Bariatric Surgery Frequently Asked Question South Jersey - Philadelphia



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How much does weight loss surgery cost?

The average cost for a sleeve gastrectomy is $13,000-$20,000. A gastric bypass ranges from $18,000-$22,000. The average cost for a laparoscopic adjustable band surgery (sometimes called LAP-BAND® surgery) ranges from $17,000-$30,000.

What is a pre-op diet?

We ask patients to do a two week pre-op diet for two reasons. First, it allows the patient to become comfortable with the diet they will need to adopt after surgery. Secondly, it shrinks the liver to allow for an easier surgery. Most patients lose 15-40 pounds on this diet prior to surgery! (This does not affect insurance coverage for the surgery. Dont worry!)

What is my expected weight loss after surgery?

This varies depending on the type of surgery performed. Average weight loss for Gastric Bypass patients is 70% of the patient’s excess body weight in the first year (ex: 70 pounds if someone starts at 100 pounds overweight). Lap Sleeve Gastrectomy produces results that are close to this (60-70% of excess body weight in the first year, on average), and Lap-Band surgery is considerably lower (40-50% of excess body weight in the first year).

Is there a chance that a bariatric patient may gain weight back long term?

This is always a possibility, but patients rarely gain ALL of their weight back, despite popularization of this notion. You must also take into account the fact that most patients without surgery would continue to gain weight over time without any reduction at all. Therefore, even if you had the surgery and gained some of the weight back, it would still be better than if you hadn’t had surgery at all. Bariatric surgery is just a tool to help someone lose weight, it is not a magic bullet for weight loss. Patients need to embrace a healthier lifestyle for long-term benefits. This includes healthy diet and exercise. Surgery will never be successful without these components.

What are the best strategies for long-term success after weight loss surgery?

Bariatric surgery is the most successful treatment for obesity. However, it is just a tool, one that can be abused, misused or harnessed successfully. 90% of weight loss surgery success depends on the person wielding the tool - the patient! Our most successful patients eat adequate lean protein at every meal, follow the 30/30 fluid rule (never eat and drink together 30 minutes before or after a meal), and stay active. Those who move the most lose the most! Exercise is key to long term weight loss success.

Where are the bariatric surgeries performed?

All bariatric surgeries are performed at Kennedy Hospital in Stratford, NJ.

What is a staple line leak? How can it be prevented?

A staple line leak is stomach content leaking from a small area along the incision line. The reasons for a leak are varied but generally occur in the absence of any identifiable cause, according to the American Association of  Metabolic and Bariatric Surgery.  However, smokers are at an increased risk. To help prevent a leak, smokers must be nicotine-free for a minimum of six weeks. All patients are also counseled in proper progression of their diet to prevent undue pressure on the staple line. The incidence of staple line leaks is low.

How are staple line leaks treated?

For sleeve surgery, most patients are treated with a stent placed endoscopically (non-surgical treatment). This is placed until the leaky area of the staple line heals. It essentially walls off the leak. In bypass surgery, treatment is more complicated and is related to the actual area of leak (there are multiple staple lines in bypass surgery). However, reoperation is sometimes necessary for a leak in bypass surgery.

How can blood clots be prevented or treated?

We place everyone on Lovenox for two weeks after surgery to minimize the chances of significant blood clots. For patients at extremely high risk, we may recommend a prophylactic vena cava filter. For treatment, we usually ask the patient to be on anticoagulants for a few months after a DVT (a vein clot) is diagnosed, depending on the location of the DVT. Other interventions include compression stockings while in the hospital and a foot exercise called the feet alphabet which helps increase circulation in the legs (where clots usually start). All patients are up walking laps while in the hospital as well. Dr. Balsama also sends his patients home with a two-week supply of medication that prevents blood clots.

How common are vitamin deficiencies after bariatric surgery?

Fairly uncommon, especially with Lap Sleeve Gastrectomy. Bypass patients have a slightly higher incidence of vitamin and mineral deficiency, due to the bypassed stomach and duodenum (where iron and calcium are normally absorbed).

What vitamins are recommended after surgery?

There are many commercial bariatric vitamin formulations on the market. We don’t promote one company over another. We will direct patients to choose an appropriate, easily dissolvable  supplement with the correct dosages of vitamins and minerals. All patients will require a multivitamin with iron, vitamin B12, and calcium. Our nurse or dietitian will review these recommendations with you.

How quickly may I return to work following bariatric surgery?

The majority of patients may return to work within two weeks of surgery, but this varies. Some patients go back earlier than this, especially if they have jobs which do not require much physical labor.

How quickly may I start an exercise routine after surgery?

Because most of our surgeries are performed laparoscopically, permission to exercise is usually granted at the first post-op visit two weeks after surgery.

How long do I follow up after surgery? At what intervals?

Our usual schedule of follow-ups is 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and then annually. We prefer to follow-up with our patients for a minimum of 5 years. During this period of time, patients will consult with either the bariatric nurse or bariatric dietitian to learn about their nutrition and lifestyle requirements.

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