Laparoscopic Procedures for Morbid Obesity
Procedure Type: Laparoscopic Gastric Bypass with Roux en Y Reconstruction (Short Limb)
Surgeon: Philippe J. Quilici, MD, FACS
This procedure is a bariatric-advanced laparoscopic surgical procedure or a surgical procedure performed via keyhole incisions designed to promote weight loss and reduce the complications associated with morbid obesity. This procedure will transect (cut) your stomach, surgically create a small stomach, recreate a new outlet for your stomach and bypass a portion (75cm) of your small intestine.
Indications – Understanding the Process of Becoming a Surgical Candidate
Becoming a surgical candidate for this procedure is a rigorous process, which you need to comprehend fully. This office has strict guidelines that comply with the guidelines of the American Society for Bariatric Surgery, the American College of Surgeons and the Society of American Gastro-intestinal Endoscopic Surgeons.
Initially, you have been fully evaluated by a nutritionist and an approved psychologist-psychiatrist. You have undergone a complete evaluation by your primary care physician and an independent internist-pulmonary care physician. All your surgical risk factors or co-morbid factors (if any) were identified, explained in detail to you, and are currently well controlled.
You have undergone two successive consultations with your surgeon, Dr. P. Quilici, and his office staff. Our bariatric clinical coordinator has met with you.
The following parameters have been met for you to qualify as a surgical candidate for the Laparoscopic Gastric Bypass with Roux en Y Reconstruction (Short Limb):
Risks of the Defined Surgical Procedure
All the risks of this procedure (as set forth in the following document) as well as the impact of this procedure on your future life style have been explained to you by your surgeon. All your questions have been answered to your satisfaction.
Please, read the following very carefully. It summarizes some of the most common risks associated with this procedure.
· The Issue of Conversion
This procedure is performed via laparoscopy, i.e. via small puncture type incisions. This will allow you to recover quicker than with conventional surgery, where an incision is made. In some cases, the laparoscopic procedure will have to be converted, meaning an incision will be made to continue and safely complete the procedure. Although this is a rare occurrence, your surgeon may decide to do so if he foresees too many technical complications, or if he cannot complete the procedure safely. If the laparoscopic procedure is converted, it will lengthen you hospital stay on the average by three days.
· Surgical Risks Associated with the Surgical Procedure
These risks are rare but do occur. The most significant are as follows:
· Surgical Risks Increased by the Condition of Morbid Obesity
Morbid obesity will increase the frequency and incidence of certain complications. This surgical team is dedicated to the utilization of all surgical means to decrease it. However, some of these complications remain severe and can still occur in spite of the best preventive measures:
· Known Late Complications Inherent to this Surgical Procedure
The American Medical literature reports that certain complications may occur after this procedure has been performed (months or years later). The most significant are as follows:
· Published Surgical Performance Data
Surgical procedures are associated with an average rate of complications or morbidity and an average mortality rate or overall rate of death within thirty days after these procedures. These statistics are published in the American Medical literature and can be easily verified. For the laparoscopic gastric bypass with Roux en Y Reconstruction, the morbidity rate is averaging 3.3% (major) and the mortality rate is averaging 0.1 to 0.4%.
Realistic Expectations for Patients Undergoing the Laparoscopic Gastric Bypass with Roux en Y Reconstruction
You must understand that by undergoing this procedure, it will not solve all your problems but will help you lose weight and maintain it. In addition, it may correct or improve some of the medical problems (diabetes, hypertension, etc.) or help your physicians manage them. Statistically, patients who undergo this procedure will lose on the average 75 % of their excess weight and will sustain it.
Post-operatively your eating habits will change as described in the provided education package. You will need to comply to the monitoring schedule proposed by your bariatric specialists.
You have read the PATIENT’S DISCLOSURE DOCUMENTS provided by our office and the section entitled “realistic expectations after bariatric surgery”.
Financial aspects of This Surgical Procedure
The financial aspects of the proposed surgical procedure have been fully explained to you.
Access to our On-Line Website and Technical Description of the Proposed Surgical Procedure
You have been given the URL address of our surgical website, The Online Laparoscopic Technical Manual, or http://www.laparoscopy.net . You can access our online chapter on Laparoscopic Bariatric Procedures. You can view all the technical data and aspects of this procedure online, including online videos. If you do not have online access, our office has printed you a copy of the Laparoscopic Bariatric Surgery Section.
Access to your Patient Education Package and Booklets
You have been given by our office the following educational documents and books:
1. This document,
2. Patient disclosure documents,
3. Operative and post-operative instructions booklet.
Patient Last Name:
Patient First Name:
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