Bariatric Surgery FAQs

Bariatric surgery is a procedure designed to make the stomach smaller so the patient feels satisfied with less food. It is intended for people who are 100 pounds or more overweight (with a Body Mass Index of 40 or greater) and who have not had success with other weight loss therapies such as diet, exercise, medications, etc. A person with a Body Mass Index (BMI) of 35 or greater and one or more co-morbid condition also may qualify for bariatric surgery.

Studies show that bariatric surgery can effectively improve and resolve many weight-related health conditions. A review of more that 22,000 bariatric surgery patients showed:

• Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea
• 61.2% reduction of excess weight

Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more that 22,000 bariatric surgery patients showed:

• 61.2% reduction of excess weight
• Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea

Talk with your surgeon about the different surgical treatments, as well as the benefits and risks. Remember:

1. Bariatric surgery is not cosmetic surgery.
2. Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
3. The patient must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
4. Problems after surgery are rare, but corrective procedures may be required.

Patients should have:

• 100 pounds or more of excess weight
• Or, a BMI of 40 or greater
• And, a BMI of 35 or greater with one or more co-morbid conditions

Other common guidelines include:

• Understanding the risks of bariatric surgery
• Committing to dietary and other lifestyle changes as recommended by the surgeon
• Having a history of weight loss treatments having failed the patient
• Undergoing a complete examination including medical tests

The qualification process includes a series of tests with your bariatric surgeon. You also will meet with a nutritionist, psychologist, and other support staff members in sessions leading up to surgery. Each healthcare professional will help you prepare for the changes and challenges that lie ahead.

• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel
• B1 Vitamin
• B12 Vitamin
• Folic Acid Serum
• Blood Glucose Test

Other tests that may be requested include:

• Psychological evaluation
• Sleep study
• GI evaluation
• Cardiology evaluation
• Pulmonary Evaluation

As with any surgery, there are immediate and long-term complications and risks. Possible risks can include, but are not limited to:

• Bleeding
• Complications due to anesthesia and medications
• Deep vein thrombosis
• Dehiscence (separation of areas that are stitched or stapled together)
• Infections
• Leaks from staple lines
• Marginal ulcers
• Pneumonia
• Spleen injury
• Stricture (scarring of the anastomosis)
• Pulmonary embolism (blood clot in lungs)
• Myocardial Infarction (heart attack)
• Death

Side effects include:

• Vomiting
• Dumping syndrome
• Nutritional deficiencies
• Gallstones
• Need to avoid pregnancy temporarily
• Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas, and dizziness

Open surgery involves the surgeon creating a long incision to open the abdomen and operating with "traditional" medical instruments. Laparoscopic, or minimally invasive, surgery is an approach that allows the surgeon to perform the same procedure using several small incisions, a fiber-optic camera, video monitor, and long-handled instruments. Learn more about the differences, as well as why your surgeon may recommend a minimally invasive technique but switch to an open one.

The decision to perform minimally invasive or open surgery is made by your surgeon before the operation. For some patients, the laparoscopic, or minimally invasive, technique cannot be used due to dense scar tissue from prior abdominal surgery. Also, the inability to see organs and/or bleeding during the operation can cause your surgeon to switch from minimally invasive to open surgery during your operation.

Roux-en-Y (pronounced ROO-en-why) gastric bypass surgery is the most popular bariatric surgery in the United States. In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” of some of the small intestine.

The smaller stomach pouch restricts the amount of food the patient can comfortably eat, and the bypass decreases the number of nutrients and calories absorbed.

Gastric banding is a purely restrictive surgical procedure in which a silicone band is placed around the uppermost part of the stomach.

The band is adjustable and can be periodically tightened or loosened depending on the patient’s needs.

The Sleeve Gastrectomy is an operation in which the left side of the stomach is surgically removed, resulting in a new stomach roughly the size of a banana. This is a purely restrictive procedure, with no “rerouting” of the intestines.

Unlike the Adjustable gastric band procedure, the Sleeve does not require the implantation of an artificial device inside the abdomen.