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Frequently Asked Questions

Olde Del Mar Surgical would love to be a resource as you explore your health options. We believe the best patient is an educated one. If you don’t find the answer you need here, contact us for more information. We are happy to help.

Revision surgery is a weight loss treatment that follows a previous bariatric surgery that did not lead to as much weight loss as the surgeon and patient hope for. Revision surgery can also be used when a patient regains significant weight after initially losing weight. Contact us if you are interested in discussing your options for revision surgery.

Weight loss (bariatric) surgery helps you lose weight and lowers your risk of medical problems associated with obesity. Bariatric surgery contributes to weight loss in two main ways. The first is restriction, as the amount of food the stomach can hold is physically restricted, limiting the number of calories you can eat. The second way is malabsorption. Because some surgeries shorten or bypass part of the small intestine, it reduces the amount of calories and nutrients the body can absorb.

Our highly skilled and experienced surgical team, led by Dr. Sunil Bhoyrul, specializes in gastric sleeve, gastric bypass, revisional bariatric surgery, and Lap Bands.

Yes, at Olde del Mar Surgical we perform most of our weight loss procedures laparoscopically. This minimally-invasive technique results in fewer complications, less pain and less down time for most patients.

The average surgical time for gastric bypass is about 2 hours and sleeve gastrectomy is about 1-2 hours. Due to the minimally invasive techniques we now use, almost all of our patients can walk just a few hours after surgery. The majority of patients only stay in the hospital for just one night or two nights.

Most weight loss surgery patients return to work after two to four weeks. Some may be able to work from home as early as one week after surgery. Because of the significantly reduced calorie intake, many patients have low energy for 1-2 weeks after surgery. However, most patients gain their energy back once they start to eat soft food.

In general, weight loss surgery patients can expect to shed up to 50-75 percent of their excess weight, depending on the procedure. Ultimately, weight loss surgery is a tool and the patients with the most weight loss success are those who adhere to a healthy lifestyle, including eating habits, activity level, and psychological support. At Olde Del Mar Surgical we are here to support you through your entire weight loss journey.

Insurance coverage varies by insurance policy. If your policy covers weight loss surgery and you meet the qualification requirements. Many insurance plans will pay for you to have gastric sleeve, gastric bypass or Lap-Band surgery if you meet the qualifications. Our staff can help you understand your insurance coverage.

The cost of bariatric surgery can vary, depending on the type of procedure performed and the patient’s medical condition. Our office is available to discuss your payment options with you after your consultation.

Yes, many women have become pregnant after the surgery without any related complications. Thousands of women have had successful pregnancies after weight loss surgery. In fact, is common for women’s fertility to increase after weight loss surgery as hormones normalize in the body. We typically recommend waiting 12-18 months after weight loss surgery before getting pregnant.

Gastric bypass surgery involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. After surgery, swallowed food will go into this small pouch and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine.

Each patient is different, but in some studies gastric bypass patients have lost about 75 percent of their excess body weight in the two years following surgery.

The type of surgery will be determined by you and your surgeon. Our goal is to match your expectations with the appropriate choices, depending on the type of surgery you need, the other illnesses you may have, and the risks and benefits of each choice.

Most patients have pain that can be easily managed with prescription strength painkillers. Typically patients are able to wean of these prescriptions within a week from surgery (longer for major abdominal surgery).

A good rule is that you should have been off your prescription painkillers for 24 hours before you attempt to drive.

You can shower 24 hours after surgery, unless you have an open wound, or have been told not to do so by your surgeon.

Avoid lifting anything greater than 10 lbs until you have seen your doctor for your post operative follow up visit in the outpatient clinic.

You can resume a sedentary (office) job 3-7 working days after you are home (depending on the type of surgery). Any heavy work (operating machinery, lifting patients) may need to wait as much as 4 weeks.

Stay on liquids till you have a bowel movement (soup is OK). After that, unless you have had surgery on your stomach, you may eat soft foods for a few days, then a regular diet, as long as you tolerate the soft foods.

Once you feel physically and emotionally comfortable you may resume sexual activity. This can typically take about a week after surgery.

The Lap-Band is an adjustable gastric band designed to help you lose excess body weight, improve weight-related health conditions, and enhance quality of life.

The adjustable gastric band is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stoma is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight.

During the procedure, Dr. Bhoyrul usually uses laparoscopic techniques (making tiny incisions rather than a large incision and inserting long-shafted instruments through “ports”) to wrap the Band around the patient’s stomach. A narrow camera is passed through a port so the surgeon can view the operative site on a nearby video monitor. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach.

Unlike gastric bypass surgery, gastric banding does not require stomach cutting and stapling or gastrointestinal rerouting to bypass normal digestion.

Once placed around the stomach, tubing connects the band to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting saline or salt water, inside the inner balloon through the access port. Adjustments are performed without any additional surgery.

Most patients have their first band adjustment 4-6 weeks after surgery. The surgeon, in consultation with the patient, schedules additional follow-up appointments and/or band adjustments as needed. Laboratory analysis of your blood is done every three months during the first year after surgery.

If the surgery is performed laparoscopically, as it most frequently is, patients typically spend less than 24 hours in the hospital. It takes most patients about a week before they can return to work, and a month to six weeks before they can resume exercising. In the case of open surgery, or if there are complications, recovery may take longer.

When your new stomach pouch has healed, an average meal will be about ½ to 1 cup of food, however, different foods move through at different rates, depending on the consistency.

