Surgery Options
First Gastric Bypass Surgery in Will County performed at Silver Cross Hospital
Joliet, Ill. (Sept. 2, 2003)—Dr. Christopher Joyce performed the first gastric bypass surgical procedure in Will County Monday, August 18, at Silver Cross Hospital in Joliet. The patient was Myrtelina Rodriguez, 62, of Oak Lawn.
Dr. Joyce, a board certified general surgeon, specializes in bariatric (weight loss) surgery. Bariatric surgery is an option for morbidly obese individuals who are often unable to lose weight through more conventional means, such as supervised weight loss programs.
The National Institutes of Health defines morbid obesity as having a Body Mass Index (BMI) of 40, which equates to about 100 pounds overweight for an average woman. BMI is calculated by dividing a person's weight (in kilograms) by his or her height (in meters) squared. Doctors may also consider bariatric surgery for patients with a BMI of between 35 and 40, if they have multiple health problems, such as high blood pressure or diabetes, associated with their weight.
"The typical patient has been trying to lose weight for years," Dr. Joyce said. "He or she also has spent about two years looking into the surgery. Patients are generally highly educated about this type of surgery."
While her overall health was excellent, Rodriquez was obese and complained of leg pain, swelling, and itching, all of which doctors told her was caused by poor circulation as a result of her weight. Because the circulation issues were an ongoing problem, her primary physician suggested that she consider gastric bypass surgery.
The physician referred Rodriguez to Dr. Joyce, who then had a practice near her home in Oak Lawn. He performed pre-operative tests, educated her on gastric bypass surgery and prepared her for the procedure.
"He gave me a lot of materials, and I read everything," Rodriguez said. "Everyone, including the nurses, the dietitian, the exercise physiologist, they all get you well prepared. They explain to you what to expect and what you'll have to do."
When Dr. Joyce moved his practice to the new Specialty Care Pavilion at Silver Cross Hospital in Joliet, Rodriguez was told that she could continue with the surgery under the care of another doctor in her area, but she chose to stay with Dr. Joyce and to have the surgery performed at Silver Cross.
According to Dr. Joyce, gastric bypass surgeries can essentially be divided into two categories: restrictive surgery, which limits the amount a person can eat at one time by drastically reducing the size of the stomach, and malabsorptive, which bypasses the upper part of the small intestine so less of the food that a patient eats is actually absorbed.
Dr. Joyce performs what is known as a vertical banded Roux-en-Y procedure, which combines both restrictive and malabsorptive surgery. Using staples, he creates a pouch about the size of an egg at the top of the stomach. He then divides the small intestine and attaches the lower part of the intestine to the stomach pouch. Dr. Joyce calls this procedure the "gold standard" of bariatric surgery, because it has the highest success rate in terms of weight loss.
Even once the surgery is over, the work has just begun for the patient trying to lose weight. They achieve their weight-loss goals by adhering to a post-operative lifestyle that includes changed eating habits and regular exercise.
For example, because patients lose the ability to eat large meals, they must learn to eat very small amounts of food at one sitting. They also must learn to chew their food very thoroughly, because the opening between the stomach and the intestine will be much smaller than it was before the surgery.
"This is a very structured program," Dr. Joyce said. "The surgery is just part of it. We provide them with a great deal of pre-op education and we tell them what to eat. We also try to enroll them in an exercise program that we tailor to the person."
A week after her surgery, Rodriguez was adapting well to her new lifestyle. "I'm following the instructions," she said. "They told me what to eat, and that I need to drink lots of water between meals. I'm continuously with a glass of water or tea or lemonade. I also do the exercises. At the beginning they're light and easy to do."
According to Dr. Joyce, 85 percent of patients who undergo the Roux-en-Y procedure accomplish what doctors consider an "excellent" result: loss of at least 75 percent of their excess body weight. Ninety-five percent of patients accomplish a "good" result: loss of 50 percent or more of their excess body weight.
In addition to weight loss, successful gastric bypass patients often experience a dramatic reduction in the number of medical problems associated with obesity, such as high blood pressure, high cholesterol levels, and diabetes. Potential long-term complications include malnutrition and vitamin and mineral deficiencies, so patients must be careful to eat small, high-protein meals and be conscious of drinking enough fluids, Dr. Joyce said.
"When they start losing weight, they lose fat but also muscle. We use the high-protein diet and muscle strengthening exercises to keep the muscle but let the fat go away."
To learn more about gastric bypass surgery, call Silver Cross Hospital at (815) 740-7108 to attend a free weekly information session.