Morbid obesity is a significant health concern effecting a growing percentage of the adult population of the United States. Significant and potentially life threatening complications are associated with morbid obesity such as diabetes, high blood pressure (hypertension), coronary artery disease, breathing difficulties (obstructive sleep apnea), and arthritis and joint problems. Patients who suffer from morbid obesity and are not able to lose enough weight with lifestyle modification alone may benefit from laparoscopic weight loss surgery.
There are three main laparoscopic weight loss procedures performed including the laparoscopic gastric bypass, laparoscopic adjustable gastric band, and laparoscopic sleeve gastrectomy. All of these procedures restrict or reduce the size of the stomach to produce early satiety. Due to the smaller stomach, patients eat smaller meals post-operatively. Early satiety and smaller meals result in substantial weight loss. The laparoscopic gastric bypass also “bypasses” a portion of the small intestine and limits the absorption of food. All of these operations are performed laparoscopically through 5 or 6 small incisions (all < 1 inch) and uses a laparoscope and long thin instruments. The laparoscope functions as a camera to visualize and magnify the abdominal contents to monitors outside of the body. Long thin instruments are inserted through the other small incisions in order to perform the operation.
The advantages of laparoscopic bariatric surgery includes less pain, a faster recovery, a smaller incision, a lower chance of future hernia formation, lower wound complications, and a faster return to normal activity.
The majority of patients spend 1-2 days in the hospital depending upon the type of bariatric procedure performed. Most patients return to work 2-3 weeks after surgery depending upon the physical requirements of their occupation. Patients return approximately two weeks after surgery for routine follow-up with their surgeon.
Hindle AK, Brody F, Fu S, McCaffrey T. Potential Molecular Pathways that resolve type 2 diabetes following a roux-en-Y gastric bypass. Submitted Surg Endosc April 2008
Brody F, Hill S, Celenski S, Kar R, Kluk B, Pinzone J, Fu S. Expression of ectonucleotide pyrophosphate phospodiesterase and Peroxisome proliferator activated receptor gamma in morbidly obese patients. Surg Endosc 21 (6): 941-944, 2007
Ponsky TA, Pucci E, Brody FJ. Alterations in Gastrointestinal Physiology following a Roux-en-Y Gastric Bypass. J Am Coll Surg 201(1): 125-131, 2005.
Brody FJ. Minimally invasive surgery for morbid obesity. Cleve Clinic J Med 71 (4):289-298, 2004
Felsher J, Brodsky J, Brody FJ. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery 134(3): 501-505, 2003.
The Surgical Review Corporation promotes the delivery of bariatric surgical care with the highest levels of efficacy, efficiency and safety. Accredited programs undergo a rigorous evaluation process to earn a Center of Excellence (COE). Overall, each CE must meet established guidelines and criteria for assessing bariatric surgical practices to become a Bariatric Surgery COE. Each COE must continue to collect clinical data on bariatrics patients pre- and postoperatively. The “Surgical Review Corporation is a non-profit corporation governed by a Board of Directors comprised of industry stakeholders. The Board of Directors sets the overall policy of the organization. SRC's Bariatric Surgery Review Committee, consisting exclusively of bariatric surgeons, assesses applicants to the Bariatric Surgery COE program and helps formulate requirement and guidelines. The Research Advisory Committee oversees the collection, analysis, and dissemination of data. SRC's Strategic Alliances Group brings together patient groups, providers, payors and other industry stakeholders in an effort to improve outcomes and provide patient, provider and payor value.”