Surgical Options at Bariatric & Metabolic Institute at Medical City Las Colinas

Surgical Options at Bariatric & Metabolic Institute at Medical City Las Colinas


(soft music) – Hello, my name is Dr. Mustafa Alibhai, and I’m the assistant medical director at the Bariatric and Metabolic Institute at Medical City, Las Colinas, and I’m here to talk to you about the different surgical
options that we have, that we provide here at our clinic. So, to introduce myself a little more, I am a board certified bariatric surgeon, and also our surgeons here,
myself and my colleagues, we are all fellowship
trained in bariatric surgery, and what that means is
that we’ve completed extra training in the field that is compliant with the
American College of Surgeons criteria as well as the American Society for Bariatric and Metabolic Surgeons. Together, the team of
bariatric surgeons and myself who practice here at
Medical City, Las Colinas have done well over 1,000 surgeries. This is something that
we are very proud of, and what this translates
to is that we have very good outcomes and
good quality measures for our patients. In fact, many of our patients come to us by word of mouth, and by referral from
our medical colleagues. It is a tremendous honor when patients want to refer their own family
members and friends to us, as well as other doctors
to refer their patients and entrust their care to us. So let’s start by discussing
about bariatric surgery options that we offer here at
Medical City, Las Colinas. So first of all, bariatric surgery has many different categories, and the way we categorize these surgeries is we describe them as malabsorptive, restrictive, or a
combination of restrictive and malabsorptive, and there are also a whole
category of procedures called revisional procedures. Here at Medical City, Las Colinas, we offer several different
options to our patients. One of the most common ones that we offer is a laparoscopic
Roux-en-Y gastric bypass. We also offer the laparoscopic
sleeve gastrectomy, a laparoscopic duodenal switch, and a laparoscopic gastric band. In comparing all these surgeries, each patient is
individualized to best suit the surgery that fits them. So let me start by talking about the laparoscopic Roux-en-Y gastric bypass. This surgery considered a restrictive and malabsorptive operation. What we do is, initially,
we take the stomach and divide it and make it into two parts. There is a small gastric pouch that’s the size of about a golf ball, which is the restrictive
portion of this operation. And then we rearrange the intestine to create a malabsorptive function by allowing the digestive
juices to not mix with the food for about
a 150-centimeter segment, thus the malabsorptive portion, or the bypass portion of the intestine. This operation offers a lot of benefits to our patients in that
the expected weight loss that we see from this
operation is about 75 to 85% of your excess weight loss. Now what excess weight
loss is we calculate your ideal body weight
based on your height, and subtract that number
from your current weight to get what we call excess weight that you have on your body. So when we say, for example,
100 pounds of excess weight, so if we say 75 to 85%,
you would expect to lose 75 to 85 pounds with this operation. The other benefits of this operation is that because it’s restrictive, it allows you to eat
less food at the time, and malabsorptive, it allows
you to absorb less calories. One of the benefits of the gastric bypass that we have seen are patients
with long-standing diabetes tend to benefit very much
from the gastric bypass in that almost we see
immediate decrease in the requirement for diabetes medications. One of the other surgeries
that we offer here is a laparoscopic sleeve gastrectomy, also known as a vertical
sleeve gastrectomy. This procedure is also done by a minimally invasive approach, and it’s laparoscopic, and what we do is we take 80% of the stomach and we use a stapling device that staples and cuts and removes 80% of the stomach. What that does is it’s a
very restrictive procedure, lowering the amount that
you can eat at each time. This operation offers about 70 to 80% of excess weight loss. If you’re 100 pounds overweight, you’d be talking about
losing 70 to 80 pounds. The gastric sleeve is one
of the newer operations, but it has been around for
about seven to 10 years, and we are receiving very
good data from this operation, and it is something that we recommend quite often to our patients. Another benefit of the gastric sleeve, is that when we remove the fundus, or the stretchable part of the stomach, a hormone called ghrelin is also removed. What we’ve noticed is that
affects the metabolism of each individual, and
it has a positive effect on weight loss, thus
making it a very effective procedure for weight loss. One of the other options is a laparoscopic diversion
with duodenal switch. This is a very complex operation, and usually it requires
a BMI of greater than 50 to be approved for. However, this is a very
efficient operation in terms of weight loss. Sometimes the expected
goal of excess weight loss is from 75 to 85%, or
sometimes even higher with this operation. This is a very restrictive procedure, and a very malabsorptive procedure that does require long term
nutrient supplementation. But let me discuss the
laparoscopic gastric band. What this is it involves
placing a silicone band around the top of the stomach, and this band is connected to tubing that then is connected to a port. This is laid under the
skin, and then over time, we place small amounts
of fluid through the port which causes the band to restrict around the top of the stomach. This inhibits the amount that you can eat, thus causing weight loss. This operation is purely restrictive, and there is no
malabsorptive part of this. The expected weight loss from bands are about 40 to 50% of your excess weight. These are all complex surgeries, no doubt. Every patient and every family member has concerns about the
risks and complications of each procedure. However, technology has also
advanced in the medical field. So today the risk of
each of these operations has significantly decreased. In fact, many of you probably know that someone or a family member that had their gallbladder taken out. Each of these operations
come with less risk than taking your gallbladder out. Now the reasons for this happening are, like mentioned, the advancements in laparoscopic technology,
stapling technology, the training that each of us received through a fellowship that
is specifically designed to understand bariatric patients and each of these procedures in detail, and also the selection
standards that we use for each patient to ensure
that they get the best outcome. So we at the Bariatric Metabolic Institute at Medical City, Las Colinas
want to partner with you to answer all your questions, to assist you in determining
what is the best option for you, and be partners with you in your journey to better health. (soft music)

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