Surgical Treatment of Morbid Obesity

The surgeons of Colorado Springs Surgical Associates have been involved in bariatric surgery, or the surgical treatment of morbid obesity, for over twenty-five years. As a result of our commitment, we are the only Center of Excellence for Obesity Care in the entire Southern Colorado region. We strive to provide a complete assessment and care program for our bariatric patients, with preoperative evaluations from a nutritional specialist as well as a psychotherapist to ensure our patients are as prepared as possible to proceed with their operation. Our physicains are intimately involved with the preoperative evaluation and postoperative management of our bariatric surgical patients. The most common surgical options offered by CSSA include laparoscopic and open Roux-En-Y Gastric Bypass and Laparoscopic Adjustable Gastric Banding (LAP-BAND®). While a relatively new procedure, we have recently begun performing laparoscopic sleeve gastrectomy, which may be an excellent surgical alternative for certain patients.

We have partnered with Penrose-St.Francis Hospital to develop and maintain a bariatric surgical program which has been recognized as a Center of Excellence by the American Society for Metabolic and Bariatric Surgery. While there is a wide variety of information available to patients regarding surgical treatment of morbid obesity, much of it can be confusing or misleading. The National Institutes of Health has an excellent web resource for patients considering weight loss surgery. More detailed information is available from Obesity Help.com.

We encourage anyone who may be interested in weight loss surgery to contact our Bariatric Nurse Coordinator, Fran Jackson, at 719-776-5359. For those whose insurance does not cover obesity treatment procedures, there are self-pay options for LAP-BAND® surgery. If interested, please contact our office for additional information.



LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS


The Roux-En-Y gastric bypass procedure has long been held as the "gold standard" for weight loss surgery. A restriction of food intake is achieved by dividing the stomach into two portions, the smaller of which is approximately 30ml in size. The small intestine downstream is divided, and a Roux limb is attached to the stomach pouch to allow it to empty. The excluded stomach and upper portion of the small intestine is bypassed, providing a small component of malabsorption. However, the main effect of the procedure is to provide a sense of fullness with eating smaller portions of food, allowing the patient to gradually adjust to smaller, more appropriate meals.








LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING (LAP-BAND®)


Laparoscopic adjustble gastric banding, using the LAP-BAND® system, is an alternative method of weight loss surgery that is less complicated than gastric bypass surgery. It involves placement of a silicone band around the top of the stomach, which can be adjusted to achieve an appropriate sensation of fullness with eating smaller portions of food. Unlike gastric bypass surgery, the procedure does not involve re-routing of the GI tract, and the band is removable. Weight loss is more gradual than with gastric bypass surgery, and the band is adjusted according to weight loss progress and sensation of fullness.



LAPAROSCOPIC SLEEVE GASTRECTOMY


A more recent innovation in morbid obesity surgery is the laparoscopic sleeve gastrectomy, in which a portion of the stomach is removed to leave a slender remnant. This is a purely restrictive operation, and provides a sense of fullness with a significantly decreased amount of food intake. This operation was originally designed as a "bridging" procedure for the super-obese patient, allowing them to lose enough weight to then tolerate a Roux-en-Y gastric bypass. Many of those patients lost enough weight to allow this to be considered a primary procedure, and it has gradually become a more frequently performed procedure. Long-term data is not available, but it appears this operation may hold considerable promise for certain patients.