypertension, and sleep apnea).
- Reduces hunger hormones, increasing satiety after smaller meals.
Suitability:
- It is ideal for patients who have a very high body mass index (BMI) of 45+ or those with severe sleep apnea and uncontrolled heartburn.
- Suitable for individuals who have struggled with weight regain after trying other treatments like weight loss medications.
Considerations:
- More complex surgery with a longer recovery time compared to other procedures.
- Requires lifelong vitamin and mineral supplementation.
Otherwise called gastric sleeve surgery, this procedure shrinks the stomach by around 75-80%, leaving a tube-like structure. The smaller stomach restricts food intake and suppresses the hunger hormone ghrelin, which helps manage your appetite. The gastric sleeve is less complex than gastric bypass since it doesn’t involve rerouting the digestive system, making it a preferred choice for anyone seeking significant weight loss and improved metabolic health.
Benefits:
- It’s a less invasive surgery with a shorter hospital stay and faster recovery than gastric bypass.
- Effective weight loss procedure, often achieving 40-50% weight reduction.
- It may improve type 2 diabetes by regulating blood sugar levels and reducing insulin resistance.
- It suppresses appetite by reducing the production of ghrelin, the hunger hormone.
Suitability:
- A good option for patients with lower BMIs (40-45) or those at higher surgical risk.
- It may be preferable for individuals with the motivation to maintain lifestyle changes alongside surgery.
Considerations:
- It may require stricter dietary control to maintain results.
- Increased risk of gastroesophageal reflux disease (GERD) for some patients.
Revision surgery involves modifying or correcting the original procedure to enhance its effectiveness or to address issues such as staple line leaks, slippage of an adjustable band, severe reflux, and other complications.
On the other hand, conversion surgery changes the original bariatric procedure to a different type of surgery when the initial surgery fails to provide the desired results or the patient experiences severe complications.
Robotic Bariatric Surgery
We can use robotic-assisted surgery technology for many bariatric procedures (e.g., sleeve gastrectomy and gastric bypass). Watching through a tiny camera, our surgeons operate through small incisions using robotic arms, which provide enhanced dexterity and visualization. This technology allows for more accurate tissue manipulation, lower risk of complications, and swifter recovery.
Determining the Right Surgical Option for You
Choosing the right bariatric surgery involves a thorough evaluation by a medical professional. Here are several factors to guide your doctor’s decision.
Medical History and Current Health Status
Certain medical conditions can create more risk factors for some procedures. For example, if you have a history of severe gastroesophageal reflux disease (GERD), a sleeve gastrectomy may not be the best option, as it can worsen reflux symptoms.
Additionally, past abdominal surgeries might influence the choice of bariatric surgery due to potential complications and scar tissue that make it more challenging for surgeons to navigate the surgical site.
Your BMI is also a factor—higher BMIs might necessitate more extensive procedures like gastric bypass or BPD/DS for significant weight loss.
Weight Loss Goals and Expectations
Bariatric procedures offer varying degrees of weight loss. For instance, gastric bypass and BPD/DS generally result in more substantial weight loss than sleeve gastrectomy or adjustable gastric banding.
Additionally, consider how quickly you aim to achieve your weight loss goals. For example, gastric bypass offers more rapid results than the adjustable gastric band, which leads to more gradual weight loss.
Lifestyle and Commitment
Evaluate your readiness to commit to a structured eating plan. This plan involves transitioning from a liquid diet to pureed foods and eventually to solid foods, with lifelong portion control and healthy eating habits.
Additionally, consider your willingness and ability to engage in a regular exercise program post-surgery. You must adhere to follow-up care to monitor your progress, nutritional status, and potential complications. Some surgeries require more frequent follow-ups than others.
Insurance and Financial Considerations
Contact your insurance provider to understand what bariatric surgeries your plan covers. Coverage often depends on meeting specific criteria; for example, you should prove that you have failed weight loss efforts after diet and exercise.
But even with insurance, there may be out-of-pocket costs, including co-pays, deductibles, and expenses for pre-surgery evaluations and post-surgery follow-ups.