Because BPD with DS is major surgery, it poses possible complications and side effects, which should be considered before making the decision to have surgery. Complications can occur both early after surgery and later during the recovery period. Although no surgery is risk-free, AtlantiCare's program takes steps to minimize the chance of complications with:
Potential Early Complications Following Duodenal Switch Surgery:
Potential Later Recovery Period Problems:
Laparoscopic Biliopancreatic Diversion (BPD) with Duodenal Switch (DS) surgery is one of four surgical weight loss options we offer at AtlantiCare. The BPD with DS was first reported by Dr. Doug Hess in 1986 and is considered the most effective surgical weight loss approach available today. It is also the most effective treatment for metabolic diseases, such as Type 2 Diabetes and hyperlipidemia associated with morbid obesity. The procedure has both restrictive and malabsorptive components. Very few centers in the world offer this procedure, especially with a laparoscopic approach.
Patients who choose to have laparoscopic BPD with duodenal switch surgery will typically experience these benefits:
*Improvement or complete resolution of medical problems is not guaranteed and they may recur if weight is regained.
Long-term follow up and daily vitamin and protein supplements are crucial to the success of this operation. Life-long monitoring is necessary to prevent nutritional and mineral deficiencies – just as with the RYGBP.
The gallbladder, if still present, is removed as a part of the procedure.
Information on laparoscopic Roux-en-Y gastric bypass surgery »
Information on laparoscopic adjustable band surgery »
Information on laparoscopic sleeve gastrectomy surgery »
AtlantiCare is committed to helping patients long after they leave the hospital – with special programs and services geared specifically for people who have had weight loss surgery.
Regular visits with your surgeon are important for monitoring your overall physical health and your progress in achieving your weight loss goals. The frequency of these office visits will depend on the type of procedure you have had (either gastric bypass or LAP-BAND®) and other factors. Your surgeon will provide information regarding your checkup schedule.
Before follow-up visits, please contact your surgeon’s office to get prescriptions for the routine lab tests you will need to have performed, such as blood work. These tests help your doctor evaluate your current physical condition and assist him in making appropriate recommendations for your care.
To request an appointment – or get information regarding office location, phone number and business hours, click a physician’s name below:
Important note: Gastric Bypass patients need to have lab testing every year for the rest of their lives to check important blood levels. These tests include:CMP (Comprehensive Metabolic Panel), CBC (Complete Blood Count), Lipid Profile (cholesterol), B12 level, folate level, Iron level, Vitamin A level, Zinc level, Vitamin D (25-Hydroxy) level, Ionized Calcium level, and Magnesium level. If for some reason you are unable to follow up with your bariatric surgeon, PLEASE have your Primary Care Physician order these tests for you. In addition, it is a good idea to have a Dexa (Bone Density) Scan to detect osteoporosis. Since Gastric Bypass patients have a malabsorption factor with their procedure, it may make them more prone to osteoporosis. All of these test can be ordered with a diagnosis code of 579.9 (malabsorption).
Following the program’s dietary regime, as explained by the nutritionist before and after surgery, is essential to both losing weight and properly nourishing your body. AtlantiCare also offers these resources to help you stay on course.
For more information, visit the Atlantic Coast Living Fit web site or call (609) 677-6980.
Recipes: A wide array of recipes focusing on healthier ingredients and providing detailed nutritional information, including calorie, protein, fat and carbohydrate content, may be found on the internet including on Cooking Light magazine’s searchable recipe database (www.cookinglight.com). Cooking Light recipes tend to focus on healthier ingredients and provide detailed nutritional information, including calorie, protein, fat and carbohydrate content.
Important Note: Always review a recipe’s nutritional content to make sure it is consistent with your diet progression and be sure to ask your nutritionist if you have any questions. AtlantiCare is not affiliated with Cooking Light and makes no representations regarding any recipes found therein.
Being active not only helps you lose weight, it also makes you feel better physically and mentally. To get started – and stay motivated – many of our patients turn to AtlantiCare LifeCenter, which offers comprehensive fitness services, including a special weight loss program. Tailored exercise instruction, nutritional counseling, spa-like amenities and many other features help care for your mind, body and spirit. In addition, AtlantiCare’s surgical weight loss patients qualify for special membership discounts.