Your surgeon recommends that your source of nutrition be protein drinks for the first few weeks, to allow your new pouch to rest and your band to settle in. The body needs 60 grams of protein per day. Avoid fibrous, stringy foods, and raw vegetables. You may eat most foods that don’t cause you discomfort. However, because you can only eat a little at any given time, it is important to include foods rich in important vitamins and nutrients-foods such as those recommended by your surgeon and/or dietitian.

If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived.

The surgery will change the way you eat and will reinforce a new eating plan. Because your new stomach is smaller, you will feel full after eating less food. Your new stomach pouch will not be able to grind food as it once did, so you will need to eat small bites and chew food very, very well.

Individual weight loss results vary but if you follow the general nutritional guidelines, you should expect to lose about 1 to 2 pounds every week on average over the first year.

Weight-loss results vary from patient to patient. A weight loss of two to three pounds a week in the first year after the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. But remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.

Drinking water keeps you from becoming dehydrated. This is particularly important after gastric bypass surgery. Drinking plenty of water allows the body to be effective and efficient in ridding itself of the excess fat and also reduces food cravings.

Since you will not be able to drink water quickly as your stomach heals from surgery, you will need to sip small amounts of water throughout the day. Carry a water bottle for convenience and to remind you to keep sipping. The water bottle should become a familiar sight in and out of your home. If you do not like your tap water, treat yourself to bottled water. A slice of lemon can add flavor.

Sleeve gastrectomy, also known as the “sleeve,” is a surgery in which the stomach is permanently reduced to 15 – 25 percent of its original size, leaving a banana-shaped portion that has both restrictive and malabsorptive qualities to induce weight loss.

No, since part of the stomach is removed, sleeve surgery is not reversible.

Patients who have the sleeve procedure and follow the other program requirements often lose up to 65% of their excess body weight. Many patients also improve or eliminate obesity-related issues such as type 2 diabetes, high blood pressure and sleep apnea. Keep in mind that each patient is different, and weight loss may be higher or lower than average.

The sleeve is technically simpler than the gastric bypass. Instead of rearranging the anatomy of the patient’s stomach and small intestine as is done with the gastric bypass, the stomach is resized to affect weight loss. In some cases the gastric bypass is preferable for patients with type 2 diabetes, but the most important consideration is that recommendations must be made after a detailed consultation with Dr. Bhoyrul.

We will restrict the treatments that we offer to the areas where we have significant experience, knowledge, and support from our colleagues. In certain cases we may refer you elsewhere, especially if we feel that there is another physician or center where your needs may be better served. Ultimately, we need to feel secure that the treatment you receive is the level that we would expect if a friend or family member of ours had the same diagnosis.

For the most part, our experience with the insurance companies has been very favorable. We will contact them, on your behalf, to have the treatment authorized, or to give you a clear understanding of your financial responsibility for the surgery.

Our experienced team of physicians and nurses have years of experience in providing physical, emotional, and psychological support to you and your family, so that we can pre-empt and address your needs. It is highly unusual for our patients to experience unnecessary suffering.

Absolutely – do whatever you need to do to ensure that you are comfortable with your choice of physicians and facilities. If you choose us as your providers, we will treat you with skill, compassion, respect, and honesty.

We recommend that you weigh once a day. Plan to weigh and measure yourself on a regular schedule, at the same time of day and in similar clothing.

During the period of weight loss, you may hit a plateau when you notice you are not losing pounds. Your body may simply be adjusting to the chemical and biological changes that occur during weight loss.

If plateaus continue for more than a few weeks, review your nutrition plan and activity level. Are you following the nutrition guidelines for portions, protein and fluid intake and limiting fats and sugars in your food selections? Decreasing your activity level can also contribute to a weight plateau. Review your activity level and see if your level of physical activity can be increased. If you are weight training, remember that muscle weighs more than fat, and while you are building muscle, you are still losing inches even though you are not losing pounds.

Do not be concerned if your weight plateaus more than once during your weight loss. If a plateau continues for more than a few weeks, review your nutrition plan and your exercise program. Speak to your surgeon about any concerns you have and for more ideas on the best way to end a plateau.

No. The Band does not limit or hamper physical activity. You should be able to do everything from simple stretches to strenuous exercises. In fact, exercise should become a regular part of your post-surgical routine. Remember, the Band is simply a tool that helps you lose weight – diet and exercise are still required. Always check with your doctor about the amount and type of exercise that is best for you.

Exercise maximizes weight loss and helps to maintain a healthy body. After surgery, you not only need good nutrition, you need to take the time for regular activity. You can build exercise into your daily schedule, and it even helps to walk to do your errands.

Here are some reasons why physical activity is important to you:

  • Exercise increases your metabolic rate, which can help you lose weight faster.
  • Exercise is fat burning.
  • Exercise improves your mood and feeling of well being by secreting endorphins (pleasure-chemicals) into your body.
  • Exercise causes a person to feel less hungry.
  • Exercise increases muscle tissue, which, unlike fat, constantly burns calories (even when the body is resting).
  • Exercise will decrease muscle breakdown while losing weight.
  • Exercise helps to alleviate constipation.
  • Exercise can improve sexual activity.

There are many more reasons for exercise. Why not consider the benefits of joining a fitness program? Use your increasing energy to discover (or rediscover) some new, active interests.

The Gastric Band can help adults, at least 18 years old, who are 80-100 pounds over their ideal weight or have a Body Mass Index (BMI) of 40 or greater. People with a BMI of 35 or greater with weight-related health problems may also be eligible for Gastric Banding.