FREQUENTLY ASKED QUESTIONS

  1. Is there an age restriction for the surgery?

    Surgery is done on patients between the ages of 18 - 65. If you are younger than 18, we would have to refer you to one of the comprehensive adolescent bariatric programs in the U. S. (five, of which Stanford University has one).

  2. Is there a weight limit for this operation?

    We look at body mass index (BMI), which is the weight over the body surface area squared. Patients that have a BMI of 35-40 and have obesity related co-morbidities are candidates for this surgery. Patients have a BMI greater than 40, even if they don’t have co-morbidities are also candidates for this operation.

  3. What are obesity related co-morbidities?

    These include diabetes, hypertension, arthritis, degenerative joint disease, sleep apnea, low pack pain, gastroesophageal reflux disease, stress incontinence, high cholesterol and triglyceride levels and depression.

  4. How successful is this operation?

    The gastric bypass operation allows you to lose about 2/3 of your excess body weight, however it is almost 100% effective in reversing the obesity related co-morbidities including sleep apnea, hypertension, and diabetes. The lap-band operation allows you to lose 50% of your excess body weight at 2 years. It is also effective in reversing obesity related co-morbidities.

  5. What are the pre-operative requirements in order to undergo either operation?

    a) You must have a stable relationship with a primary care physician who has been treating you continuously for one year prior to consideration for surgery.

    b) You must have a dietician evaluation.

    c) You must have a psychological evaluation.

    d) If you have a history of heart disease, if you have taken Fen-Phen in the past, if you are over the age of 50, or other cardiac risk factors you will require an echocardiogram.

    e) If you have any abdominal pain you will require an ultrasound of your gallbladder.

    f) At some point prior to surgery, you will have to undergo a chest x-ray, an EKG and blood tests.

    g) If you have any smoking history you will have to undergo a pulmonary function test and a blood gas.

    h) If you have any history of sleep apnea or snoring, you will have to undergo a sleep apnea test.


  6. What does laparoscopic surgery mean?

    Laparoscopic surgery means that instead of making one large incision in your abdomen, we make 5 small incisions in the middle of your abdomen and to the left side. These smaller incisions allow you to recover faster.

    You have less pain, are out of the hospital sooner and will be back to your normal activity sooner. In general, we start all of our cases laparoscopically unless the patient has had previous surgery on their stomach.


  7. Why is there a 10% pre-operative weight loss required?

    We require patients to begin a diet and exercise program that allows them to lose 10% of their weight pre-operatively for three reasons:

    • Patients that undergo weight loss before surgery have fewer complications during and after surgery.

    • This allows patients to truly understand the lifestyle changes that will occur after surgery and therefore make an informed consent about the diet and exercise programs that they will have to be on for the rest of their lives.

    • This allows us to identify the patients who are truly motivated and therefore who will be most successful following surgery. We will work with you.

  8. When will I meet the surgeon?

    Your initial workup will be done by one of our surgeons who will evaluate patients and their medical problems. Once we have determined that you are a good candidate for this operation and if you have met all of our criteria, you will again meet with the surgeon. This will occur anywhere from 2 weeks to 2 months prior to your scheduled surgery.


  9. When will my surgery be scheduled?

    We will work with you.

  10. What are the risks of the operation?

    Weight loss surgery is major abdominal surgery with significant risks. The following potential complications include, but are not limited to:

    • risk from general anesthesia

    • bleeding

    • infection

    • pneumonia

    • blood clot in the legs or lungs

    • hernias (internally or externally)

    • blockage or obstruction

    • narrowing where surgeons suture the pouch to the intestine, which can require another endoscopy and dilation

    • leakage from the stomach or the intestines

    • injury to liver and/or spleen

    • pulmonary and/or cardiac and/or renal failure

    With the lap-band, there is a risk that the band can either slip or erode. There is a risk that you will not lose weight if you do not follow the diet and exercise program. There is a risk of needing another operation or conversion to an open operation with a long incision. There is a risk of death with both procedures, 1 in 200 with the gastric bypass and 1 in 10,000 with the lap band.

  11. What is the conversion rate?

    Conversion to open surgery is required in less than 5% of patients. The risk of conversion is higher in patients who have had previous upper abdominal surgery.

  12. How do I know which operation is for me?

    Deciding which procedure, the gastric bypass or lap band, is best for you is largely a personal one best achieved in discussion with your surgeon.

  13. Is there anything else I need to know?

    It is very important that you understand that this surgery will not remove your sense of hunger. It will not cause you to lose your desire to eat and it will not remove any of the psychological cravings that you may have for food. If you eat when you are stressed, you will still feel like eating when you are stressed. Therefore, it will be very important that you understand the stresses that make you feel like eating and identify other ways of resolving these issues.

  14. What will happen when I’m in the hospital?

    In general, you will be in the hospital for 3 nights. We will expect you to get up and walk while you are in the hospital - this is your best defense against blood clots. You will meet with the dietician before going home and while you are here you will have a clear liquid diet that will limited to a medicine cup every 15 minutes.

    15. Once home, you can drink until full. Please walk, drink once every hour, and take in at least 40 - 60 grams of protein daily for women and 60 - 80 grams of protein daily for men. Once home, if there are any medical concerns, contact either the clinic at (702) 671 - 5150 or the surgery resident on call at (702) 383 - 2000.