The Bariatric Surgery Program

Types of Bariatric Surgery offered at
Monmouth Medical Center

Roux-En-Y Gastric Bypass
According to the American Society for Bariatric Surgery and the NIH, roux-en-y gastric bypass is the current gold-standard procedure for weight-loss surgery. One of the most frequently performed weight-loss procedures in the United States, it is surgery that significantly reduces the amount of food that can be eaten at one time, and somewhat reduces the amount of calories and nutrients the body absorbs, thus creating a restrictive and malabsorptive approach to losing weight. In this procedure, surgical “stapling” creates a small stomach pouch. The remainder of the stomach is not removed, but is completely stapled and shut and divided from the stomach pouch. Ultimately, the “old” stomach and the first portion of the small intestine are “bypassed,” thus delaying food from mixing with digestive juices to avoid complete calorie absorption The lower portion of the intestine is now joined to the new stomach pouch, creating a y-shaped connection. In most cases, patients report an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat.

Advantages of this procedure include weight-loss ranging from 60 percent to 75 percent of excess body weight over the first two years, and an improvement in the majority of obesity-related medical conditions, including diabetes, high blood pressure and sleep apnea.

Disadvantages or risks include poor absorption of vitamins, minerals, iron and calcium resulting in the lowering of total-body iron and a predisposition to iron-deficiency anemia and metabolic bone disease in some patients. Chronic anemia due to vitamin b-12 deficiency also can occur. These deficiencies can be managed through proper diet and vitamin and mineral supplement. A condition known as “dumping syndrome” can occur as a result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, fainting and diarrhea.

Laparoscopic Adjustable Gastric Banding Or Lap Banding
Lap band adjustable gastric banding is a restrictive surgical procedure that limits the
amount of food that can be eaten at one time. An adjustable silicone band is placed
around the upper part of the stomach, creating a small “stomach” or reservoir that
causes most patients to feel full faster. Food digestion occurs through the normal
digestive and absorptive process. This procedure is less invasive than other
surgical techniques and the band can be adjusted or removed. Other advantages
include shorter hospital stays and quicker recoveries. Weight loss ranges from 35
percent to 45 percent of excess body weight.

Possible complications of this procedure include band erosion and esophageal dilatation, outlet obstruction, pouch dilatation and band slippage.

Waiting period for surgery
It may take up to 6 months for your surgery to be scheduled.

Requirements of the program
Our program has found optimal results are obtained with the involvement of a multidisciplinary team approach.  We require the following to participate in the program:

• Initial consultations with :  Surgeon, Registered Dietitian, Clinical Psychologist

• Pre operative visit with:  Surgeon, Registered Dietitian, Clinical Psychologist

• 1 week post operative visit with the Surgeon

• 6 week post operative visit with the Surgeon, Registered Dietitian, Clinical Psychologist

• Documentation of attendance of 2 support group meetings before surgery

• Reports from all required testing and medical clearance

• Participation in Remedy MD data base

How Effective Is Surgery?
The actual weight a patient will lose after the procedure is dependent on several factors. These include:

• Patient's age

• Weight before surgery

• Overall condition of patient's health

• Surgical procedure

• Ability to exercise

• Commitment to maintaining dietary guidelines and other follow-up care

• Motivation of patient and cooperation of their family, friends and associates

In general, weight loss surgery success is defined as achieving loss of 50% or more of excess body weight and maintaining that level for at least five years. Clinical data will vary for each of the different procedures mentioned on this site. (Keep in mind that results may also vary by surgeon.)

Clinical studies show that, following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Patients may lose 30 to 50% of their excess weight in the first six months and 77% of excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60% loss of excess weight 10-14 years after surgery. Patients with higher initial BMIs tend to lose more total weight. Patients with lower initial BMIs will lose a greater percentage of their excess weight and will more likely come closer to their ideal body weight. Patients with Type 2 Diabetes tend to show less overall excess weight loss than patients without Type 2 Diabetes. The surgery has been found to be effective in improving and controlling many obesity-related health conditions. Additional studies have shown that 96% of certain associated health conditions (back pain, sleep apnea, high blood pressure, diabetes and depression) are improved or resolved. For example, many patients with Type 2 Diabetes, while showing less overall excess weight loss, have demonstrated excellent resolution of their diabetic condition, to the point of having little or no need for continuing medication.

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