Prime Care Surgical Weight Loss Program

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Prime Consideration Surgical Health improvement plan. "A far reaching program coordinating body, mind and soul" Gaylord Kavlie, M.D., F.A.C.S. Brandon Helbling, M.D. Jean Ellefson, RN Jessica Mill operator, RN, BSN, CPAN Clinical Coordinator Clinical Organizer

Presentation Transcript

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Prime Care Surgical Weight Loss Program "A far reaching program coordinating body, mind & soul" Gaylord Kavlie, M.D., F.A.C.S. Brandon Helbling, M.D. Jean Ellefson, RN Jessica Miller, RN, BSN, CPAN Clinical Coordinator Clinical Coordinator Mid Dakota Clinic St. Alexius Medical Center Bernie Kraft, LRD CDE Laura Russell, LRD CDE Affiliated With:

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Mission Statement To offer help to those focused on a more advantageous way of life and enhanced personal satisfaction through therapeutic and surgical treatment of stoutness.

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What Is Morbid Obesity? Clinically extreme corpulence and soon thereafter genuine restorative conditions happen as an immediate aftereffect of the stoutness Defined as >200% of perfect weight, >100 lb overweight, or a body mass record of 40

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Degrees of Obesity NORMAL BMI 18.5 – 24.9 OVERWEIGHT BMI 25 – 29.9 OBESE BMI 30 – 34.9 SEVERE OBESE BMI 35 – 39.9 MORBIDLY OBESE BMI  40

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Do You Know Your Own BMI?

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Diabetes Hypertension Hyperlipidemia Cardiac ailment Respiratory illness rest apnea Arthritis Depression Stress Incontinence Menstrual abnormality Infertility Problems Fatigue Adult Onset Type II Diabetes Fatty Liver Gallbladder Disease Venous Insufficiency Hernia Premature Deaths Cancer Obesity Related Co-Morbidities (Health Risks) These are only a couple. There are more than 30!

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Surgical Weight Loss At present surgery is our best alternative in accomplishing SUSTAINED weight reduction in the excessively fat patient. "Not a Miracle"

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Medical Benefits of SWL Type II Diabetes 76.8% reduction rate, fundamentally enhanced in 86% High Blood Pressure wiped out in 61.7%, essentially enhanced in 78.5% High Cholesterol diminished in over 70% of patients Sleep Apnea dispensed with in 85.7% of patients Joint Disease, Asthma, and Infertility drastically enhanced or settled Plus numerous other imperative health advantages JAMA 2004

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PrimeCare Weight Loss Program Surgical Options Restrictive just: Adjustable Gastric Banding Sleeve Gastrectomy Restrictive and Malabsorptive: - Roux-en-Y Gastric Bypass

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Laparoscopic Adjustable Gastric Banding A silicone band is put around the upper piece of the stomach The band is connected to a port A little pocket is made Stomach holds less nourishment Induces sentiment satiety OR time = 30-45 minutes Generally outpatient strategy Return to work in 3-5 days Frequent assessments and changes expected to address singular issues

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Stomach Perforation Device Malfunction Esophageal Dilation Erosion Prolapse Slippage Infection Obstruction Possible Complications of Lap Banding

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The LAP-BAND System Advantages Adjustable – tweaked per understanding No stomach stapling, cutting or intestinal rerouting Removable and reversible Low lack of healthy sustenance hazard OR time = 1 hour or less Generally outpatient methodology Mortality rate 0.02-0.10% Disadvantages Slower starting weight reduction than gastric sidestep Soft calories, for example, frozen yogurt, milk shakes, and so on can be absorbed and may moderate weight misfortune. Consistent follow-up is basic for optimal comes about Only prepared specialists can do adjustments Less long haul data is available in light of the fact that it hasn't been done as long Foreign body

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Roux-en-Y Gastric Bypass Combination strategy First done in 1967, done laparoscopically since 1993 Gastric pocket is around size of your thumb Considered the "Best quality level" ASMBS

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SUCCESS OF GASTRIC BYPASS SURGICAL TREATMENT In a 5 Year Study of 500 Roux En Y Surgical Weight Loss Patients: 77% Of Excess Body Weight Was Lost in 1 Year & Maintained For 60 Months 96% Of Severe Co-Morbidities Were Eliminated Within 1 Year 98% Of Type II Diabetes Was Clinically Reversed Dr's. Wittgrove & Clark, 1993 - 1999

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POSSIBLE SURGICAL COMPLICATIONS OF GASTRIC BYPASS Abscess Deep Vein Thrombosis Pulmonary Emboli Gastric Leaks Bleeding Development of a Fistula Obstruction Pulmonary Complications Infection Hernias Strictures Stomal Ulcers Ventral Hernia Anemia Vitamin & Mineral Deficiencies Perforation

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Bariatric Surgery Has Become More Safe Mortality rate identified with bariatric surgery dropped 78.7% from 0.89% in 1998 to 0.19% in 2004. Also, beefy beyond belief patients have a more drawn out future after bariatric surgery because of determination of comorbidities.

