Qualifying for bariatric surgery
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), a patient qualifies for bariatric surgery based upon the following criteria:
- BMI >/= 35 kg/m2, regardless of presence, absence, or severity of co-morbidities.
- BMI >/= 30 kg/m2 and T2D.
- BMI 30-34.9 kg/m2 who do not achieve substantial or durable weight loss or co-morbidity improvement using nonsurgical methods.
- As obesity definitions using BMI thresholds do not apply similarly to all populations, clinical obesity in the Asian population will be recognized at a BMI > 25 kg/m2.
- No upper patient-age limit – patient will be carefully assessed for co-morbidities and frailty.
After an initial evaluation to determine your personal weight-loss challenges, you will work with our team of clinicians and dietitians to prepare for the physical and mental aspects of your weight loss surgery.
Weight loss surgery can improve obesity-related conditions such as high blood pressure, heart disease, joint pain and sleep apnea. We offer three effective types of bariatric surgery: Roux-en -Y gastric bypass, sleeve gastrectomy and duodenal switch. We also offer various revision options.
Our weight loss treatments and services
We offer a wide range of noninvasive and minimally invasive weight management techniques. All of these procedures are completed with a minimally invasive technique using the most advanced technology that is currently offered with robotic assistance. Some of the most common weight loss surgical procedures we offer include:
Sleeve gastrectomy (gastric sleeve) surgery
Sleeve gastrectomy (sometimes called "vertical sleeve gastrectomy") is a restrictive procedure, meaning it reduces the amount of food you can consume. This procedure involves removing 75 percent of the stomach, virtually eliminating the hormones in your gastrointestinal tract that stimulate hunger. A sleeve gastrectomy procedure does not involve any bypass of the intestinal tract.
With this surgery, you can eat less, and your appetite decreases. It offers not only significant long-term weight loss of greater than 65 percent but also improves or resolves Type 2 diabetes, hypertension and sleep apnea.
Gastric bypass
Gastric bypass surgery (sometimes called Roux-en-Y gastric bypass) involves making the stomach smaller and bypassing part of the small intestine. This limits how much food you need to feel full and decreases the nutrients and calories your body is able to absorb. This procedure also causes gut hormones to be released earlier, making you feel less hungry.
This procedure will significantly improve acid reflux and is very effective for treatment of Type 2 diabetes. It also significantly improves hypertension, sleep apnea and a variety of other weight-related medical problems.
Most patients will need to stay in the hospital for one day after their operation, and they can return to their typical lifestyle within two weeks.
Ideal candidates include patients with a BMI greater than 35 with additional conditions such as diabetes and acid reflux.
Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)
The Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy is referred to as the SADI-S. It combines a sleeve gastrectomy (removing most of the stomach) and intestinal bypass (shortening the effective length of the small intestine). This is the most effective weight loss surgery . SADI-S typically leads to greater weight loss with a lower risk of obesity recurrence. It is the most effective treatment option for type 2 diabetes. Vitamin levels need to monitored carefully to avoid issues with malnutrition. Significant acid reflux can sometimes be a contraindication to completing this procedure. This is also an option for patients who have had weight regain or inadequate weight loss with a previous sleeve gastrectomy alone.
Discuss with your bariatric surgeon if a SADI-S procedure is right for you.
Bariatric revision surgery
Bariatric surgeries are excellent treatment options that help many patients successfully lose weight. However, some patients may not experience the results they want. In these cases, you may need follow-up or additional bariatric surgery. Because these patients have already had bariatric surgery, this type of surgery is called "revisional" bariatric surgery.
Bariatric revision surgery procedures can vary greatly based on the original operation, how long ago it was performed, the degree of weight loss achieved and the current nutritional and physical state of the individual. Revision procedures are not one size fits all and not everyone is a candidate for a revision.
Your physician may suggest a second procedure if your initial surgery hasn't produced the desired weight loss effects, or you have regained a significant amount of weight.
A few examples of revisional bariatric surgery include:
- Development of an ulcer or hiatal hernia
- Weight regain or inadequate weight loss after a sleeve gastrectomy
- Slippage or deflation of the band after gastric band surgery
