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Surgical Procedures

Am I a good candidate for bariatric surgery?

Gastric Sleeve

A relatively new procedure for weight loss is the sleeve gastrectomy. It was first designed as part of a staged approach to a gastric bypass in people who had excessively high risks for postoperative complications. However, it was found to cause significant weight loss in these patients without completion of the second stage. It has since become a primary bariatric procedure which provides weight loss comparable to that of the gastric bypass.The procedure is done through 5 small incisions through which a part of the stomach is removed to create a much smaller stomach. Since the stomach is now much smaller, patients are quickly satisfied with smaller meals. Like a lap band procedure, the sleeve gastrectomy is only designed to help you control the amount you can consume at any one time. Its advantage over the lap band, however, is that it helps to control appetite and cravings, thus increased compliance and weight loss versus the lap band .This makes it very important that you follow the diet you will be given carefully. Sweets, breads and red meats are generally discouraged as with the band.

The procedure lasts about 1 hour and requires a one night stay in the hospital. Most patients are able to return to work in 1 week after surgery.

Gastric Bypass

The laparoscopic gastric bypass procedure is currently the gold standard procedure for weight loss. It combines the restrictive operations with the malabsorbtive operations to induce a more consistent, rapid weight loss. As with any surgical intervention for weight loss, how you deal with food and the type of food you enjoy will change. You will be more easily satisfied with meals and certain types of food, such as sweets and red meat may not be well tolerated.For this procedure the abdomen will be accessed via six small incisions about 1cm in length. Special instruments are introduced via canulas placed through these incisions to partition the proximal stomach forming a pouch about the size of a large egg or lemon.

This pouch dramatically reduces the amount of food you can consume at any one time. In addition, a small part of the intestine is bypassed so that less of the food eaten is able to be absorbed forcing your body to lose weight. You can expect to lose between 60 and 80 percent of your excess body weight, see a significant reduction in your comorbidities and have a better quality of life. The procedure will take between 60-120 minutes and is generally safe. The risk of complication is approximately 0.5-1%. These risks will be thoroughly reviewed with you at the time of your visit with the doctor. You will spend 1-2 days in the hospital and you can expect to return to work in 1-2 weeks.

Biliopancreatic Diversion

BPD/DS is a complex procedure that tackles weight loss in 3 different ways. First, a sleeve gastrectomy is performed. For this, a large portion of the stomach is removed with a stapling instrument, leaving you a narrow tube, or sleeve, from the top to near the bottom of the stomach. With less stomach to fill, you will feel full more quickly and eat less food and fewer calories. The second part of the procedure reroutes food away from the upper part of the small intestine, which is the natural path of digestion. This cuts back on how many calories and nutrients your body is able to absorb. The small intestine is divided and a connection is made near the end of the small intestine.

The third part of the BPD/DS procedure changes the normal way that bile and digestive juices break down food. This cuts back on how many calories you absorb, causing still more weight loss. One end of the small intestine is connected to the duodenum, near the bottom of the stomach.

Revision of Weight Loss Procedures

Weight regain after bariatric surgery? You are not alone. Weight loss surgery is an important decision. It will decrease the risk of obesity related health challenges, but it will require that you incorporate new lifelong healthy eating habits.

Most common weight regains after surgery is a phenomenon caused by a failure to maintain the new habits and tools given with surgery. Bad habits are very difficult to break and if you are not careful, relapse is always close at hand. Regardless of your initial weight loss procedure, regaining weight after surgery results from a loss of satiety, usually from the stretching of your pouch and/or adaptation of the small intestine allowing more efficient absorption of digested food.

Remediation for post-surgery weight gain should involve a stepwise approach and surgery may or may not be the best answer.

We recommend:

Trial once again of diet and behavior modification with the assistance of our trained dieticians
We strongly recommend attendance at support groups
Incorporation of exercise into your daily routine-exercise need not be arduous and it can even be FUN! eg. Basketball with the kids, a brisk walk with your spouse, housework (arguably not fun), dance class, etc. Just get off the couch and MAKE TIME FOR YOURSELF
Consider consultation with a psychologist or life coach to help deal with stress, a big cause of mindless snacking
If these simple measures fail, revision surgery may be the next best step

The revision surgery best for you can vary from a redo lap band, band over bypass, recision gastric bypass, gastric sleeve, and duodenal switch or Stomafix procedures. Dr. Turnquest will meet with you one on one to review your medical and surgical history and formulate the best approach for you. Failure of a previous procedure is not necessarily indicative of your future success. You can be successful with the right solution and the right surgeon.

We are excited to help rewrite your success story. Call us today and make an appointment with our experienced surgeons.

Turnquest Surgical Solutions

✆ Phone (appointments): 281-688-5251

Address: 17070 Red Oak Dr., Suite 101, Houston, TX 77090

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