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Advantages Rapid introductory weight reduction More successful, fast co-grimness changes Food limitation with the additional weight reduction advantage of minor nourishment malabsorption Better long haul weight reduction comes about than prohibitive just techniques Assists the individuals who devour excessively numerous calories by making them sick – "dumping" Has been done the longest Is the "Best quality level" and remains the most examined heftiness surgery to date Disadvantages Cutting and stapling of stomach and gut is required More agent & post-operation intricacies Portion of stomach related tract is avoided, diminishing ingestion of fundamental supplements Nonadjustable, hard to turn around Technically more perplexing Gastric Bypass

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Sleeve Gastrectomy

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POSSIBLE SURGICAL COMPLICATIONS OF SLEEVE GASTRECTOMY Deep vein thrombosis Pulmonary embolus Pneumonia Acute respiratory trouble disorder Accidental aperture of inside organs Gastric release Postoperative draining Small gut obstacle

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Advantages Stomach is lessened in volume yet tends to work ordinarily. Most nourishment things can be expended in little sums. Kills the segment of the stomach that creates the hormones that fortify craving (Ghrelin). No dumping disorder in light of the fact that the pylorus is safeguarded. By evading the intestinal sidestep, protein insufficiency and vitamin lack are nearly disposed of. Extremely viable for high BMI patients Appealing alternative for individuals with existing iron deficiency, Crohn's illness and various different conditions that make them too high hazard for intestinal sidestep strategies. It can be changed over to whatever other weight reduction method. Burdens Soft calories, for example, dessert, drain shakes, and so forth can be consumed and may moderate weight reduction. Potential for releases identified with long staple line on the stomach. Since the stomach is evacuated, it is not reversible. Sleeve Gastrectomy

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Frequently Asked Questions About Bariatric Surgery.... Q: Is Weight Loss Surgery Reversible? A: Lap Band-Yes, Gastric Bypass-No, Sleeve Gastrectomy-No. Q: Is There Guaranteed Success? A: No. These surgeries can be crushed if healthy way of life changes are not kept up.

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More Frequently Asked Questions Q: Will you take my gallbladder out when you do my surgery? A: No. We don't evacuate solid gallbladders. On the off chance that you have confirmation of stones or illness it might be evacuated. Q: What are as far as possible for these surgery? A: 18 is the most youthful. Patients up to age 65 have had these surgeries, be that as it may, all patients are exclusively considered.

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More Frequently Asked Questions Q: When would I be able to backpedal to work? A: Depends-in light of the method done and the sort of work you do. Q: When would I be able to drive? A: When off of opiate torment pharmaceutical. Q: When would I be able to work out? A: Walking is prescribed with some restraint immediately after surgery. a month and a half for more intense exercise.

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More Frequently Asked Questions Q: Can I drink liquor? A: No lager due to carbonation. Wine and other mixed drinks are fine however contain many exhaust calories. Q: Am I going to have free skin after I get more fit? A: Probably. Reconstructive surgery to remedy this is normally secured by protection in the event that you lose 100 pounds or more.

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Nutrition Bernie Kraft, LRD, CDE Laura Russell, LRD, CDE Diabetes & Nutrition Center Mid Dakota Clinic

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Pre-Operative Expectations Goals of ideal weight reduction amid the pre-operation period: Reduce liver size Increase the chances that surgery can be finished laparoscopically Demonstrate responsibility to the healthful program that has been endorsed for you Demonstrate your dedication to rolling out way of life improvements.

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Lifetime Rules for Eating Eat gradually and bite well Avoid gorging Moisture rich nourishments Limit sugar and high fat sustenances Total of 64 oz. liquid day by day, taken between dinners Avoid carbonated refreshments incorporates brew Take your endorsed supplements

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Insurance Requirements for Pre-Authorization Surgical Evaluation Psychological Evaluation Pre and Post-Op Nutrition with LRD Documented weight reduction endeavors Medical Records with archived weights

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Jean Ellefson, RN MDC Clinical Coordinator Surgical Weight Loss Program Call with inquiries or to enlist in our program: (701)530-6330 1-800-472-2113, ext. 6330 Fax: (701)530-6387