Laparoscopic Bariatric Surgery

In laparoscopy, the surgeon makes one or more small incisions through which slender surgical instruments are passed. This technique eliminates the need for a large incision and creates less tissue damage. Patients who are super-obese (more than 350 pounds) or have had previous abdominal operations may not be good candidates for laparoscopy, however. Adjustable gastric banding is routinely performed via laparoscopy.

This technique is often used for Roux-en-Y gastric bypass, and although less common, biliopancreatirc diversion can also be performed laparoscopically. The small incisions result in less blood loss, shorter hospitalization, a faster recovery, and fewer complications than open operations. However, combined laparoscopic procedures are more difficult to perform than open procedures and can create serious problems if done incorrectly.

Bariatric Surgery for Adolescents

With rates of overweight among youth on the rise, bariatric surgery is sometimes considered as a treatment option for adolescents who are severely overweight. However, there are many concerns about the long-term effects of this type of operation on adolescents’ developing bodies and minds. Experts in pediatric overweight and bariatric surgery recommend that surgical treatment only be considered when adolescents have tried for at least 6 months to lose weight and have not been successful. Candidates should be severely overweight (BMI of 40 or more), have reached their adult height (usually 13 or older for girls, 15 or older for boys), and have serious weight-related health problems such as type 2 diabetes or heart disease. In addition, potential patients and their parents should be evaluated to see how emotionally prepared they are for the operation and the lifestyle changes they will need to make. Patients should also be referred to a team of experts in adolescent medicine and bariatric surgery who are qualified to meet their unique needs.

Medical Costs
 

Bariatric procedures cost from $20,000 to $35,000. Medical insurance coverage varies by state and insurance provider. If you are considering bariatric surgery, contact your regional Medicare or Medicaid office or insurance plan to find out if the procedure is covered.

Is Surgery for You?

Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, or for people who have an obesity-related disease.
 

Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, or for people who have an obesity-related disease. Surgery to produce weight loss is a serious undertaking. Anyone thinking about undergoing this type of operation should understand what it involves. Answers to the following questions may help you decide whether weight-loss surgery is right for you.

Are you:

   1. unlikely to lose weight or keep weight off long-term with nonsurgical measures?
   2. well informed about the surgical procedure and the effects of treatment?
   3. determined to lose weight and improve your health?
   4. aware of how your life may change after the operation (adjustment to the side effects of the operation, including the need to chew food well and inability to eat large meals)?
   5. aware of the potential for serious complications, dietary restrictions, and occasional failures?
   6. committed to lifelong medical follow-up and vitamin/mineral supplementation?

Remember: There are no guarantees for any method, including surgery, to produce and maintain weight loss. Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up-and this cooperation and commitment must be carried out for the rest of your life.

Research  

In 2003, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) formed a partnership with researchers called the Longitudinal Assessment of Bariatric Surgery, or LABS. LABS researchers are experts in bariatric surgery, obesity research, internal medicine, behavioral science, and related fields. Their mission is to plan and conduct studies that will lead to better understanding of bariatric surgery and its impact on the health and well-being of patients with extreme obesity. For more information on LABS, visit www.niddklabs.org.

(source: www.nih.gov)