FAQ

FAQ


Frequently Asked Questions

Which procedure should I choose?

After a thorough review of your medical and lifestyle history and analysis of your Body Mass Index, your surgeon will recommend the procedures that will produce the best results for you. Ultimately, the decision is up to you. Whether you opt for the LAP-BAND® System, Laparoscopic Gastric Bypass, or Laparoscopic Sleeve Gastrectomy, remember that the surgery is just one step in the weight loss process. Your willingness to commit to lifestyle changes is also critical.

How long before I can return to work after surgery?

That depends on the type of surgery and the type of job you have. If your job is relatively sedentary, you may be able to resume work after 5-10 days. If your job is more physical, you may be out longer, but usually not longer than 3-4 weeks.

After surgery, when can I start exercising?

We recommend that you start walking within hours after surgery. Gradually increase your walking time and speed as you continue to heal. You should walk multiple times a day. For more strenuous exercise, consult with your physician.

Will I need cosmetic surgery due to the dramatic weight loss?

Many factors affect the need for cosmetic surgery after weight-loss surgery. Skin type as well as the amount of weight-loss, has an effect on skin appearance after surgery.

We recommend that you wait 1 to 2 years before cosmetic surgery to give yourself time to drop enough excess weight and accurately determine your need for plastic surgery. Discuss this with your surgeon as time (and weight loss) progress.


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LAP-BAND® System FAQ

What is the LAP-BAND® System?

The LAP-BAND® Adjustable Gastric Banding System is the first U.S. FDA-approved (2001) adjustable gastric band for use in weight reduction. To date, this simple, reversible, surgically implanted device has been used in more than 300,000 procedures worldwide.

Which patients are eligible to receive the LAP-BAND® System?

The LAP-BAND® System is approved for patients (18 years and above) with a BMI of 40 or more or for people with a BMI of at least 35 plus at least one severe obesity-related health condition such as Type 2 diabetes, hypertension and asthma.

What are the benefits of the LAP-BAND® System?

The LAP-BAND® System is considered less invasive than gastric bypass, as there is no stomach cutting, stapling or intestinal re-routing. It is adjustable and reversible and has a lower severe complication rate perioperatively and a lower mean short-term mortality rate compared with gastric bypass. In fact, the LAP-BAND® System has a mortality rate of 0.05 percent, approximately 1/10 the mortality rate of gastric bypass. However, the expected weight-loss is not as great as gastric bypass or sleeve gastrectomy.

How is the LAP-BAND® System procedure performed?

The LAP-BAND® System’s inflatable band is placed around the top portion of the stomach laparoscopically which offers the advantages of reduced pain and shorter hospital stays and recovery periods.

How much weight can a person expect to lose after having the LAP-BAND® System?

As with any surgery there are possible risks and complications with the LAP-BAND® System, including, but not limited to, infection, nausea, vomiting, band slippage and obstruction, and in rare cases, gastric perforation and reoperation. You can find more risk information by visiting www.lapband.com or by calling 1-877-LAPBAND.

How much weight can a person expect to lose after having the LAP-BAND® System?

Weight should be lost gradually. A weight loss of two to three pounds a week in the first year after the operation is possible, but one pound a week is more likely. Individual results may vary.

How does the LAP-BAND® System compare to gastric bypass?

The average weight loss after LAP-BAND® System is significantly less than the average weight loss after gastic bypass or sleeve gastrectomy.

What are the common side effects associated with the LAP-BAND® System?

As with any surgery there are possible risks and complications with the LAP-BAND® System, including, but not limited to, infection, nausea, vomiting, band slippage and obstruction, and in rare cases, gastric perforation and reoperation. You can find more risk information by visiting www.lapband.com or by calling 1-877-LAPBAND.

Is there a risk of death when using the LAP-BAND® System?

As with other major surgeries, death is considered a potential risk. However, the LAP-BAND® System has a lower mean short-term mortality rate compared with gastric bypass (0.05 percent, approximately 1/10 the mortality rate of gastric bypass).

Could a patient fail to lose weight after having the LAP-BAND® System procedure?

Results can vary because of a number of factors. Even though the LAP-BAND® System can limit the amount of food consumed, lifestyle changes are critical to weight loss success.

Do patients experience a heightened sensitivity to alcohol following LAP-BAND® System surgery?

