The Bariatric Surgery Center of Excellence at Presbyterian/St. Luke' s Medical Center features a highly skilled, experienced and caring team of weight loss specialists who are here to help you. Our team offers a comprehensive, multidisciplinary program, as recommended by the National Institutes of Health. We offer exceptional outcomes for Lap Band and Gastric Bypass Surgery.

Bariatric surgery (or "weight loss" surgery) provides a wonderful opportunity to undergo a healthy and fulfilling life change by helping patients accomplish long-term weight loss. P/SL's Bariatric Surgery Program is designated a Center of Excellence by the American Society of Bariatric Surgery.

Our multidisciplinary approach to bariatric surgery has proven to increase the likelihood of a successful, positive long-term outcome. While bariatric surgery is an effective tool for promoting dramatic weight loss for those who are morbidly obese, it also requires a commitment to dietary and lifestyle changes. Our surgical team will guide you through every step of the process.

Bariatric surgery is recognized by the American Medical Association as the only effective means of long-term weight loss for morbidly obese patients (appx. 100 lbs overweight) who have repeatedly failed other weight loss therapies. Surgical treatment resolves or improves 80% of co-morbidities.

Our multidisciplinary approach includes nutrition, psychology, education, medicine and surgery. The majority of our surgeries are laparoscopic, which can (in many cases) reduce patient recovery time.

Bariatric Surgery options offered at P/SL include:

• Laparoscopic Roux-en-Y Gastric Bypass (RYGBP)
• Laparoscopic Adjustable Band
• Conventional (open) RYGBP
• Conventional (open)
• VBG Revision interventions for failed or unsafe operations

More about Laparoscopic Bariatric Surgery: A Review

Bariatric surgery is increasingly recognized as an attractive and viable treatment option for those who are morbidly obese. Clinically morbid obesity is a true disease state.

It is a disease with a strong genetic component (25 to 50%), often characterized by an overactive appetite center in the brain that results in excessive fat stores in the body. It is not a disorder of willpower, as sometimes implied.

Morbid obesity affects four million adults in the U.S. and is identified in a person who has a Body Mass Index (BMI) of 40 kg/m2, or is 100 pounds overweight. Being severely overweight is dangerous to your health because it is associated with a variety of medical conditions as well as an increased mortality rate.

Most morbidly obese people have struggled endlessly with failed attempts at weight loss and the frustration of limited alternatives. Surgical treatment is the only proven method of achieving potential long-term weight control for the morbidly obese, greatly impacting health and longevity.

While there are several bariatric or gastric bypass procedures, the laparoscopic approach to bariatric surgery is demonstrated to have clear advantages over other procedures, including:

• Shorter hospital stay
  
  
• Earlier return to normal activities
  
  
• Less pain and discomfort

Here at the Bariatric Surgery Center of Excellence at P/SL, our Medical Director, Tom Brown, MD, prefers the laparoscopic gastric Roux-en-Y procedure as it has been shown in clinical studies to have the most favorable impact on achieving maximum weight loss. Approximately 98% of our patient cases are performed laparoscopically.

Laparoscopic Adjustable Band: An Overview

The Laparoscopic Adjustable Band was approved by the FDA in 2001, and since that time has become a popular alternative to the gastric bypass surgery in this country. Although experience with Lap Band is only 5 years in this country, it has been offered in Europe and Australia for over ten years and is the most commonly performed weight-loss operation outside of the United States.

Attractive attributes of the Lap Band System are:

• Least invasive surgical option
  
  
• Safe - no stomach stapling, cutting or intestinal re-routing
  
  
• Effective - weight loss, comorbidities, quality of life
  
  
• Effective over time
  
  
• Low re-operation/revision
  
  
• Minimal side effects
  
  
• Easily reproducible
  
  
• Adjustable - customized by our surgeons to meet each individual's unique needs
  
  
• Reversible Low malnutrition risk
  
  
• Satiety-inducing procedure
  
  
• Overnight hospital stay in most cases and early return to work (1 week or less)
  
  
• Operating Room time of one hour or less

Weight loss occurs much slower with the Lap Band as compared to the Gastric Bypass with most patients reaching their maximum weight loss at three years. The expected long-term weight loss with the Lap Band ranges from 50-60% of the excess body weight.

Multiple studies have documented resolution of a majority of the weight-related comorbidities. Follow up with your surgeon for adjustments, especially in the first year, is vital to the success of the Band. The Lap Band is a hollow silicone tube that is wrapped around the upper portion of the stomach and then attached to a small port buried beneath the skin and adipose tissue on the abdominal wall.

To perform the procedure requires five small incisions through which we place our laparoscopic instruments. We then create a small tunnel around the upper portion of the stomach through which we pass the Band and lock it into place. Several sutures are also placed on the stomach to hold the Band in the correct position.

Once the Band is secured in the correct position, the amount of food that you can eat is diminished considerably. By adding or removing saline through the port, we can adjust the size of the band to allow you to eat more or less food.

The actual adjustment of the Band takes place in our office. It is a quick and simple procedure that is performed by placing a needle into the access port and adding or removing a small amount of saline. During your first year after surgery, you will meet with your surgeon several times to make sure the adjustment is perfect for you.

A well-adjusted band will provide a sense of satiety (satisfaction) with small portions and allow you to lose 1.5-2.0 pounds per week.