For those suffering from obesity, newer surgical weight-loss procedures can help shed pounds and encourage better health, without many of the complications seen in older surgeries.
Dr. Jonathan Arad, a bariatric surgeon at Montefiore Nyack Hospital, says patients who undergo gastric sleeve surgery on average lose 65 percent of their excess body weight, and often no longer need to take medication for diabetes, heart disease or high blood pressure. “This is not just a weight-loss procedure, but a way to get healthier overall,” he said.
Who is a Candidate for Weight-Loss Surgery?
Weight-loss, or bariatric surgery, is considered for a person with a body mass index (BMI) of 40 or higher without related illnesses, or a BMI of 35 to 39 with a related illness such as diabetes, heart disease, uncontrolled high blood pressure or sleep apnea.
Gastric Sleeve Surgery
Gastric sleeve surgery, also known as vertical sleeve gastrectomy, consists of removing about 65 percent of the stomach, resulting in a stomach that looks like a long tube or sleeve. It is performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large incision.
This procedure makes the stomach much smaller, so a person can’t eat as much. The “new” stomach restricts food intake by allowing only a small amount of food to be eaten at one time. A person who has undergone the procedure quickly feels full and has a decreased appetite.
Improvement Over Older Procedures
The gastric sleeve procedure is an improvement over older weight-loss procedures, such as gastric bypass, which makes the stomach smaller and reroutes the intestines. Up to 35 percent of patients who have gastric bypass surgery gain back more than half of their excess weight within five to seven years of their initial surgery. “This weight regain can happen for many reasons, but one is the technical failure of the procedure over time in which the stomach pouch stretches, allowing for more calories to be readily consumed,” said Arad.
Overstitch Gastric Bypass Revision Surgery
Another newer procedure, called overstitch gastric bypass revision surgery, can help patients who have had gastric bypass surgery and have regained weight. “Redoing the entire gastric bypass is a big surgery and is very risky,” said Arad. The overstitch procedure avoids problems with scar tissue because it is done through an endoscopy, a nonsurgical procedure in which a flexible tube with a light and a camera attached is passed through the mouth into the digestive tract.
As with the gastric sleeve procedure, the overstitch procedure takes about an hour, and most people go home the next day. Because there are no incisions, recovery is fairly quick and generally involves only some nausea for the first several days as the body adjusts.
Making Weight Loss Happen
“When a patient and their doctor decide weight-loss surgery is right for them, the Bariatric Center at Montefiore Nyack Hospital makes it simple," said Arad. "Unlike many hospitals, where the wait can be six months to a year, we can usually get patients into surgery in two months. We also offer nutrition and behavior coaching to help patients stick to their new lifestyle and healthy diet.”
For more information on the services offered by Montefiore Nyack Hospital, click here.