Surgical treatment of obesity
UC Davis Medical Center offers a program for the surgical treatment of obesity. The program is staffed by Mohamed Ali, M.D.; Jonathan Pierce, M.D.; Aaron Carr, M.D.; Judy Yamasaki, R.N., B.S.N., Clinical Nurse III/Bariatric Nurse Coordinator; Barbara Jachniewicz, R.N.F.A., M.S., F.N.P.-B.C., N.P.; Abigail J. Scheitlin, B.S.N., R.M., M.S.N., F.N.P.-B.C.; Elaine Souza, M.P.H., R.D., Dietitian; Sky Baucom-Pro, M.A.S., R.D., Dietitian; Jane McClay, Psy.D., Psychologist ; Elizabeth Martinez, new patient referral coordinator; Alexis Trombley, surgical coordinator; Christina Garcia, nurse coordinator assistant, and Galina Poruchikov, post-surgery follow up coordinator.
There are three types of surgical procedures for obesity performed at UC Davis Medical Center. Roux-en-Y gastric bypass, vertical sleeve gastretomy, and adjustable gastic banding. [Click here for more information about each type of surgery]
All three bariatric surgeries are laparoscopic, which means five one-half inch incisions are made on the abdomen. The surgeon then performs the operation using special laparoscopic tools and by observation through a small camera.
- The program involves at least three pre-operative interviews with each patient in order to review medical, surgical and psychosocial history. The patient's understanding of the method of operation, possible complications, and post operative diet and exercise requirements is also assessed
- Candidates for surgery are chosen based on clear information that the medical indications for bariatric surgery are met as well as the patient’s candidacy for major surgery as determined by our team.
- A medical evaluation by the patient’s primary-care provider, including laboratory work, should accompany the patient to their visit with our team. Other medical tests such as a colonoscopy, upper endoscopy, and sleep study may be ordered based on a patient's medical history.
- Psychological assessment is required and will be done by the bariatric psychologist who will be available for the patient post-operatively, if needed.
Once a patient is medically, psychologically, and nutritionally cleared for surgery, insurance authorization is requested and must be received prior to scheduling surgery.
Eligibility for surgery
In general, patients seeking bariatric surgery for weight loss must be at least 100 pounds overweight and have failed prior medically supervised attempts at weight loss. Documentation of such attempts will need to be provided at the time of consultation. If this is not available, we may recommend a medically supervised weight-reduction program prior to further consideration.
The method of weight loss is the restriction of oral intake because the stomach becomes full with small amounts of food. In order to successfully lose and maintain a lower weight, the patient must adhere to a lifelong low-fat, low-calorie diet and exercise routine. The rate of success with this surgery varies; approximately 30% to 40% of the patients lose at least 100 pounds of their excess weight and are able to maintain this loss for years. Approximately 50% to 60% lose 100 or more pounds and then regain some of the weight. Approximately 10% to 20% lose less than a desired amount of weight or regain a great deal of their weight. The successful patient is one who is able to maintain a low-calorie diet and consistent exercise. Our dietitian is available to all post-operative patients to assist with dietary and behavior changes.
Following the surgery, patients are in the hospital for a minimum of 2 to 10 days if there are no major complications. The status of the patient’s lungs prior to surgery is important to know, as those with prior lung disease are more likely to require mechanical ventilation for longer periods after surgery.
Recuperation and follow-up
Your activity will be restricted to no strenuous activity for six weeks after the operation. You may walk, use a stationary bike, and perform light household duties as tolerated upon your return home. Most patients remain off work for six weeks to allow enough time to heal and work on new lifestyle changes.
After surgery, patients will be seen in bariatric clinic at 2 weeks post-op, 2 months, 6 months, and 1 year. We then continue to follow our patients at least one time per year, with no end date. Patients may be seen by the nurse practitioner, nurse, dietitian, and surgeon at each visit.