Eligibility Criteria: Gastrointestinal surgery is an available weight-loss option for patients who present the following criteria: BMI>40 or BMI>35 with significant co-morbid conditions. Between the ages of 18 and 65 years old. Acceptable operative risks. Failed attempts at behavioral and medical therapy. Realistic expectations. Motivated. Capable of understanding procedure and implications. Commitment to prolonged lifestyle changes. Commitment to long-term follow up. To see if you are a candidate for this procedure please call us at 978-475-7700 to set up a consultation.

Results:
These surgeries result in reductions of 40% to 70% of excess body weight. Controlled clinical trials have demonstrated that the gastric bypass procedure is more effective in inducing weight loss than gastroplasty alone.

In addition:

• 78% discontinue anti-hypertensive and anti-hyperglycemic medications.
• Significant reduction in degenerative arthritis symptoms
• Enhanced quality of life

Risks:
In most medical centers, the perioperative morbidity of gastric restrictive surgery is 5%.

Surgical risks include:

• Anastomosis leaks
• Wound infections
• Stomal stenosis
• Incisional hernia

What is Bariatric Surgery?

Bariatric surgery changes the way your digestive system works by closing off parts of the stomach. Making the stomach smaller means that you ay feel full after eating a small amount of food. Operations that reduce the stomach size are known as restrictive operations because they restrict the amount of food the stomach can hold.

Some operations combine restriction with a partial bypass of the small intestine. (The intestines are where food and nutrients are absorbed into the body.) By creating a detour around part of the intestine, less food is absorbed. Operations that use the mechanism to enhance weight loss are called malabsorptive operations. There are a number of different restrictive and malabsorptive operations begin done. The Lap-Band and Laparoscopic Gastric Bypass are done at the Beth Israel Deaconess Medical Center. Both procedures produce changes in how your body digests food. These changes, in combination with an overall plan of diet and exercise, can increase your chances of losing weight.

Information about these and other procedures can be found at:

www.bidmc.harvard.edu/wls

http://win.niddk.nih.gov/publications/gastric.htm

Laparoscopic Adjustable Band

The word LAP-BAND is the abbreviated and trademarked combination of two words (LAP from laparoscopic and BAND from gastric band). The LAP-BAND is a silicone band which is placed around the upper part of the stomach to create a small pouch which can only hold a small amount of food. The lower, larger part of the stomach is below the band. These two parts are connected by a small outlet created by the band. Food will pass through the outlet ("stoma" in medical terms) from the upper stomach pouch to the lower part more slowly, and you may feel full longer. The first adjustment usually occurs eight weeks after surgery. This operation can be reversed if it is necessary.

Roux-en-Y Gastric Bypass

In this operation, the stomach is separated into a small upper pouch. A "Y" segment of the jejunum is attached to the pouch. This gastric partitioning delays the mixing of food and digestive juices from the lower stomach, and may result in absorption of fewer calories and earlier satiety.

These surgeries may result in the reductions of 30-70% of excess body weight. Obesity-related health risks (e.g., diabetes, hypertension, hyperlipidemia, arthritis, and sleep apnea) have been shown to improve with weight loss. In most cases the surgery is performed laparoscopically (through small incisions).

		Remember: The possible long-term complications include vitamin and mineral deficiencies (particularly iron and vitamin B-12), nausea and vomiting, constipation and "dumping syndrome." The above information is provided through our affiliation with Beth Israel Deaconess Medical Center, a major teaching hospital of Harvard Medical School.