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Update on Local Weight-loss Surgery

Local Weight-loss Surgery

People with clinically severe obesity may undergo one of two types of weight-loss surgery performed at Cayuga Medical Center.

Laparoscopic roux-en-y gastric bypass surgery reduces the size of the stomach (limiting the amount of food that can be eaten) and redirects the flow of food to a different part of the intestine, (where less food and fewer nutrients are absorbed).

LAP-BAND surgery, in which a silicone band is placed around the top of the stomach, significantly reduces the amount of food that can be consumed.

At the same time Cayuga Medical Center initiated the weight-loss surgery program, a local support group for weight-loss surgery patients was established. This group has expanded into two separate groups (one for each of the two different surgical procedures) facilitated by their members. People who are considering weight-loss surgery are required to attend a support group prior to surgery, both to meet people who have had the procedure and to learn about various issues related to the surgery.

Criteria for weight-loss surgery

As the effectiveness of this approach to treating severe obesity becomes more widely known and accepted, a review of the criteria for surgery can inform people's thinking as they consider the possibility of surgery.

There are several criteria a patient must meet to undergo weight-loss surgery at Cayuga Medical Center. These criteria include the national (NIH) guidelines, as well as additional recommendations of surgeons who are expert in weight-loss surgery. The goals are patient safety first, followed by successful weight loss. The risk of complications from surgery may differ depending on the individual. Since no surgery is risk-free, we must do everything we possibly can to ensure a good outcome for each and every patient.

Candidates for weight-loss surgery must either have a body-mass index (BMI) greater than 40 or a BMI greater than 35, with a life-threatening or disabling condition related to obesity, such as high blood pressure, cardiac illness, or type 2 diabetes. Body mass index is a measure of weight for height and it correlates with the amount of body fat a person is carrying.

In addition, weight-loss surgery candidates:

• must have made several attempts at medical weight loss and failed in those attempts • cannot have alcohol or drug abuse problems or untreated psychiatric illness • must be non-smokers. • should be between the ages of 18 and 65 • must have no absolute contraindication to major abdominal surgery • must have a long-standing obesity problem • must understand the need for lifelong post-surgical changes in lifestyle and dietary habits • have been fully counseled on the risks and benefits of weight-loss surgery.

Patients who are extremely obese (i.e. BMI greater than 50 or weighing more than 400 lbs.) or who have serious health issues may be poor candidates for surgery initially. These patients may require medical interventions and non-surgical weight-loss prior to being considered for surgery or may be referred to a tertiary care center.

To learn more about weight-loss surgery, talk with your primary caregiver. You can also get information on-line at www.obesityhelp.com and at the Web site of the American Society for Bariatric Surgery at asbs.org.

To contact a local support group for additional information, call Surgical Associates at (607) 273-3161. The office staff will put you in touch with one of the support group leaders.

Weight-loss surgery at Cayuga Medical Center is performed by Dr. John Mecenas, who did his fellowship training in minimally invasive surgery and minimally invasive weight-loss surgery at NYU Medical Center. He is board certified in general surgery and is in practice with Surgical Associates of Ithaca, where he can be reached at (607) 273-3161.

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