Laparoscopic Weight Loss Surgery - Common Questions and Answers

Why consider Laparoscopic Weight Loss Surgery?

In the United States, obesity has become a common problem. In a report released in 2009 by the "Trust for American's Health" and the Robert Wood Johnson Foundation called, "F as in Fat", studies show that two-thirds of adults are overweight or obese, and nearly one-third of children and adolescents are also considered overweight or obese.

And it doesn't stop there. According to the Center for Disease Control and Prevention, England ranks in at 3rd, and Australia and New Zealand top the scales at the #7 and #8, respectively.

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Treating obesity can be a long and difficult process, made even more so when the patient doesn't have a correctable endocrine problem.

The first line of defense is usually a recommendation of more exercise and a low-calorie, low-fat, balanced diet. Most doctors do not recommend 'fad diets' - also known as 'crash diets' or diet drugs as their effects are short lasting and may cause additional long-term complications.

However, as is shown by the results in the report above, diet and exercise alone are sometimes not effective.

Laparoscopic weight loss surgery is becoming a treatment of choice for doctors whose patients are morbidly obese.

What is morbid obesity?

A person is considered 'morbidly obese' when they weight 100 pounds (or more) over their 'ideal body weight', or when a calculation of the body mass index (BMI) is greater than 35 - 40.

Want to calculate your own BMI (Body Mass Index)?

Grab a calculator (or a pen and paper if you're good at math), and start by multiplying your weight by 705. Divide that number by your height in inches. (Someone who is 5;7' inches is 67 inches tall, as an example.) Now divide that number by your height again. The number you end up with is your BMI.

Health Problems Associated with Obesity

Obese or morbidly obese people are at increased risk for diabetes, hypertension, heart disease, hyperlipidemia, sleep apnea (temporary stopping of breathing during sleep), and osteoarthritis, to name just a few.

If diets and exercise have failed, ask your doctor if you're a candidate for laparoscopic weight loss surgery

Your doctor can test your BMI and talk to you about your general health condition, and carefully assess your need for surgery. He can also explain the procedure and answer all your questions about having laparoscopic weight loss surgery.

Will my insurance company cover this procedure?

In recent years, research has clearly shown a link to obesity and many health problems, such as diabetes, heart disease and stroke. We also know that obese individuals are at risk for having a shortened life span and a lesser quality of life.

Many insurance companies now recognize obesity as a substantial health risk and will cover laparoscopic bypass procedures.

To determine if your insurance company will cover this type of medical care, contact them.

What's the biggest advantage of laparoscopic weight loss procedure?

Also known as laparoscopic bypass procedure, the most important benefit to patients is significant weight loss during the first year after surgery. (Imagine being able to lose 50, 60, or even 80 pounds in only 12 months?)

Another big benefit of laparoscopic bypass surgery is that with this significant weight loss, many of the medical problems you may face - such as diabetes, hypertension and coronary artery disease - can be easier to treat - or they could be eliminated altogether!

And the third biggest benefit is that by choosing laparoscopy, (which requires much smaller incisions than traditional abdominal surgery), most patients generally have less pain and scarring after surgery and recover more quickly.

Laparoscopy also reduces the risk of developing hernias, which are more common after traditional abdominal surgery.

Of course any surgery carries risks, and that's why it's very important that you speak with your doctor and understand all the facts before considering laparoscopic weight loss surgery.

What are the most common procedures for weight loss surgery?

There are three generally accepted procedures most commonly used today: laparoscopic isolated gastric bypass, adjustable gastric band, and sleeve gastrectomy.

In a "Roux-en-Y" gastric bypass, more than 95 percent of the stomach is "bypassed" and a tiny portion - (only about the size of an egg) remains functional. In an adjustable gastric band procedure, the stomach is restricted or "cinched" by the placement of the band, which can be adjusted after surgery as needed for further weight loss. (This has become the most common procedure being carried out today.) Sleeve gastrectomy is the removal of two-thirds of the stomach with a "bypass"

What is involved before, during, and after surgery?

Before surgery

Your doctor will naturally perform many tests before deciding if you're a good candidate for laparoscopic weight loss surgery. Tests may include cardiovascular, pulmonary, and endocrine systems.

Most doctors also consider a psychological evaluation essential as well, to determine their patient's response to weight loss and the resulting change in body image and permanent lifestyle changes that will be needed.

And basic nutritional counseling is also a must before laparoscopic weight loss surgery.

During surgery:

As mentioned before, one of the advantages of laparoscopic weight loss surgery is that it's considered minimally invasive as compared to traditional methods of surgery. The general goal in a laparoscopic bypass procedure is to"shunt" or bypass a portion of the stomach. During your surgery, here's what to expect:

Four to six small openings (each about the size of a dime) are made in the abdomen. These openings allow the surgeon to pass a light, camera, and surgical instruments into the abdomen. The abdomen is inflated with carbon dioxide gas, so the surgeon can see your stomach and other organs better. Surgical instruments (only about the width of a pencil) are placed into the abdomen to the surgery.

After surgery:

Most patients recover from surgery without any complications. You can expect to be in the hospital usually only from 1 to 3 days. Depending on the type of work you do, you may be off work for 2 to 4 weeks. Once at home, you will need to follow very specific eating guidelines. Your dietician will help you understand what your new eating regime will involve and what you need to know. Regular follow-up visits will be scheduled during the first year after surgery to check your overall physical and mental health, metabolism and nutritional status. Many patients will need plastic surgery (abdominoplasty) 1 to 2 years after weight loss to remove the excess skin around the abdomen. (The longer you are overweight and the more overweight you are, the harder it can be for your skin to 'shrink' down to your new size and weight.)

If you're overweight, and diets and exercise haven't worked for you, talk to your doctor to see if laparoscopic weight loss surgery can help you to start a new healthier, happier life.

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