No, unlike gastric bypass surgery, there is no stomach cutting, stapling or intestinal re-routing involved with the LAP-BAND® System; therefore absorption of alcohol is not affected.

Following their surgery, we counsel our patients regarding appropriate lifestyle and diet choices, including the consumption of alcohol.

How many patients remove the band after having it placed?

While the LAP-BAND® System is a reversible weight-loss surgery option and it can be removed at any time. 15% or more of LAP-BAND® Systems are removed for a variety of reasons.

Prior to the procedure, our practice closely evaluates patients to ensure they are appropriate candidates for the LAP-BAND® System. This includes an evaluation of the causes – both physical and emotional – that contribute to the patient’s excessive weight gain. And following the procedure, West Georgia Health’s bariatric team will work closely with you to develop a healthy eating plan, learn how to incorporate physical activity into your daily routine, have routine check-ups and ongoing band adjustments if necessary, and regularly attend support group meetings so you don’t feel the need to remove your LAP-BAND® System. Studies have shown 15% or more of Lap Bands are removed for various reasons.

i Chapman A, Game P, O’Brien P, Maddern G, Kiroff G, Foster B, Ham J. Executive summary: Laparoscopic adjustable gastric banding for the treatment of obesity: Update and re-appraisal. Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) Report No. 31, Second Edition. Adelaide, South Australia: ASERNIP-S, June 2002. (Laparoscopic adjustable gastric banding surgery, like the LAP-BAND® System surgery, is associated with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical Banded Gastroplasty.)

iiParikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic bariatric surgery in super-obese patients (BMI>50) is safe and effective: a review of 332 patients. Obes Surg. 2005 Jun-Jul;15(6):858-63.

iiiChapman AE, Kiroff G, Game P, Foster B, O’Brien P, Ham J, Maddern GJ. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326-351


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Gastric Bypass FAQ

Is the LAP-BAND® System safe?

Additionally, the LAP-BAND® System has a lower severe complication rate perioperatively (less than 1%), lower mean short-term mortality rate (0.05 percent, approximately 1/10 the mortality rate of gastric bypass)iii and carries fewer risks of vitamin and mineral deficiencies than gastric bypass.

How long will I be in the hospital?

For laparoscopic gastric bypass surgery, the hospital stay is usually two to three days unless a complication from the surgery develops.

Is the remaining stomach that is separated from the new pouch removed during surgery?

It is not necessary to remove the “remnant stomach” during gastric bypass surgery. The “remnant stomach” will shrink over time because it is not being stretched out with food and liquids. However, it still produces stomach acid and receives enzymes from the liver and pancreas to aid in the digestive process in the intestines.

What are some of the possible complications of gastric bypass surgery?

Any surgery can cause infection, blood clots, or respiratory complications. Gastric bypass surgery can lead to leaking, obstruction, and a ruptured pouch, all of which are rare.

Who should not have gastric bypass surgery?

Choosing to have a gastric bypass surgery is a very serious choice. People who suffer from depression, bipolar disease, or schizophrenia should consult and be under the care of a psychiatrist before gastric bypass. Weight loss can exaggerate these conditions.

What is a realistic amount of recovery time for gastric bypass surgery?

A minimum of 2-3 weeks is realistic for gastric bypass surgery depending on your surgeon’s preference, your recovery needs and job demands.

When can I resume normal behavior?

You can begin regular activity within 4 to 6 weeks after your gastric bypass. You should be pain free after 10 days or so. Fatigue is common, and can last from 3 to 4 weeks after your gastric bypass.

Can I eat whatever I want after gastric bypass surgery?

Fats and sweets will need to be eaten with caution. A West Georgia Health clinical dietician will go over the diet changes you’ll need to make after surgery. This could result in “dumping.”

What is dumping syndrome?

With gastric bypass surgery, food moves from the new pouch directly into the small intestines bypassing the first part of the digestive breakdown in the duodenum. Foods high in fat and sugar content enter the intestine inadequately digested, causing unpleasant feelings of nausea, cramping, sweating, and abdominal pain. By monitoring your intake of sugar and fat, you can avoid dumping. Eating and drinking at the same time or eating too much can also produce dumping.

Will I ever be able to drink alcohol again?

It is recommended that alcohol be avoided after gastric bypass surgery. It may not be well tolerated and the results of the alcohol may affect you quickly.

Is it possible to gain weight back after gastric bypass surgery?

