Embarking on a weight loss journey is a significant decision, and Sentara aims to be your partner in achieving your health goals. Combining expert providers, comprehensive solutions, and the latest techniques, Sentara offers various weight loss surgery options. This article provides an overview of these options, the requirements for surgery, and what you can expect throughout the process.
Surgical Weight Loss Options at Sentara
Sentara's weight loss surgery centers are nationally accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Two primary surgical options offered are Roux-en-Y gastric bypass and sleeve gastrectomy.
Roux-en-Y Gastric Bypass
According to the American Society for Metabolic & Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass (stomach stapling) is the current gold standard procedure for weight loss surgery. The Roux-en-Y gastric bypass procedure is a restrictive and malabsorptive procedure. The surgeon creates a small upper section of the stomach, called a pouch, about the size of an egg. The remaining, larger part of the stomach is bypassed, so it no longer holds or digests food. The small intestine is divided and connected to the new, smaller stomach pouch so food can pass through.
Like many weight loss surgeries, this procedure creates a smaller stomach pouch that holds less food, helping you eat fewer calories. When your smaller stomach pouch fills with food, it sends signals to your brain to help you feel full and turn off feelings of hunger. The very small opening between the stomach pouch and the small intestine limits how fast the pouch can empty. Changing the path food takes through your digestive system helps reduce hunger, helps you feel full sooner and supports your body in reaching and maintaining a healthier weight.
Many, if not most, gastric bypass surgeries are performed using a minimally invasive, or laparoscopic procedure. In comparison to traditional open procedures, this approach offers less pain and discomfort, a quicker recovery, and less scarring. It also reduces the risk of certain complications. The surgery takes around two hours of operating time. This depends greatly on the patient's anatomy and whether they have adhesions inside the abdomen or have had previous surgery. Most patients remain in the hospital for one to two nights.
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In terms of weight loss, depending on the factors above, most people (around 90 percent), will lose between 50 and 80 percent of their excess body weight. For someone weighing 350 pounds, with an ideal body weight of 150 pounds, this is equal to a loss of 100 to 160 pounds. Two years after gastric bypass surgery, 98 percent of patients have lost more than 50 percent of excess weight, with an average of 75 percent of excess weight.
Sleeve Gastrectomy
Sleeve gastrectomy, also known as gastric sleeve surgery, involves laparoscopically or minimally invasively removing approximately 75-85 percent of the stomach. The remaining stomach takes the shape of a tube or “sleeve” and is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption.
Requirements and Preparation for Weight Loss Surgery
Before undergoing weight loss surgery at Sentara, several steps and requirements must be met to ensure patient safety and the best possible outcome.
Initial Steps
Your first step in our program is to attend a free information seminar. You will learn about the surgeries and the benefits of our program. Watch online seminar. After attending our information seminar, you should contact your insurance company to confirm that you have benefits for "morbid obesity."
Pre-Surgical Evaluation and Preparation
Before surgery, you will spend several months working with us to prepare for your surgery. You will learn how to eat before and after your procedure. Often, patients lose weight before surgery because of what they learn from our dietitians. Our team will teach you about portions, nutrients, what to eat and what not to eat. You will need to modify your diet so that it is compatible with a smaller stomach. That also includes eating more slowly to give your smaller stomach more time to digest.
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Many insurance companies require that you meet with a psychologist so that you can be sure you are ready for the long-term dietary requirements after weight loss surgery. You will also discuss the future changes in your weight.
We will order presurgical blood work and need a supporting letter from your primary care provider. We schedule patients for an upper endoscopy (EGD) to look for any abnormalities in their stomach that would affect their future surgery. We will ask some patients to gather supporting letters from their other long-term providers (cardiology, pulmonology, psychiatry, etc.) as well as updated preventative healthcare screenings.
You will need to make changes to your diet and lifestyle before and after weight loss surgery. A registered dietitian and an exercise physiologist lead this class. A couple of weeks before surgery, you will meet again with the bariatric program coordinator and registered dietitian. A month after surgery, you will meet with the registered dietitian and exercise physiologist to discuss the next steps in diet and address any questions you may have.
Medical Clearance
Your health and safety are our utmost concerns. We schedule various medical clearance tests depending on your particular medical conditions. We evaluate every patient thoroughly. These tests might include lab work, X-rays, a sleep apnea test, gallbladder ultrasound, EKG, or other tests. All patients are also administered a psychological clearance test.
Insurance and Financial Considerations
Weight loss surgery is a significant investment in your health, and many patients have questions about insurance coverage and costs. Costs for weight loss surgery can vary significantly based on your personal needs, the type of surgery you choose and your insurance. Many health insurance plans do cover weight loss (bariatric) surgery, but coverage varies by plan. To qualify for surgery, many insurers require supervised diets and special clearance letters from your doctors.
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If your insurance coverage does not cover weight loss surgery, you may consider paying for the surgery yourself. We will provide you with a comprehensive overview of pricing to help you plan for the financial investment in your health. While a typical range for surgery is around $17,000 to $26,000, insurance may cover part or all of the cost.
At Sentara, we recognize that understanding the financial aspects of surgery can be overwhelming. If your insurance plan covers weight loss surgery, we will provide the necessary medical documentation and work directly with your insurance company to support the approval process. While your insurance provider makes the final decision on payment, our team will guide you every step of the way to help you feel informed and prepared.
After you receive authorization from your physician and insurance company, we will schedule surgery.
Post-Surgery Expectations and Lifestyle Adjustments
After gastric bypass surgery, you will need to follow specific dietary guidelines for several weeks to help your body heal and adjust to your new stomach size.
Lifestyle changes are an important part of your journey. Many patients find it helpful to join a support group to connect with others who understand the challenges and victories that come with weight loss surgery. Ask your weight loss surgery team about support groups and additional resources that can help you stay motivated and on track as you build a healthier life.
It’s important to remember that weight loss surgery is a tool to help you on your journey to better health. If used incorrectly or not at all, the weight will return. In other words, the pouch can be "beaten." Like any tool, it works best when used correctly and consistently, alongside healthy eating and lifestyle habits.
After surgery and over time, the small stomach pouch created will gradually stretch and may be able to hold more food. Certain habits, like frequent snacking or drinking high-calorie beverages, can cause the pouch to stretch more quickly. As the pouch and the opening to the small intestine enlarge over time, food may pass through more quickly, which can trigger feelings of hunger.
We expect that during the first two years after surgery, you will develop and adopt new, healthier eating habits. If weight regain happens, it does not mean you have failed. Many people can get back on track by returning to the healthy habits learned after surgery and using the pouch as a tool to support weight management again. Our team is here to help you every step of the way, providing guidance and support whenever you need it.
Potential Complications
No. Gastric bypass surgery should be considered permanent. Over one-third of the people who have gastric bypass develop gallstones. Between 10% and 20% require a second surgery to repair a complication. It is possible for the staples to pull loose (so there is no longer a pouch). It is possible for a leak to occur from the stomach or intestine into the abdominal cavity. There is a very small risk of death from the surgery. There may be other complications; be sure to discuss your concerns with your weight loss surgeon.
The Sentara Support Team
At Sentara, your weight loss journey is supported by a full team of experts, including board-certified surgeons, nurses, nurse practitioners, physician assistants, registered dietitians and experienced support staff.
Benefits of Gastric Bypass Surgery
Gastric bypass surgery is more than a weight loss tool; it can help you improve your overall health and quality of life, allowing you to live more actively and comfortably.