Pathway to Surgery


These steps are required before weight loss surgery.

1. Information Seminar. more info

Our 90 minute, free Information Seminars are led by one of our bariatric surgeons. You will learn about your weight loss surgical options and have the opportunity to ask questions. Friends and family members are invited to attend with you. View Seminar schedule

2. Completion of the Health History Questionnaire. more info

The Health History Questionnaire can be obtained at an Information Seminar. This packet must be completed and an Information Seminar attended before a visit with the surgeon can be scheduled.

3. Initial Appointment with Dr. Glass or Dr. Bettendorf. more info

Our office will call you to schedule an Initial visit with the surgeon after you have attended an Information Seminar and provided us a completed Health History Questionnaire.

4. Nutrition appointments with dietitian. more info

Your nutrition visit with our dietitian will be scheduled after your Initial surgeon visit.

5. Psychology appointments with a psychologist experienced in bariatric assessment.more info

At your initial visit we will provide you with a list of psychologists who specialize in assessment for weight loss surgery. You will arrange your psychology visit with one of these individuals.

6. Additional requirements specified by your insurance
company. more info

Your insurance company may require additional items before granting surgery approval. Common requirements include: a pre-surgery medically supervised diet, lab tests, medical scans, or medical records. Our office will assist you with your requirements.

7. Attendance at Support Group more info

We require attendance at one support group meeting prior to surgery. Our upcoming support group schedule can be found in our most recent newsletter.

8. Insurance submission for pre-approval. more info

Our office submits your materials to your insurance company for pre-approval. The pre-approval process usually takes 2-3 weeks.

9. Pre-Surgery Visit with Dr. Glass or Dr. Bettendorf. more info

While we are waiting for pre-approval we schedule you to see your surgeon for a pre-surgery visit.

10. Surgery date is scheduled.more info

We schedule your surgery date after your visit with the surgeon.

11. 2-week pre-surgery liquid diet.more info

Once a surgery date is schedule we also give you a date to begin the 2-week liquid diet.

12. Pre-surgery physical with primary care provider. more info

Our scheduler arranges your pre-surgery physical with your primary care provider.

Surgical Procedures

A variety of weight loss surgery options are offered through the Minnesota Metabolic and Obesity Surgery Program. The three most common surgeries performed today for weight loss are the Roux-en-Y gastric bypass procedure, the laparoscopic adjustable gastric banding (Lap-Band®), and the sleeve gastrectomy.

Laparoscopic Roux-en-Y Gastric Bypass
This surgery results in durable weight loss and an improvement in weight-related medical illnesses. During this procedure a small gastric pouch is formed and the length of the intestine is shortened.  Thus, weight loss occurs as a combination of volume restriction, and nutrient malabsorption.Weight loss is often very rapid during the first six months after surgery with peak weight loss usually occurring at 12-18 months post-surgery. The obesity-related diseases/conditions that may be improved or cured with gastric bypass include: diabetes, hypertension, high cholesterol, arthritis, venous stasis disease, bladder incontinence, liver disease, certain types of headaches, heartburn, sleep apnea and many other disorders. Furthermore, this surgery usually results in marked improvements in quality of life.

Laparoscopic Adjustable Gastric Banding (Lap-Band®)
This procedure works by placing a band around the upper part of the stomach which separates the stomach into one small and one large portion. The band is adjusted after surgery via a needle and a port to either increase or decrease restriction. Unlike the gastric bypass procedure, nutrient digestion and absorption are normal and the lap band can be reversed. Weight loss is attained solely through the restriction of food intake. Strict patient compliance and frequent follow-ups for band adjustments are required for optimal results.
Weight loss is generally less with laparoscopic adjustable gastric banding (Lap-Band® than with gastric bypass. Steady weight loss (1-2 pounds per week) is expected over about three years. Improvements in weight-related diseases/conditions have been observed with diabetes, dyslipidemia, sleep apnea, gastroesophageal reflux, hypertension and asthma.

Laparoscopic Sleeve Gastrectomy
This procedure works by reducing the size and shape of the stomach. During a sleeve gastrectomy, the left side of the stomach is surgically removed. This surgery does not involve rerouting or reconnecting of the intestines, thus it is a simpler operation than gastric bypass. Unlike the laparoscopic adjustable gastric banding procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. Weight loss is achieved through volume restriction.

 

 

Comparison of Laparoscopic Gastric Bypass &
Laparoscopic Gastric Banding

Gastric Bypass

Adjustable Gastric Banding

Sleeve Gastrectomy

6 small incisions.
Increased risk of nutrition deficiencies.
Faster weight loss.
Risk of a leak.
1-2 day hospital stay.
Longer surgery.
More excess weight loss.
Permanent.

5 small incisions.
Small risk of nutrition deficiencies.
Slower, steadier weight loss.
Minimal risk of a leak.
1-2 day hospital stay.
Shorter surgery.
Less excess weight loss.
Adjustable and Reversible.

6 Small incision
Small risk of nutrition deficiencies.
Minimal risk of a leak.
2-3 Day hospital stay.
Shorter surgery.
Less excess weight loss.
Permanent.