As you already know, there are choices that have to be made when you’re considering weight loss surgery. You need to choose a surgeon, a program and of course, the operation you will have. The final decision as to what operation you undergo should be a decision YOU make. It’s your body and your life. You are the one that will need to follow the recommended lifestyle changes and restrictions. You are the one that needs to be comfortable with the possible complication profile, follow up regimen afterwards and reversibility/adjustability of the procedure if applicable. In my opinion, the main role of the surgeon in this respect is to educate potential patients as to exactly how the different procedures change their body, how they work to help them lose weight and the possible, associated risks and complications. The other important role of the surgeon on the initial consultation with the patient is to obtain a thorough medical and surgical history. This allows the surgeon to determine whether or not a particular weight loss procedure is contraindicated for that patient, or shouldn’t be performed for them. For example, a patient who has gastroparesis, a condition affecting their stomach function usually associated with long-standing diabetes, should not have a Lap-Band operation. They can however have a sleeve gastrectomy or gastric bypass, and in addition to helping them lose weight, these operations will also diminish or completely alleviate their gastroparesis symptoms. Patients who come to me with a history of Crohn’s disease or Lupus will undergo specific testing to ensure they are a candidate for surgery. If they ‘pass’ these pre-op tests I will perform a Lap-Band surgery for them, but will not recommend a gastric bypass or sleeve gastrectomy. In these patients I prefer a lesser invasive, reversible operation. In the future event that they develop problems with their esophagus or stomach from these chronic diseases, I know that I can go back in laparoscopically and simply remove their Lap-Band device and they will be right back where they were before surgery, and can have any medical treatment needed without any additional fears or concerns. If they never have any of these complications from their Lupus or Crohn’s, their band stays in forever.
The take-away message is as follows : whatever surgeon you choose should educate you completely, answer all of your questions, give you the pros and cons of each of the operations and act as a guide to help you choose your operation. He or she should not choose the operation for you. Most patients make their decision at the initial office visit but I have had several patients come back to discuss things and ask questions on one or two additional office visits. Remember, there is no rush. I want my patients to be comfortable, educated and ready before we go to the operating room.