About Surgical Procedures

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What types of procedures are performed at AtlantiCare’s Center for Surgical Weight Loss & Wellness?

We perform Laparoscopic Roux-en-Y gastric bypass, Laparoscopic adjustable gastric banding (LAP-BAND®) and Laparoscopic Sleeve Gastrectomy procedures.

What should I look for in choosing a surgeon and hospital to perform weight loss surgery?

In selecting a physician and surgical center, you should consider the following:

The physician’s education, knowledge and reputation, including specialized training in bariatric surgery and experience in performing surgical weight loss procedures.
The hospital’s expertise in bariatric surgery, including designation as a Bariatric Center of Excellence by the American Society for Bariatric Surgery;
Recognition for excellence by national authorities on healthcare, such as the Joint Commission on Accreditation of Healthcare Organizations, the American Nurses Association (through its Magnet Nursing Program), J. D. Power and other independent sources.
Ability to provide a comprehensive program of care – including patient education, consultation and medical services – before, during and after surgery.
Expertise in the most advanced procedures, including laparoscopic techniques.
Caregivers who provide compassionate, competent and professional service – focusing on your individual needs and addressing your personal questions and concerns.

How long does surgery take?

For laparoscopic Roux-en-Y gastric bypass, the average operation takes two to three hours.
For laparoscopic Sleeve Gastrectomy, the average operation takes 90 minutes to three hours.
For the LAP-BAND® procedure, the average surgical time is one to two hours.

How is laparoscopic surgery different from open surgery?

Laparoscopy is considered a more technologically advanced, less invasive approach to surgery. It requires that the surgeon have special training and skills in the laparoscopic technique.

While open surgery uses an 8- to 10-inch incision (cut) to open the abdomen, the laparoscopic approach involves six small incisions (¼ or ½ inches long). Through these small incisions, a fiber optic tube (the laparoscope) connected to a camera and long-reaching instruments are inserted. The entire operation is performed “inside” the abdomen.

Using laparoscopy, patients usually recover faster, require a shorter hospital stay, and have fewer complications, including less pain and scarring.

Can I still have laparoscopic weight loss surgery if I have had previous abdominal surgery?

Your personal surgical history and the technique to be used are discussed at your surgical consultation.

Can BMI be too high to have the surgery performed laparoscopically? If so, what is the cut off?

Yes. The laparoscopic technique uses a number of small incisions and long instruments to reach deep inside the abdominal cavity. When BMI exceeds 50 (or in patients with a large distribution of body fat in the upper abdomen), the instruments may not be long enough to perform laparoscopic surgery. The surgeon will discuss surgical approaches with you at your initial consultation.

Is the appendix removed at the time of surgery? Why or why not?

The appendix is not removed. There is not an increased incidence of reported appendicitis after bariatric surgery.

Is the gallbladder removed at the time of surgery? Why or why not?

There is some controversy over this issue, which we discuss in detail at our informational seminar.

Which insurance companies cover weight loss surgery?

You will want to obtain a copy of your current insurance policy to determine if these procedures are covered. Insurance details can be difficult to navigate, and our insurance specialists will gladly assist you in determining if these procedures are a covered benefit in your plan.

What does the laparoscopic Roux-en-Y gastric bypass procedure involve?

Gastric bypass is regarded as one of the most popular and effective surgical weight loss procedures today. At AtlantiCare, we perform this procedure laparoscopically.

Gastric bypass limits food consumption by dividing the stomach into two sections:

A small upper portion that can hold only a few ounces of food eaten at one time; and
A large lower portion, which is considered a “remnant” (unused section).

In addition, the intestine is redirected so that it connects with both sections of the stomach, creating a Y-shaped formation.

By reducing the size of usable stomach and reconfiguring the intestine, the procedure restricts the quantity of food that can be eaten and absorbed, creating early fullness, greater satiety (satisfaction from eating a small amount) and ultimately weight loss.

How many centimeters of intestine are bypassed in Roux-en-Y gastric bypass cases?

For those with BMI less than 50: 75 cm
For those with BMI greater than 50: 100 cm

What determines the size of the gastric pouch (15 ml, 30 ml, 60 ml)? Do doctors use different numbers in different situations?

Several different techniques are used in the gastric bypass procedure, and surgeons have specific reasons for using certain gastric pouch sizes.

In gastric bypass cases, how do you check for anastomotic leaks (leaks at the surgical site where the stomach and intestine are connected)?

While in the operating room, a test is performed to check for leaks before the surgery is completed. Our nurses will also monitor you closely for any signs of a leak. The morning after surgery you will begin a clear liquid diet of water, sugar-free gelatin and fat-free broth.

In gastric bypass, what happens to the stomach remnant?

The unused part of the stomach remains in place. Although not used, its ability to function remains intact.

How is laparoscopic adjustable gastric banding (LAP-BAND®) performed?

LAP-BAND® surgery works by restricting the amount of food the stomach can hold. Like gastric bypass, it is performed laparoscopically by AtlantiCare surgeons. The procedure is considered a less invasive form of weight loss surgery.

The procedure involves placing a silicone band around the top part of the stomach, creating a small pouch that fills quickly and gives the patient an early sense of fullness when eating.

The band contains a reservoir that may be adjusted through a port located just beneath the skin. By adding or removing solution to/from the reservoir, the surgeon can increase or decrease the tightness of the band – regulating the amount of food that can be taken in. The surgeon’s ability to adjust the band’s tension helps ensure that desirable weight loss levels are achieved.

About Surgical Procedures

Questions

General Questions About Surgical Procedures

Laparoscopic Gastric Bypass

Laparoscopic Adjustable Gastric Banding

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