In this 10-minute weight loss surgery seminar video, Dr. Marina Kurian will outline a few of the different procedures we offer at New York Minimally Invasive Surgery. Our hope is that this weight loss seminar video will answer most of your questions and give you a better understanding of what happens before, during, and after a weight loss procedure.
The informational seminar will cover why patients go to see bariatric surgeons, how bariatric surgery helps with healthy weight management, recovery times, diet, and more. After watching the bariatric surgery seminar video, please reach out if you have any more questions (payment, insurance, support groups, etc.) or would like to schedule that first consultation.
Marina Kurian, MD
Hi, I am Dr. Marina Kurian, and I’m a general surgeon who specializes in weight loss surgery, or bariatric surgery. I’ve been in practice in New York City since 2000. During my career, I have performed over 4,000 weight loss surgery procedures.
When patients come in, I try to work with them to look at what their personal goals are and what the health outcomes that they’re hoping to achieve are, and then we come up with an operation. Every patient that comes in has their own health profile and comorbid diseases that we’re trying to help treat.
What does it mean to be morbidly obese?
Weight loss surgery is offered to patients who are morbidly obese. That is a definition that can be done by looking at your weight, looking at your height, and then coming up with a number. That number’s called a BMI or body mass index.
There are many calculators that are available to check and see what your BMI is, and I also have one on my website. Morbid obesity itself is a problem because it can result in high blood pressure, diabetes, sleep apnea, and other health conditions.
Morbid obesity is also extremely painful for many of our patients. There are a lot of joint issues related to it, low back pain, all things that we can affect and improve with weight loss.
One of the great things about weight loss is that freedom of movement that patients experience. They feel trapped in their bodies, but I look at my patients as if they’re in a cocoon, they’re not able to move. And then as they lose weight, they kind of emerge as butterflies
And I know that sounds a little bit touchy-feely, but it really is the truth. They have this new freedom, and the most successful patients really enjoy that freedom and start being more physically active every day.
How does weight loss surgery work?
Weight loss surgery works in a variety of different ways. We have restrictive procedures that make you eat less food, such as gastric banding, sleeve gastrectomy, and gastric bypass. We do all of those through very small incisions, so we frequently call them laparoscopic procedures.
And then also there are malabsorptive procedures, which usually encompass the duodenal switch, which can also be done laparoscopically.
Laparoscopic surgery refers to small incisions that we do. This enhances recovery. We also refer to it as minimally invasive surgery, and all the procedures can be done in this manner.
With a laparoscopic adjustable gastric band, I’m taking this very soft silicone device, putting it around the upper part of the stomach, and then I connect it to a port that goes under your skin. And through that port–and again, nothing’s visible outside–through that port, I inflate the band so that it cinches around the stomach, making you less hungry and having you eat less food.
(With) laparoscopic sleeve gastrectomy, I take out about 70% of the stomach and completely remove it from the abdomen. So it’s gone. It can’t grow back. It’s an irreversible procedure. This procedure, though, also removes some of the hormones that make you hungry, notably ghrelin
And it also affects some of the sugar metabolism in your body because of the nature of the sleeve itself. And because of that, it’s actually a hormonal operation as well, and it makes you eat a lot less food.
Laparoscopic Roux en Y, gastric bypass, also known as gastric stapling. But we, we really as professionals or surgeons, refer to it as the Roux en Y gastric bypass. And that procedure makes you eat less food because your stomach is about one to two ounces in size.
We also bypass a significant part of the intestine to create some level of malabsorption. And that combination of eating less and absorbing less helps patients keep weight off for a long time.
I do all of the weight loss procedures. I do gastric banding, sleeve gastrectomy, gastric bypass, and I also do revisions for my patients. I believe that all of the operations can work, but each one may not work for everyone.
You’ll find videos about all three of these procedures, gastric banding (video), sleeve (video), and bypass (video) on my website, and I encourage you to watch that.
How much weight can I lose with bariatric surgery?
