Obesity is a significant health concern, and for individuals who haven't achieved lasting weight loss through diet, exercise, or medication, weight loss surgery, also known as bariatric surgery, can be a viable option. This article explores the various weight loss surgery options available in Raleigh, NC, including primary procedures and revision surgeries, with a focus on the expertise offered by local medical centers.
Understanding Weight Loss Surgery
Weight-loss, or bariatric, surgery helps you lose weight and lowers your risk of medical problems associated with obesity. Weight loss surgery is just the beginning of your journey. It's a tool to help you achieve a healthier weight and improve your overall well-being.
How Weight Loss Surgery Works
Bariatric surgeries primarily work through two mechanisms: restriction and malabsorption.
- Restrictive procedures: These procedures reduce the size of the stomach, limiting the amount of food one can eat. Bands or staples are used to section off a part of the stomach, creating a pouch. Because this stomach pouch is so small, the amount of food one can eat is limited. Food continues to be digested through the normal digestive and absorption process. Most restrictive procedures involve the use of a polymeric silicone ring or mesh band around the stomach. This band provides stability by not allowing the pouch outlet to expand.
- Malabsorptive procedures: These procedures alter the digestive process to reduce the amount of calories and nutrients the body absorbs. Malabsorptive procedures, such as the Biliopancreatic Diversion (BPD) techniques, involve rearrangement of the small intestine to decrease the functional length or efficiency of the intestinal mucosa for nutrient absorption. This procedure restricts both food intake and the amount of calories and nutrients the body absorbs. In addition to creating a small gastric pouch, the surgery disrupts the body's normal digestive process. As a result, food bypasses a large part of the stomach and some of the small intestine.
Types of Weight Loss Surgery Offered in Raleigh, NC
At UNC REX, their bariatric surgeons perform several types of weight loss surgery. Most types of weight loss surgery are performed in Rex Hospital's state-of-the-art operating rooms in Raleigh. They have designated inpatient rooms specifically designed to accommodate you during your inpatient stay. Duke Health, as a Bariatric Center of Excellence, provides safe, effective, high-quality bariatric care to people who have been unable to maintain weight loss through diet, exercise and/medication.
Here's an overview of common bariatric procedures:
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- Gastric Banding: An inflatable band is placed around the upper stomach to restrict the flow of food through the stomach. This procedure requires you to eat slowly and makes you feel full sooner. Gastric banding typically results in a smaller percentage of weigh loss when compared to other types of weigh loss surgery.
- Gastric Bypass Surgery: Gastric bypass surgery separates the stomach into two parts: a lower remnant stomach and an upper functioning pouch. The small upper portion of the stomach is attached to the small intestine close to the large intestine.
- Sleeve Gastrectomy: The sleeve gastrectomy removes two-thirds of the stomach, leaving a long pouch or "sleeve". This restricts the amount of food intake.
- Bilio-pancreatic Diversion with Duodenal Switch (Duodenal Switch): Bilio-pancreatic diversion with duodenal switch, more commonly referred to as duodenal switch, is both a restrictive and a malabsorptive procedure. The stomach is reduced in size by about 70% and connected to the small intestine close to the large intestine.
Revision Weight Loss Surgery
While many individuals experience success with their initial weight loss surgery, some may require additional intervention. If you have one of these concerns, having an experienced surgeon evaluate your condition is very important, as revision weight loss surgery can be challenging and requires advanced skills and techniques. Our experience using different revision surgeries to treat all types of complications associated with weight loss surgeries is well known.
Reasons for Revision Surgery
A small group of people may require additional intervention, and possibly additional surgery, to help them reach their goal, due to:
- Insufficient Weight Loss, Weight Regain, or Unresolved/Return of Medical Conditions: While most people have success following weight loss surgery.
- Complications that Require Corrective Treatment: In some cases, a corrective procedure may be necessary to control or close a leak, fix an obstruction, repair an ulcer, or control bleeding.
- Issues related to previous procedures: People who underwent lap-band surgery in the past and are now experiencing chronic complications related to the band or the port may require medical or surgical intervention. Reversing the procedure by removing the band is one option. Converting to a different weight loss procedure is another option. People who underwent older weight loss surgeries, such as stomach stapling (vertical banded gastroplasty or VBG), jejunoileal bypass, and other procedures that are no longer performed, may have complications that require evaluation and possible reversal or conversion to a different procedure.
- Stretching after Gastric Bypass: There are times when people experience trouble reaching their weight loss goals, or even weight gain after gastric bypass, because of stretching that may occur at the connection between the stomach and small intestine. In this case, we may recommend an endoscopic gastric bypass revision, which is performed by inserting a tube into your mouth to reach the stomach.
Revision Surgery Options
Depending on the specific issue, revision surgery may involve:
- Band Removal: Reversing the procedure by removing the band is one option.
- Conversion to a Different Procedure: Converting to a different weight loss procedure is another option.
- Endoscopic Revision: In this case, we may recommend an endoscopic gastric bypass revision, which is performed by inserting a tube into your mouth to reach the stomach.
The Evaluation Process for Revision Surgery
Before we consider revision weight loss surgery, one of our weight loss surgeons will meet with you either through a video or in-person visit to review your medical history, your records, and understand your concerns. We take a close look at your eating and exercise habits and perform a behavioral assessment to identify a possible cause. Understanding Your Options If revision weight loss surgery is the right next step, we offer you a list of possible options based on your condition. You are encouraged to research these options and bring your questions to an in-person class where we review those options and determine which revision weight loss surgery is right for you. This is a crucially important step to optimize you for success and ensure your insurance company approves your weight loss revisional surgery.
Comprehensive Care and Support
Rather than sending patients to numerous professionals, our program offers a comprehensive, unified and personalized approach. Led by expert board-certified bariatric surgeons, members of our weight loss surgery program will participate to use their expertise to meet your healthcare needs. These individuals include your bariatric coordinator (also called a navigator, or advocate), nurses, dieticians/nutritionists and exercise/health and fitness specialists.
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Insurance and Payment
Duke Health contracts with most major health insurance carriers and transplant networks, including the ones listed below. Before scheduling your appointment, we strongly recommend you contact your insurance company to verify that the Duke Health location or provider you plan to visit is included in your network. Your insurance company will also be able to inform you of any co-payments, coâinsurances, or deductibles that will be your responsibility. If you proceed in scheduling an appointment and your health insurance benefits do not participate with Duke, your out of pocket liability may be higher. We will contact you regarding your coverage and patient liability.
Visiting Duke Weight Loss Surgery Raleigh
The Duke Raleigh Campus has two free parking decks available for visitors and patients. Plan your trip to Duke Weight Loss Surgery Raleigh through GoRaleigh bus routes 2 and 24L. The closest bus stops are Wake Forest Rd at Navaho Dr and Wake Forest Rd at St Albans Dr.
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