Dr. Koura offers two types of weight loss surgery: the Roux-en-Y Gastric Bypass, and the Lap-BandŽ. The National Institute of Health's guidelines for treating obesity states that surgery is an option for treatment when other therapies have failed, and the patient is at high risk for serious disease or death related to obesity.
ROUX-EN-Y GASTRIC BYPASS
The Roux-En-Y Gastric Bypass is a combined restrictive and malabsorptive operation. Staples are used which create a small stomach pouch approximately 2-3 ounces in size. The rest of the stomach is not removed. It is stapled completely shut and divided from the stomach pouch. This pouch is then connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and upper part of the small intestine. Bypassing this part of the intestine results in fewer calories and nutrients being absorbed.
Even though after surgery there is little change in a patient's digestion, all patients must take oral multivitamins, iron, and calcium supplements daily. Although uncommon, a few patients may later be required to take injectable vitamins. In addition, protein supplements will be recommended postoperatively to those patients whose oral intake progresses more slowly than expected. Within one to two months after surgery, most patients are on a regular diet but ingesting only 600-800 kcal per day.
LAP BAND
The second type of surgery performed is the Lap-BandŽ. The Lap-Band is the least invasive surgical weight loss procedure and is performed laparoscopically. It is a restrictive procedure and works by placing a silicone ring around the upper part of the stomach, creating a small pouch. With the Lap-Band, there is no cutting or stapling of the stomach, or bypassing of the intestines. If for any reason the Lap-Band needs to be removed, the stomach generally returns to its original form.
The Lap Band System is not right for you if:
- You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohn's disease.
- You have severe heart or lung disease that makes you a poor candidate for surgery.
- You have some other disease that makes you a poor candidate for surgery.
- You have a problem that could cause bleeding in the esophagus or stomach. This could be an esophageal or gastric varicies (dilated vein). It may also be something such as congenital or aquired intestinal telangiectasia (dilation of a small blood vessel).
- You have cirrhosis.
- You have chronic pancreatitis.
- You or someone in your family has an autoimmune disease such as lupus.
- You are pregnant. (You can become pregnant after getting the Lap Band placed, however we discourage this for at least 18 months to 2 years post-operatively)
- You are addicted to alcohol or drugs.
- You are on chronic, long-term steroid treatment.
- You cannot or do not want to follow the dietary rules that come with this procedure.
- Allergy to the materials in the device.
LAP BAND FINANCING
Some patients may find that their health plans have exclusions for surgical weight loss or the Lap-Band system. The Lap-Band company has partnered with Wells Fargo to offer financing to those patients who wish to undergo the procedure. Patients can choose from a variety of loan options suited best for their needs. To find out if financing is available for you, contact:
1-877-LAP-BAND, Option 4
You will be asked the name of your surgeon. (No committment is necessary at that point) Make sure you tell them:
AARYAN KOURA, MD in Sacramento, California
Dr. Koura
