Weight Loss Surgery at Emory Decatur Hospital’s Comprehensive Weight Loss Center


Hi, I’m Dr. Scott Steinberg.
I’m the medical director of bariatric surgery
at Emory Decatur Hospital.
Along with my partner, Dr. Rashid, we have
performed thousands of successful laparoscopic
and robotic weight loss operations.
Hello.
I’m Dr. Rashid of the Comprehensive Weight
Loss Center at Emory Decatur Hospital.
Our nurses, anesthesiologists and many of
the professionals on our team have also done
this work for decades.
Our program is designated as a center of excellence
because our doctors do hundreds of these operations
each year with very low complication rates
and we’re always perfecting our technique.
The purpose of this video is to help people
who’ve had weight loss surgery two or more
years ago and either never lost the projected
weight, or their results have trickled off,
or they might’ve re-gained some of the weight
that they started to lose.
Obesity is a chronic disease, and like other
chronic diseases, it sometimes takes multiple
approaches to achieve successful management
of it.
We want you to understand that you did not
fail, and if you haven’t lost the weight
you had hoped, we’d like you to follow up
with us.
Please try to remain hopeful and understand
that we want to work alongside you to help
you reach your goals.
Whether you currently have a lap band, sleeve
gastrectomy, Roux-en-Y gastric bypass, or
a loop DS, we would like to meet with you
to discuss your options and tailor a plan
specific to you.
Morbid obesity is a very complex disease,
and like anything that is complex, it can
require complex solutions.
Each patient needs to be treated differently
so want to learn as much as we can about your
unique case to recommend the best option for
you, and to ensure the best possible outcomes.
We may recommend you have corrective or revisional
surgery, though not all patients will need
additional surgery.
Sometimes, additional medication added to
your current prescriptions, or tweaks to your
exercise or diet regiment may work.
We will determine exactly what changes need
to be made for your unique case, in order
for you to see the desired results we all
want.
Let’s talk about the lap band procedure,
one of the most common weight loss procedures.
For many years, the lap band was very popular
but, after performing thousands of these operations,
we’ve learned that long term weight loss is
not as robust with the lap band.
If you have a lap band, there are many options
for you.
Your lap band can be removed and converted
into a sleeve gastrectomy, Roux-en-Y Gastric
Bypass, or a loop duodenal switch.
We will now go over the sleeve gastrectomy
in a bit more detail.
During this restrictive procedure, we take
away the greater curvature of the stomach.
It is stapled, cut off, and taken out to make
the stomach the size of a medium banana, that
can hold about six ounces of semi-liquid or
solid food.
Your hunger will actually be controlled after
this operation.
The majority of lap band patients who were
converted to a sleeve gastrectomy, will have
excellent results, greatly surpassing their
goals.
Another option for lap band patients is the
Roux-en-Y Gastric Bypass.
For this conversion, we make a very small
pouch out of your stomach that will end up
being the size of a golf ball.
Then we bypass part of your intestine and
connect the other part of it up to that new
small pouch.
The gastric bypass will reduce your hunger
and restrict the amount of food you can eat.
Many lap band patients will suffer from severe
acid reflux.
Following a conversion to a gastric bypass,
they will no longer suffer from acid reflux
and reach their weight loss goals.
Another option for lap band patients is to
get a loop DS, or Duodenal Switch.
We will basically perform a sleeve gastrectomy
first and then attach your new stomach much
further down your intestines.
This greatly decreases the calories you can
absorb and also effectively controls the intake
of food as well as hunger.
In many instances, we’ve had lap band patients
who converted to a loop DS and then show fantastic
results, losing up to 85% of their excess
weight.
Next, we’ll go over the options for patients
who originally had a sleeve gastrectomy.
15-20% of patients will not meet their weight
loss goals.
One option is to convert the sleeve to a Roux-en-Y
Gastric Bypass.
The sleeved portion of the stomach will be
re-stapled to make a small gastric pouch,
which will be attached to the small intestine.
Similar to lap band patients, sleeve gastrectomy
patients will often suffer from acid reflux,
and after converting to a Roux-en-Y bypass,
their acid reflux is resolved, and their weight
loss goals are also achieved.
Another option is to convert the sleeve to
a loop DS.
The first stage of a loop DS is a sleeve gastrectomy,
so, in this case, the only stage needed is
reattachment of the sleeved stomach further
down the intestinal tract.
This reduces the amount of calories absorbed.
In nearly all cases, this additional step
is all it takes for the excess weight to start
coming off.
Now let’s talk about your options if you’ve
had a Roux-en-Y Gastric Bypass.
Apart from potentially requiring only some
nutritional or medicinal changes, another
option for gastric bypass patients is to revise
it into something called a Distal Gastric
Bypass.
This procedure is very dependent on the anatomy
of each patient, but in suitable cases, we
would detach the alimentary limb and reattach
it further down the small intestine, so that
even fewer calories are able to be absorbed.
Some patients who are converted to a distal
gastric bypass benefit greatly from it, and
we will help determine if you are a good candidate
for this procedure.
If you previously had a Loop DS procedure
and have not had the results you want or need,
it’s important that you follow up with us.
Sometimes Loop DS patients just need a change
in diet, exercise, or an additional medication.
But even additional surgical revisions can
be performed.
No matter your particular situation, we’ll
discuss your options and tailor a plan specifically
to you.
If you have had weight loss surgery of any
kind, and are unhappy with the results, we
want you to know you’re not a failure, and
you have many other options.
There is always hope.
Please set up a one on one appointment with
either me or Dr. Steinberg.
Prior to that appointment, you’ll meet with
our center’s navigator, who’ll guide you
through the requirements of our program and
of your insurance provider.
Let’s remember that diet, exercise, and weight
loss medications do not have lasting effect
on morbid obesity.
Bariatric surgery is a viable long-term solution
when it’s done at a center of excellence where
the risks are minimal, and the follow-up is
close and long term.
The good news is you won’t make a wrong decision
and we’ll help you fine tune the best option
based on our experience with thousands of
patients.
For us, the goal of revision surgery is clear.
Its purpose is to improve health, quality
and length of life, when another method or
methods did not give you the best results.
We here at the comprehensive weight loss center
at Emory Decatur Hospital have helped thousands
of patients have a better life after weight
loss surgery and we want to do the same for
you.

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