Basics of Weight-Loss Surgery
Surgeon Explains "Bariatric 5 Ws": What, When, Which, Why and Where
In discussing bariatric surgery during his Monday night meetings for the morbidly obese, Yves Manigat, M.D. alters the traditional "five Ws" of news reporting. He provides the basics this way:
What is bariatric surgery? It is the surgical option (actually several options) for the "morbidly obese," a phrase which describes a person so overweight that he or she is an unhealthy state.
When a person should consider weight loss surgery is explained precisely by Dr. Manigat, who first notes that the potential candidate for surgery must have tried and failed other non-invasive weight loss programs. (This usually is required by insurance companies before they will consider a request for surgical coverage.)
The candidate also must have a sufficiently-high Body Mass Index, or BMI, number, he said. (The BMI is a popular index, using height and weight calculations, to estimate health risk related to weight. The upper limit normal BMI is 25. See a BMI calculator here.)
A candidate for bariatric surgery must have a BMI of greater than 40, although it may also be an option for those who have a BMI greater than 35 and also have significant risk factors.
Because there are various bariatric surgery options, Dr. Manigat helps the patient consider Which type of surgery is best for her or him. Bariatric surgery includes two medical pathways: restrictive, which reduces the size of the stomach and the volume of food that is consumed, and malabsorptive, which alters and reduces the way material is absorbed from consumed food.
Dr. Manigat, using the laparoscopic approach, performs two types of surgeries: the Roux-en-Y gastric bypass (which is both restrictive and malabsorptive) and the adjustable gastric band (restrictive only).
The Why of bariatric surgery would seem to be obvious to many. Morbidly obese individuals often are limited in their mobility and endurance and society tends not to be kind to them. Beyond that, however, surgeons such as Dr. Manigat know that successful weight loss surgery can often alleviate physical and emotional problems. His lists the following potential advantages:
- Significant sustained weight loss
- Partial or complete reversal of the diabetes
- Lowering of the blood pressure
- Normalization of serum (blood) cholesterol levels
- Relief from sleep apnea and acid reflux
- Less osteoarthritis pain and increased mobility
- Improved mood and self-esteem.
Where to have bariatric surgery? Dr. Manigat points out that the bariatric surgery program at Our Lady of Lourdes Medical Center has rated five stars from HealthGrades®., the leading healthcare ratings organization in the United States.
One more Why in his presentation deals with his reasons for performing the surgeries with laparoscopic instruments that require only four or five small incisions as opposed to the large incision of open surgery. They are:
- Foremost, it is better tolerated, even on less healthy patients, with no significant alteration of their vital functions.
- The fluid shift usually associated with open surgery does not occur, eliminating the need for excessive fluid replacement.
- Very little pain and discomfort is reported and the need for post-operative narcotics is significantly reduced.
- The recovery is hastened, allowing for a short hospital stay and a quick resumption of normal activities, including work.
- Because surrounding organs are less likely affected, the risk of complications is markedly reduced.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
