Our Program
Began in 2000
2200 Total cases
629 Gastric Bypasses
615 Sleeve Gastrectomies
712 Adjustable Gastric Bands
Data from 2000 to Date
Our Surgeons
Dr. Pete Avara Bariatric Surgeon Medical Director
Dr. David Jenkins Bariatric Surgeon
Our PatientAdvocates
Kim Fortier, MHS, PA-CPhysician Assistant
Dena Trusler, RN, CBN Clinical Nurse
Robyn Roberts, RMA Medical Assistant
Valorie Barnes, MA Insurance Coordinator
Tanya Delacruz, MA Billing Coordinator
Allison LewisPatient Outreach
Our Hospital
Singing River Hospital Pascagoula, MS
Obesity is a Disease
Psychological
Emotional
Genetic
Behavioral
Physical
Hormonal
Dietary
“It’s Not Your Fault, But It’s Your RESPONSIBILITY”
-Dr. Pete Avara
Medical Weight Loss
Full Meal Replacement Program utilizing OPTIFast® products
Utilizes ‘Stimuli Narrowing’ to Help in Weight Control
Weekly Behavior Modification
For Patients with a BMI of 30-35 or Who Aren’t Candidates for Surgery Need to Lose a lot of Weight Before Surgery is a Safe Option
Have Severe Medical Conditions that Prevent Surgery as a Safe Option
Patients Can Lose an Average of 50 lbs in a 6 Month Period*
*Per the Nestle Corporation’s studies, utilizing a 800 cal/day meal replacement option
Why Surgery? “Bariatric Surgery is the only proven method that results
in durable weight loss.” 2
76.8% of Patients Show Remission to Type 2 Diabetes 3
Hypertension is Eliminated in 61.7% of Patients 3
High Cholesterol is Reduced in 70% of Patients 3
85.7% of Patients Show Improvement in Sleep Apnea 3
Joint Disease, Asthma, and Infertility Either Significantly
Improved or Resolved 3
Information gathered from JAMA 2004
Criteria for Weight Loss Surgery
BMI of 40 or Greater
BMI between 35-40 with significant
obesity related conditions: Diabetes
Hypertension
Severe sleep apnea
Important Considerations
Be aware of risks and benefits of surgery
Long Term Success Depends on a
Lifelong Commitment to Your Health
Involve Family and Friends in Your
Decision, Success Improves with Support
Normal Digestive Anatomy
Surgical Options
Adjustable Gastric Banding
Restrictive
Sleeve Gastrectomy
Restrictive
Roux en Y Gastric Bypass
Restrictive and Malabsorptive
Laparoscopic Adjustable Gastric Banding
Laparoscopic Adjustable Gastric Band Outpatient Procedure
Return to Work in 4 Days to 1 Week
Band Adjustments are Done Every 6 to 8
Weeks
Once Band is at an Acceptable Fill Level
Follow Up in Clinic Yearly with Labs
Follow up is Lifelong
Band Adjustment
Adjustable Gastric Band Advantages Average of 40% Excess Body Weight
Loss4
It is completely reversible
Digestion and Absorption is Not
Changed and Anatomy is Not Altered
Slow and Gradual Weight Loss
Resolution of Co-Morbid Conditions with
Weight Loss
Adjustable Gastric Band Disadvantages Potential Injury to the stomach, liver or
spleen
Frequent Follow up Consisting of an Injection every 6 to 8 Weeks
Potential of Infection or Leaking Around Port or Tubing
Potential of Erosion of Band into Stomach
Potential Stretching of Pouch or Slippage of Band
Potential Intolerance to the Band
Band Slippage
Laparoscopic Sleeve Gastrectomy
Overnight Hospital Stay
Return to Work in 1 to 2 Weeks
Return to Clinic: 3 Weeks, 6 Months, and
1 Year, and Yearly Thereafter
Lab Work done at 6 Months, and 1 Year,
then Yearly Thereafter
Follow up is Lifelong
Laparoscopic Sleeve Gastrectomy
Laparoscopic Sleeve Gastrectomy Advantages
Average of 65% Excess Body Weight
Loss 4
No Dumping Syndrome
Significant Improvement of Co Morbid
Conditions
Potential for Leaks or Bleeding Along Staple Line
Potential for the Sleeve to Enlarge Over
Time if Lifelong Lifestyle Changes are not Made
Potential for Stricture or Narrowing
Not Reversible
Laparoscopic Sleeve Gastrectomy Disadvantages
Laparoscopic Gastric Bypass
2 to 3 Day Hospital Stay
Return to Work in 1 to 3 Weeks
Return to Clinic: 3 Weeks, 6 Months, and
1 Year, and Yearly Thereafter
Labs Checked at 6 Months, and 1 Year,
then Yearly Thereafter
Follow up is Lifelong
Laparoscopic Gastric Bypass
Gastric Bypass Advantages
Average of 70% Excess Body Weight
Loss 4
Significant Improvement of Co Morbid
Conditions Especially Diabetes and Cholesterol
Most Well Studied
Potential for Leaks or Bleeding Along Staple Line
Potential for Malnutrition
Potential for Strictures and/or Ulceration at the Connection Between the Pouch and Intestine
Potential for Dumping syndrome
Potential for Internal Herniation
Potential for Enlargement of the Pouch Over Time with if Lifelong Lifestyle Changes are not Made
Gastric Bypass Disadvantages
Other Surgical Options
Vertical Banded Gastroplasty Duodenal Switch
Any person having surgery is at risk for certain complications:
Pneumonia
Blood clots
Heart Attack
Stroke
Wound infections
General Risks for Bariatric Surgery
Obesity is a Disease
“It’s Not Your Fault, But It’s Your
RESPONSIBILITY” -Dr. Pete Avara
Insurance Benefits will be Verified
An Assessment Visit will be Scheduled with the Surgeon or Physician Assistant
The Next Steps
Preparation for Surgery
Weight Management
Perioperative Nutrition Class (PET)
Psychological Evaluation
We Want You to be Successful!
Follow up is Key
1. http://www.surgerylaparoscopic.co.uk/website/wp-content/uploads/2011/10/band-adjustment-3.jpg
2. Story of Obesity Surgery. ASMBS. http://asmbs.org/story-of-obesity-surgery-introduction/
3. Benefits of Bariatric Surgery. ASMBS. http://asmbs.org/benefits-of-bariatric-surgery/
4. Rationale for Surgical Treatment. ASMBS. http://asmbs.org/rationale-for-surgical-treatment/
References
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