Important Note: Always consult your physician before beginning any type of exercise program. AtlantiCare is not affiliated with Thera-Band and makes no representations regarding any exercises or instructions contained therein.
Surgical weight loss – and the many physical and emotional changes that come with it – are too difficult to deal with alone. At AtlantiCare, you will find a community of caring individuals – people with whom you can share your problems and concerns and who understand what you are going through.
AtlantiCare patients are strongly encouraged to take part in our monthly support group meetings, which bring together people in various stages of weight loss surgery and recovery. These meetings are open to anyone who has had weight loss surgery, regardless of where the procedure was performed.
As an AtlantiCare patient undergoing weight loss surgery, you must receive a psychological evaluation before the procedure to ensure that you are a good surgical candidate. Your psychologist is also a valuable resource after surgery for dealing with emotional issues.
Making the decision to have weight loss surgery and having the procedure performed are the first steps in the journey toward significant weight loss. However, after surgery, patients must make a lifetime commitment to adhering to the program regime to stay healthy and achieve their weight loss goals.
These lifestyle requirements are outlined in what we call “The Six Rules,” which focus on:
Follow the rules faithfully and the weight will come off and stay off. Break the rules continually and you will gain weight. Your surgeon won’t expect you to achieve your weight loss goals unless you adhere to the program’s dietary, nutrition and exercise guidelines.
The Six Rules should be adopted as soon as possible and used for the rest of your life.
At every meal, eat the protein portion first. Fruit and vegetables come second, followed by starch (potato, rice, pasta, cereal, bread, etc.), if you still have room.
Eat one to three meals a day. One to two meals a day seem to agree well with most of our patients. The body does not need three meals a day, so listen to your hunger cues – rather than watch the clock.
Drink plenty of water (a minimum of 48 to 64 ounces every day). Your surgeon recognizes that soon after surgery you may only be able to tolerate a mouthful at a time – that is normal. Eventually, the amount will increase to as much as 2 to 4 ounces at a time.
Do not use coffee, tea, soda or juice as a substitute for water. You may have other fluids – in addition to water – but not in between meals. Flavorful liquids between meals encourage snacking.
Ultimately, the goal is to exercise for at least 30 minutes every day. However, immediately after surgery, some patients may struggle with simply walking down the hall – their energy level is at an all-time low. The solution is to start out slowly and move your body a little more every day.
While every body is different, most patients feel back to normal in four to eight weeks. At this point, you can begin exercising on a treadmill at home or go to the gym, dance class, water aerobics class – or whatever you choose.
Be sure to consult your physician before beginning any weight training.
Anything eaten between meals that is flavorful or has calories is considered a snack.
When one snacks, glucose (sugar) goes to the brain. The brain, which lives off glucose and oxygen, remembers how good that shot of glucose felt. When the glucose if gone (about one to three hours later), the brain sends a message to snack again. As a result, snacking makes us feel hungrier – and it can slow down or actually stop weight loss. Snacking can also cause weight gain, depending on how much and how often we snack.
While the surgeon can alter you digestive system, you control your eating habits. To lose weight, make a commitment today to stop snacking.
Because you are eating only small meals and losing weight rapidly, your body cannot receive all the vitamins and minerals it requires. So you will need to take vitamin supplements daily. It’s especially important for gastric bypass patients, who have additional malabsorption issues.
Because your daily vitamin requirements are greater than those who’ve not had weight loss surgery, you may not easily find the right vitamin products for you on the store shelf. To make sure you get adequate nutrients, our program dietician will give you detailed information on the amount and type of vitamin products you should take – and where to buy them.
After surgery (and later as symptoms warrant), your surgeon will test you for vitamin and mineral deficiencies to help ensure that you have proper nutrition.
If you don’t smoke don’t start. If you smoke…quit and never start again. You will be required to have a nicotine level test run prior to surgery. If it comes back positive, your surgery will be cancelled, you will need to quit smoking, and your surgery can be rescheduled for a future date. Smoking increases the chance for respiratory complications during the procedure and can significantly increase your chance of developing gastric ulcers.
If your surgery was performed at AtlantiCare, follow the dietary and exercise guidelines provided by your medical team. Do not use any other follow-up care program – either off the Internet or from another healthcare provider.
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