Wellington Surgical Weight Reduction Center

Severe morbid obesity affects the body's mechanical, metabolic and physiologic functions. These comorbidities affect every organ in the body and can result in serious illness, including:

• Diabetes
• Essential hypertension
• Gastroesophageal reflux disease
• Obstructive sleep apnea
• Respiratory insufficiency
• High cholesterol
• Arthritic symptoms of weight-bearing joints

At the Wellington Surgical Weight Reduction Center, we provide a comprehensive approach to morbid obesity. Using advanced techniques, we specialize in:

• Laparoscopic Roux-en-Y gastric bypass surgery
• Adjustable gastric banding
• Sleeve gastrectomy

Our program provides you with extensive preoperative education and a postoperative plan of care that includes exceptional support groups, nutritional counseling and fitness programs.

Surgical Procedures

Roux-en Y Gastric Bypass

The stomach is divided to create a small pouch that can hold approximately 30cc (1/8 cup) from its original capacity of 2,000 - 3,000cc. This dramatically limits the amount of food that can be eaten. The remaining stomach is stapled closed and surgically separated but not removed.

The small intestine is divided further downstream and attached to the new pouch so that any food eaten bypasses the old stomach. The connection from your new stomach to the intestine is small, approximately 1.0-1.5 cm wide (approximately ½ inch) to limit the food that passes through.

Absorptive Changes. The duodenum, the first section of the small intestine, continues to receive liver bile, enzymes and pancreatic juice needed for digestion.

The small intestine is surgically divided to create a Y limb. None of the intestine is removed. One section of the divided intestine is then connected to your new smaller stomach pouch. This opening from your new stomach to the intestine is small, approximately 1.0 to 1.5 cm wide (approximately ½ inch).

The duodenum is rejoined to the side of the jejunum, the second part of the intestine to form a common limb. This opening is wide so food can pass through easily. Pancreatic juices and liver bile from the duodenum now reaches the food as it travels down the jejunum. Liver bile begins fat absorption at this time. Fat is only being partially absorbed. Sugars are absorbed but discouraged because they cause most patients to experience the "dumping syndrome". This is a very uncomfortable feeling of flushing, cold sweats, palpitations, weakness and abdominal cramps.

Insurance Information

Laparoscopic Adjustable Gastric Banding

This FDA-approved surgery has gained popularity recently and is performed in less than one hour. A silicone band is placed around the upper part of the stomach and is connected to a reservoir placed under the skin on the abdominal wall. By injecting water into the band through the reservoir (adjustments), a greater restriction can be achieved. A well-adjusted band not only limits intake but also lessens hunger.

This procedure has produced some very successful results. Patients must meet the same criteria for eligibility into the bariatric program as required for gastric bypass. For more information, please call us at 561-798-8587 to attend an information session, support group or education class.

Laparoscopic Sleeve Gastrectomy

Originating as the first part of the Duodenal Switch (or Biliopancreatic diversion), the laparoscopic sleeve gastrectomy has gained popularity due to research showing that this procedure alone is highly effective in treating morbid obesity. Long-term studies are currently underway, and we perform this procedure by special request.

The operation is laparoscopic, and involves cutting the stomach longitudinally so that stomach volume is reduced to less than 100cc. Important hunger hormones called Grehlin are removed with the resection. This is a purely restrictive surgery similar to the gastric band that uses no tubes or foreign bodies.

For Gastric Bypass Surgery

Gastric Bypass and Sleeve Gastrectomy surgery usually require a two- to three-day hospital stay and two to six weeks recovery time, depending on the type of work you do. Gastric banding requires one-day hospitalization and one to two weeks of recovery.

Many insurance companies cover bariatric surgery as a benefit, depending on the type and terms of the policy you have. Even when they are issued by the same insurance company, insurance policies may vary.

Some patients may choose to pay for the surgery on a self-pay basis. You can arrange this by calling the Wellington Surgical Reduction Center and speaking directly with the insurance coordinator. Two fees are involved: one for the surgeon and another for your hospital stay.

Determining Medical Necessity

Insurance coverage depends on whether your primary care physician, surgeon and sometimes a specialist determine that bariatric surgery ismedically necessary to reduce significant medical risks to your life.

A thorough medical history, a detailed diet history for the past two consecutive years under medical supervision, current height, weight and BMI (body mass index) and a list of all comorbidities that are or may be caused by your morbid obesity must be included in a letter of medical necessity written by your primary care physician and provided to Wellington Surgical Weight Reduction Center for submission to your insurance company. This letter, along with a psychological evaluation/clearance is a requirement for all insurance companies.

Insurance Denials

If you receive a denial of coverage by your insurance company, you should not consider this as a "definite no." In many cases, providing additional detailed information in an appeal letter will result in a denial being overturned. If your insurance carrier remains unreasonable, you may want to consider writing to your legislator or seeking legal assistance. Insurance companies will often relent to avoid confrontation.

We accept many insurance plans. For more information, please call Gwen at 561-798-8587.