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Weight loss surgery (Bariatric Surgery) in Costa Rica

Weight loss through bariatric surgery is a procedure used with patients who suffer from morbid obesity and is a good weight loss alternative. Morbid obesity is defined as a total weight with more than 100 pounds over ideal weight (or with a body mass index of 40+).

Clinica Biblica Hospital has ample experience in different surgical treatments for obesity that can satisfy your needs or preferences. We offer you a surgical procedure performed by four skillful and experienced physicians.

Some of the elective procedures include:

Laparoscopic Adjustable Gastric Band (Lap Band)

Laparoscopic Roux-en-Y Gastric Bypass (Stomach Stapling)

General description
Lap band weight loss surgery is a restrictive bariatric surgery procedure that limits the gastric capacity so the patient looses weight because of reduced food intake. All patients who undergo bariatric surgery must be aware of pre and post surgery requirements and be sure to fully understand them.

Benefits
Bariatric surgery in the form of laparoscopic weight loss banding, is for patients who have a body mass index (BMI) of 40 kg/m2+ or those with BMI of 35+ who suffer from obesity-related morbidity. The age range is from 14 to 65, nevertheless, there can be exceptions to this rule.

Advantages of adjustable gastric banding:
a. Does not alter gastric anatomy much.
b. It is reversible.
c. Technically, it is the fastest option.

Some of its disadvantages are:
a. Requires adjustment for proper functioning.
b. There is no weight loss of more than 70% of excess weight.

Potential complications are:
a. Slipping
b. Gastric perforation
c. Gastric erosion
d. Vomiting
e. Impossibility to produce restriction
f. Impossibility for placing it.

Technical description
Procedure: Weight loss surgery of this type (laparoscopic adjustable gastric band) is a procedure to place a devise around the stomach, through laparoscopic surgery, that has an adjustable band with a valve. In this way, the devise limits the amount of food intake and makes the person feel full sooner. Each time the patient eats more than is allowed, some discomfort will be experienced.

Hospitalization: One night stay is usually required.

Time: Laparoscopic adjustable banding takes between 45 minutes and two hours.

General description
Laparoscopic Roux-en-Y Gastric Bypass (also known as stomach stapling) is a bariatric surgery procedure considered the golden rule by many. It has a restrictive and malabsortive side to it:

  • Surgical stapling limits your gastric intake, so you will loose weight since you will be eating less.
  • Intake of some nutrients is limited due to a surgical change in the biliar and pancreatic secretions and their union with food.

All patients who undergone bariatric surgery must be aware of all pre and post surgical requirements.

Benefits
Laparoscopic Roux-en-Y Gastric Bypass is a surgery for those who have a body mass index of 40 kg/m2 and higher, or those whose BMI is above 35 and who suffer from comorbidity associated to obesity. The age range is from 14 to 65, nevertheless, there can be exceptions to this rule.

Laparoscopic Roux-en-Y Gastric Bypass has the following advantages:
a. It does not require readjustments, only periodical control.
b. It is the most common bariatric surgery since weight loss is very successful (close to 80% of excess weight).

Disadvantages are:
a. Possibility of surgical complications.
b. Occasional vomiting.
c. There might be the need for further surgical procedures.
d. Irreversible alteration in the gastrointestinal anatomy.
e. Needs vitamins after surgery.

Possible complications are:
a. Trans and post surgery bleeding
b. "Anastomotic" leakage
c. Internal hernia
d. Intestinal obstruction
e. Pulmonary embolus
f. Obesity-related respiratory distress syndrome
e. Death

Technical description
Procedure: Laparoscopic Roux-en-Y Gastric Bypass reduces the size of the stomach through surgical staling. This type of weight loss surgery cuts the stomach and leaves a reservoir of approximately 30ml. Then, the small intestine is divided to form a Y and changes the course of biliopancreatic secretions and unite the Y to the gastric reservoir so food follows a different course.

Weight loss surgery of this type performs gastrointestinal cuts and unions and could eventually cause leaks. This is a risk involved in this type of surgery.

After surgery, the patient must follow special diets and vitamin intake to loose weight properly.

Hospitalization: Laparoscopic Roux-en-Y Gastric Bypass requires 4 nights hospitalization.

Time: Between an hour and a half and four hours

 

Sleeve Gastrectomy

Biliopancreatic Deviation

General description
Sleeve gastrectomy as weight loss surgery is a relatively new procedure that is rapidly gaining popularity due to the many advantages it offers over other weight loss surgery procedures.

It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals.

The Sleeve Gastrectomy allows any BMI patient to undergo weight loss surgery laparoscopically. Most patients with a BMI under 60 kg/m2 achieve successful, effective weight loss in a manner similar to the gastric bypass or duodenal switch. Some patients with much higher BMI may need a second stage to the procedure, again performed laparoscopically at a later date. Most patients can lose 75 to 80% of their excess body weight over 6-12 months with sleeve gastrectomy alone.

W eight loss surgery patients must be aware of pre and post surgery requirements.

The sleeve gastrectomy offers the following advantages:
a.

It does not require disconnecting or reconnecting the intestines.
b.

It is a technically simpler operation than the gastric bypass or the duodenal switch

c.

It may be a safer operation for patients with a body mass index (BMI) more than 60. To figure out your BMI.

d.

Does not require periodic maintenance such as tightening and refills as in the case of the gastric band.


Disadvantages are:
a. Some higher BMI patients may need to have a second stage procedure later to help lose the rest of the weight.
b.

Because the stomach is removed, it is not reversible.


Potential complications are:

Like any surgical operation, sleeve gastrectomy has possible complications, such as leakage, dilation of the sleeve (which allows for more food intake) and other usual complications associated with bariatric surgery, though the risks are known to be much lower than the gastric bypass and duodenal switch.

Technical description
Procedure: Weight loss treatment is acheived solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure.

Hospitalization: The sleeve gastrectomy procedure usually requires one night in the hospital and five days recovery in a hotel or recovery retreat before the patient can fly home.

Time: 2 hours

General description
Biliopancreatic diversion is a malabsorsive bariatric surgery procedure: the absorption of some nutrients decreases because the passage of biliar and pancreatic secretions is altered. There could also be “duodenal change”.

Weight loss surgery patients must be aware of pre and post surgery requirements.

Benefits
Bariatric surgery of this type can be performed on patients who have body mass index (BMI) of 50 kg/m2 and above. The age range is from 14 to 65, nevertheless, there can be exceptions to this rule.

Biliopancreatic diversion offers the following advantages:
a. This type of surgery is advisable for patients with extreme obesity and BMI of 50 kg/m2 +.
b. Weight loss is over 90% of excess, nevertheless, the majority of patients suffer from frequent diarrhea.

Some of its disadvantages:
a. Frequent diarrhea.
b. Flatulencies.
c. Some cases of malnutrition.

Potential complications involved are:
a. Trans and post surgery bleeding.
b. Anastomotic "leakage".
c. Internal hernia.
d. Intestinal obstruction.
e. Pulmonary embolus
f. Obesity-related respiratory distress syndrome
g. Death

Technical description
Procedure: Biliopancreatic diversion reduces the stomach, but not as much as in bypass surgery. The small intestine is cut and put back together in a way to have food and secretions unite in a common one-meter handle before they reach the colon. Sometimes, poor nutrient intake can result, which in turn causes diarrhea and flatulency in some patients.

Hospitalization: Biliopancreatic diversion needs you to stay four nights at the hospital.

Time: Between two and a half and four and a half hours.


 

 

 
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