A lot of times patients wanna know exactly how much they can lose. With gastric banding, you can see up to about a 50% reduction of the excess weight or the weight above your ideal body weight. With a sleeve gastrectomy, we see about 60% reduction. And with a gastric bypass, it can be up to 70% reduction of the excess weight. We’re talking about sustained durable weight loss and helping patients stay successful on their weight loss journey.
What if I don’t meet the criteria for weight loss surgery?
There’s an exciting option that’s available called the gastric balloon that helps people reduce weight who may not meet the criteria for weight loss surgery. So they may have anywhere from 30 to 50 pounds to lose, but it’s also been used in patients who weigh 600 and 700 pounds in an effort to try and get them to lose weight so that there can be less risk for weight loss surgery.
So, it’s sort of approaching the problem from two different aspects. The procedure is done endoscopically, meaning that we’re gonna be putting a camera down your throat into your stomach, but don’t worry: you’re not gonna be awake for that. We give you some IV sedation and numb up the throat so we can pass this down.
Once we get the balloon in the stomach, we inflate it with saline, and then we leave it in there for six months. After six months, the balloon has to be removed, and by that time though, you will have lost 20 to 40% of your excess weight. And you’ll be on a diet that is gonna help you maintain it long term.
Are bariatric procedures covered by insurance?
Many insurance plans do cover weight loss surgery, and we participate with several of them. These plans do require a dietary and psychological evaluation before surgery.
How will my diet change after bariatric surgery?
After all the procedures, patients are on a specialized diet. They will need to be on 10 days to two weeks of a liquid diet, followed by 10 to 14 days of a pureed diet. This gradual progression helps make sure that the patient does great after surgery and does not have any issues
After surgery, it really is important to eat healthfully and mindfully. In general, I have a few tips for you. One is really to try and eat meat, fish, chicken, and fruits and veggies. I think those are critical to long-term success. And if you’re a vegetarian, you can do fruits and veggies and beans.
I think the other issue is really to look at not eating foods that come out of a package. Processed foods, if you’re opening a box or opening a plastic bag of something, those are not going to be the best snacks or foods for you to eat long term for success.
The surgery can be looked at as a tool and it helps patients eat less and it helps you be less hungry so that you can stick to that healthier diet plan.
What are the possible side effects or complications after bariatric surgery?
All of these operations, while they benefit you with weight loss, they can have side effects. Immediately after surgery, there can be some nausea or vomiting. There are also some other side effects with the stapling procedures such as gastric bypassing, sleeve gastrectomy. It is something called dumping, where if you have something that’s high in fat, it sort of races through your system and you can have abdominal cramping, diarrhea, some nausea.
Weight loss surgery is also known to have certain complications, and the ones that I really focus on are leak, bleeding, and infection. And these are things that I am concerned about. And while I have a low rate of each one of these complications, it’s still something that I want you to be aware can happen with any procedure.
The key to any complication after surgery is really the follow-up. It’s calling your surgeon, calling me, because I know what to expect and what is within normal range for most patients. We can work with you to help you on your journey to success.
When is revision surgery necessary?
We have to understand that obesity is really a chronic disease. Revisions are done for a number of different reasons. One of them is that there can be weight regain and weight regain can happen because people have sort of fallen off their journey. They’re not eating as healthfully, they’re not being as active.
What I do is I get them back into the office, we meet with a dietician, and we determine if we can actually give them medications to help them get back on their journey. Or if there’s something anatomically changed with their original weight loss procedure.
Revisions can also be done for complications. Sometimes patients get ulcers, sometimes people have heartburn, reflux. There are a variety of different reasons why we look to do a revision of a weight loss procedure.
The key to it is that I do so much weight loss surgery that I have my own patients coming back to me in need of revision. Or I see other patients coming in from around the country. The goal of my practice is really to help the patient. And together we come up with what the best solution is for the problem that the patient has.
So thank you so much for watching this video, and I hope to see you soon in my office.