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For Some, Surgery Offers Weight-Loss Option

Posted on: Tuesday, 28 February 2006, 21:00 CST

By DR. THOMAS R. WALSH

After more than 20 years as a general surgeon, I had treated many obese patients with chronic diseases such as diabetes and hypertension, joint injuries and sleep apnea, all of which were made worse by excess weight.

I truly sympathized with these patients, knowing that most had tried every diet plan, medication and behavioral modification program they could find.

I knew how hard they had tried to lose excess weight and have seen how their many attempts have failed, usually making them heavier and more at risk than before. For this group of patients, there truly seemed to be no easy answer.

During the late 1990s several surgical procedures were introduced, all being touted as safe and resulting in long-term weight loss, but I, and my partners, remained skeptical.

However, in 2002, my partners and I learned of a new form of surgery called mini gastric bypass, or MGB, which is less invasive than other options, involve s a much shorter recovery time and results in high patient satisfaction rates.

Dr. James Dasher and I became trained in this revolutionary procedure and began performing it on patients through our bariatric surgery program at High Point Regional Health System.

In brief, the surgery involves the partitioning of the stomach into a long, narrow tube and a separate larger piece. The smaller stomach is attached about 6 feet down the small intestine. The larger remnant of the stomach is sealed and left unattached to the new stomach tube, but is still attached and drains through the small bowel.

This smaller stomach decreases the amount a patient can eat, and the bypass of a portion of the small intestine decreases the absorption of fat and calories.

The small bowel bypass also seems to reinforce better food selections by our patients after their operation.

In a recent report of the more than 2,500 patients who have undergone the procedure, the combination of smaller stomach volume and decreased absorption has resulted in an average weight loss of 140 pounds in one year in a 300-pound patient.

Overall, the average patient loses between 72 percent and 80 percent of his or her excess body weight by two years after the operation.

While controversy still surrounds bariatric surgery of all kinds, MGB has been found to be safer than other kinds of bariatric surgery and many patients find that the benefits outweigh the risks.

Independently verified results show that many weight-related medical illnesses were completely resolved in a high percentage of patients after the operation.

These illnesses include high blood pressure, diabetes, sleep apnea, elevated cholesterol and triglycerides, edema, arthritic pain and shortness of breath.

In our program at High Point Regional Health System, we have taken care of more than 400 patients in the past three years.

Our average patient stays in the hospital slightly more than one day .

Our biggest concern about the risks of the MGB (and really any bariatric surgical procedure) is that of a leak where the new stomach is hooked into the small bowel.

This can lead to infection and a very long hospitalization.

Luckily, we have only had four leaks in our first 440 patients.

Before someone is accepted into our program to undergo a MGB, they must demonstrate a thorough understanding of the various options for the treatment of obesity and the risks.

We have a multidisciplinary educational program set up to help people through this rigorous process.

In addition, they need the support of their primary care physician, any other specialist physicians they see regularly, and, of course, a family member who will be helping them through the preoperative process, the operation and the recovery back to normal daily function.

Most people are back to nonlifting activity by a week after the operation and full, unlimited activities after two to three weeks.

Our patients are expected to follow up with doctors throughout their life to ensure a healthy postoperative lifestyle and long- term success.

The relative weights of the risks and benefits will differ for each patient, and we are happy to discuss those risks and benefits with you.

If you have any questions or are generally interested in bariatric surgery as a weight loss option, we have a patient clinic 4 to 5:30 p.m. every Monday and Wednesday at the Millis Regional Health Education Center on N. Main St. in High Point.

For directions or to register, please call Lisa Hege at 878- 6340.

We also invite you to attend our monthly support group meetings held at 6 p.m. the third Monday of every month, also at the Millis Center.

Thomas R. Walsh, MD, is with Cornerstone Surgery. For more info on this topic, tune in to Regional Health Talk today at 8 a.m. on WMFR (1230 AM).

To suggest a column topic, call 878-6200 or write to info@hprhs.com

Source: Greensboro News Record

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