MCSA adds bariatric surgery to services offered
“This is not cosmetic surgery. It used to be thought of as cosmetic surgery, but those days are long gone,” said Dr. Mark Gibbs of the Medical Center of South Arkansas.
Dr. Gibbs is introducing a new service line to the MCSA– bariatric surgery.
Bariatric surgery is a catchall term for a variety of medical procedures performed on obese people to help achieve weight loss. Obesity is defined as a disease of excess fat storage, often combined with a number of associated diseases, known as co-morbidities.
Gibbs said obesity can be a life-long, progressive and potentially life-threatening health complication. It is called morbid obesity when a person has a BMI of over 40 or a BMI of 35 or higher with co-morbidities present; this is also when a person becomes an eligible candidate for bariatric surgery.
“Sleep apnea, diabetes, heart disease, bone and joint problems – oh, the list is a mile long. There’s an increased risk of cancer in obese patients,” Gibbs said. “We know – the reason those numbers were picked – is that once your BMI reaches 35, your life expectancy is shortened.”
Gibbs, a general surgeon at MCSA, has been practicing bariatric surgery since the 1990’s, when he devoted a large part of his private practice (now closed so he can work at MCSA) to the operations. He has performed over 1,500 bariatric procedures in his career and has even taught a bariatric procedure to other surgeons across the United States.
Gibbs performs two types of bariatric procedures: restrictive and malabsorptive. Restrictive procedures limit the volume of solid food a person can consume, while malabsorptive procedures limit the amount of nutrients absorbed by the body.
Sleeve gastrectomies are the primary restrictive procedure, with about 65 percent of all bariatric surgeries being sleeve gastrectomies. In the procedure, 90 percent of a patient’s stomach is removed, leaving a banana-shaped pouch that will be able to hold about 100 cubic centimeters of solid food.
“The patients have to be dedicated to stay away from sweet things on their own,” Gibbs said. “The studies vary, but roughly, you’re looking about 60 percent of the excess weight lost in one to two years.”
Most malabsorptive procedures also combine some elements of restrictive procedures. Gibbs also performs gastric bypass surgeries, also known as Rouxen-Y gastric bypasses or simply bypasses. In those procedures, the small intestine is rerouted so that food skips it, disallowing nutrient absorption; the stomach is also made smaller by closing part of it off to the rest.
“So how a gastric bypass works is it limits the volume and it creates malapsorbtion,” Gibbs said. “On a bypass, you’re looking at about 75 percent excess weight loss, so this creates the most excess weight loss.”
Gibbs said obese patients who undergo bariatric surgery typically have better health outcomes than those who do not. However, there is more to the ensuing weigh loss than the surgery – patients must follow strict diets following their surgeries to ensure the treatment is effective.
“If you look at sleeve [gastrectomy] and bypass, my experience is that patients will lose about two-thirds of what they’re going to lose in the first six months [following the procedure],” Gibbs said. “At the end of a year, that’s pretty much where they’re going to be.”
The bariatric surgery service is new to MCSA – so far, there is only one prospective patient awaiting insurance approval for her surgery, scheduled for September. Gibbs is holding monthly seminars at MCSA currently, so that area residents can learn more about the procedures.
Obesity is a pressing issue in Arkansas. In Union County alone, 79 percent of adults are considered overweight or obese, meaning they have a BMI of 25 or greater, according to the Aspire Arkansas survey.
“Roughly 25 percent of this country is obese. It’s on the rise, and it has been for a long time,” Gibbs said. “It’s just about every state now.”
Gibbs said those interested in learning more about bariatric surgery or potentially becoming a patient themselves should attend one of his seminars. To learn more, visit southarkansasphysicians.com or call 870-863-2000.