Weight-Loss Surgery

The Bariatric Center at Southwest Healthcare System at Inland Valley Medical Center has been designated a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Surgical Review Corporation (SRC). It means that this is a Center for weight-loss surgery where you can place your confidence. To become certified, the Bariatric Center at Southwest Healthcare System and the bariatric surgeon's practice were required to satisfy or exceed requirements in 10 categories, including:

• Annual number of cases
• Complication rates
• Long-term follow-up and support

Patients seek bariatric surgery to reduce the number of obesity-related complications like heart disease, stroke, sleep apnea and diabetes. And then to reduce their weight, look better and feel better. Minimally invasive, laparoscopic bariatric surgery at the Bariatric Center reduces the size of the stomach to limit the amount of food eaten. Also, this procedure requires a smaller incision, usually involving less pain and faster recovery. David Suh, MD, who was trained at UCSF, has perfected the laparoscopic technique at Southwest for patients who are excessively overweight. "This is the surgical solution many dangerously overweight patients have been waiting for," says Dr. Suh. "It offers the same permanent weight loss without the pain, disability and complications that can result from major abdominal surgery."

An Alarming Trend

Up to 40% of Americans can be considered obese. "There's an alarming trend among the population toward obesity," Dr. Suh says. "It is a problem that a lot of people have their entire lives. They also develop serious medical conditions—such as severe diabetes—that can affect the length and quality of their lives." For those who are dangerously overweight, diet, exercise and drug therapy have not provided a lasting solution. Now, laparoscopic techniques can make surgery easier on the patient than standard, major abdominal surgery. And more private insurers now are offering coverage for bariatric surgery.

Types of Surgery

Gastric Bypass and Gastric Banding The choice of which type of weight-loss surgery to have is an important and serious decision. While the majority of patients who undergo these procedures are very successful, no procedure is perfect. You are encouraged to discuss the benefits and risks of each type of surgery in detail with your surgeon.

Gastric Bypass In this procedure, the surgeon staples across the top portion of the stomach to create a very small stomach pouch. The surgeon then connects the new stomach pouch to the small intestine, bypassing some of the upper and more absorptive part of the small intestine. This reduces the amount of food eaten as well as decreases absorption of the food and calories consumed. Results vary but the average patient usually can expect to lose 50 to 90 percent of excess weight in 12 to 18 months after surgery.

Laparoscopic Adjustable Gastric Band Gastric Band Surgeons use a silicone band to create a small pouch using the top part of the existing stomach. Using thin surgical instruments and a small internal camera to monitor the operation, the surgeon places a silicone band around the top portion of the stomach creating a small pouch, without cutting or stapling. This pouch later limits the patient's food consumption without disrupting the normal progression of food through the digestive tract. In some cases, the gastric band is connected via a small tube to a small reservoir that contains saline. This reservoir is placed under the skin of the upper abdomen. After surgery, the surgeon will examine the patient to ensure that the band contains enough saline. It needs to be tight enough to allow for gradual weight loss while ensuring that the patient eats enough food for proper nutrition. Adjustments typically are made to the band one month after the procedure. Using a fine needle, the surgeon can add or remove saline to enlarge or shrink the band. This results in allowing moreor less food to pass between the two parts of the stomach. The number of adjustments varies from person to person, but most patients usually need three to five before the band is at the ideal tightness. This procedure allows for pregnancy since the stomach outlet size can be opened to increase nutritional uptake. With the Lap Band procedure, patients can experience weight loss of one to three pounds a week in the first year after surgery. The amount usually decreases after 12 to 18 months.

Health Impacts