Weight loss surgery is simply a tool that helps you lose weight. In order to be successful, you must make a commitment to a healthy lifestyle forever. Otherwise it is possible to gain your weight back by overeating and resorting to old habits.

When can I attempt to get pregnant after bypass surgery?

Patients are advised to not get pregnant for a year to a year and a half after surgery. By waiting, you are assured better nutrition which is important for the health of you and your baby.

Is gastric bypass surgery reversible?

Gastric bypass surgery can be reversed, but it can be difficult and has risks. Only patients who experience substantial long term problems would be considered for a reversal. Any person who has their gastric bypass reversed will probably regain any weight loss seen after the first surgery.

Is gastric bypass covered by insurance?

Gastric bypass is covered by most insurance companies. You must be approved for coverage. Since gastric bypass can reverse serious health problems, including the chance of premature death, it is medically essential. Many insurers acknowledge the validity of weight-loss surgery in keeping health costs down long-term.


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Laparoscopic Sleeve Gastrectomy FAQ

What is the main advantage of sleeve gastrectomy surgery over gastric bypass surgery?

What is the main advantage of sleeve gastrectomy surgery over gastric bypass surgery?

There is no malabsorption of nutrients or vitamins, unlike with gastric bypass. The risk of developing malnutrition or a vitamin deficiency is very low if you eat a healthy diet and take any recommended vitamin and mineral supplements. Also, when eating you will not have to worry about dumping syndrome, unlike with gastric bypass. The initial risks associated with sleeve gastrectomy are lower than a gastric bypass in most studies, yet the rate of weight-loss is about the same over time.

What is the advantage of sleeve gastrectomy surgery over LAP-BAND® System surgery?

The rate of weight loss is about 2-3 times faster with a sleeve gastrectomy than the LAP-BAND® System. There is no implantable device, therefore slips and erosions are not an issue. You will never have to get adjustments or have surgery to remove a device. It is important to note that the short-term risk of a sleeve gastrectomy is higher than that of LAP-BAND® System surgery. The weight-loss after sleeve gastrectomy is significantly higher than after LAP-BAND® System surgery.

What are the disadvantages of sleeve gastrectomy surgery?

Beyond the usual risks of infection that follow any surgery, the biggest disadvantage of the surgery is that is irreversible, but this is true of most surgeries. There is a risk of bleeding or leakage along the staple line.

How big will my stomach be after surgery?

The size of your stomach will vary depending on your surgeon’s preference and your individual needs. Your surgeon will use a tube to guide them when stapling the stomach. This tube size is generally three to five ounces. The average stomach before surgery is approximately forty five ounces.

Is removing the stomach safe?

This type of stomach removal has been performed with the other surgeries since the mid-1980s and has been demonstrated to be a safe procedure. It involves stapling the remaining stomach, just like gastric bypass, and has similar, but fewer risks.

Does sleeve gastrectomy surgery make you feel less hungry?

The portion of the stomach that’s removed is responsible for manufacturing the hormone (Ghrelin) that stimulates hunger, so the feeling of physical hunger should decrease after surgery. However, this surgery cannot resolve emotional eating. If you eat to soothe your emotions versus for nutrition, you may hinder your weight loss efforts. None of the weight loss surgeries can stop emotional eating and weight gain.

Can I drink alcohol after sleeve gastrectomy surgery?

You can physically digest alcohol after surgery. However, the drink may cause dumping syndrome and if carbonated will make you feel very uncomfortable. Alcohol provides “empty” calories and after surgery excellent nutrition is of the upmost importance. Please talk with your surgeon regarding alcohol consumption. He will consider your health condition, medications and psychological state before allowing you to drink alcohol.

Will I have to take vitamin supplements after sleeve gastrectomy?

We recommend a multivitamin for all of our procedures including sleeve gastrectomy.

What can I eat after sleeve gastrectomy?

You will require smaller portions but, you can eat most things in moderation. Unlike gastric bypass, dumping syndrome is not likely to be a problem. Important with all surgeries is to eat slowly and chew your food well.

Can you regain weight after sleeve gastrectomy?

That is always a risk. If you do not follow the recommended diet and exercise plan then weight will be regained. If you have a sleeve gastrectomy then the hormone that controls hunger called ghrelin will have been removed along with the stomach portion. Many patients report experiencing very little hunger after the surgery.


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