Bariatric Surgery
Also known as: Clinical Obesity,
Surgical Treatment for Obesity
More than 50 percent of Americans are
overweight and 5 percent have serious
weight-related medical problems. Clinically
severe or morbid obesity is defined as a body
mass index [weight (kg)/height in m2) )]
greater than 35 with significant medical
problems, or more than 100 pounds over the ideal
body weight. Severe obesity carries a six- to
12-fold increase in overall mortality when
compared to non-obese individuals. Co-morbid
conditions associated with severe obesity may
include any of the following conditions:
* Diabetes
* Hyperlipidemia or hypercholesterolemia
* Asthma
* Sleep apnea
* Pulmonary hypertension
* Coronary artery disease
* Hypertension
* Menstrual problems
* Urinary incontinence
* Venous stasis of the lower extremities
* Degenerative joint disease
* Gastroesophageal reflux
* Fatty liver hepatosteatonecrosis
Surgical weight loss, or bariatric surgery,
may be an option for severely obese patients who
fail to maintain weight loss after trying medical
weight loss strategies such as modifications in
diet, behavior and exercise, and medically
supervised weight loss regimens.
Facts
- Most patients experience significant
improvement or resolution of weight-related
medical problems following bariatric surgery.
- Other benefits include improved body image
and self-esteem, more energy, and return to
normal activities including employment.
- Bariatric surgery should be considered when
the medical benefits of weight loss outweigh the
risk of complications related to surgery.
A mutidisciplinary approach means better
outcomes
- Comprehensive pre-surgical assessment and
post-surgical follow-up including behavior
modification and nutrition counseling are
critical for sustained weight loss. Working with
referring physicians, our therapists and
dietitians teach patients to eat properly and
use the stapled stomach to assist weight loss.
- All patients undergo psychological screening
and nutrition counseling to help identify
uncontrolled depression, psychosis, eating
disorders, a history of substance abuse and any
other emotional issues that might interfere with
the patient’s ability to comply with
post-surgical instructions.
Choosing the best operative technique
The gastric bypass operation performed at Penn
State Milton S. Hershey Medical Center promotes
weight loss by restricting food intake and
causing rapid passage of sweet foods, called
dumping. Robert Cooney, M.D., director, surgical
weight loss program, performs the procedure via
an open technique through a small (six to 10
inch) abdominal incision.
Randy S. Haluck, M.D., director, Penn State
Minimally Invasive Surgery Program, offers the
option of laparoscopic gastric bypass surgery.
The laparoscopic technique follows the same
principles as the open procedure: create a small
gastric pouch to create a sense of fullness after
as small meal; restrict the gastric outlet to
slow down gastric emptying; and perform a partial
intestinal bypass.
Benefits of a laparoscopic approach include
- Less postoperative pain
- Faster recovery
- Better cosmesis
- Fewer wound complications such as hernia or
infection
Transition of care - Referring physicians
receive
- Educational material.
- Phone consults.
- Routine follow-up instructions
Physician's Who Perform Bariatric Surgery
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
