Bariatric Surgery.

 

Vital Bariatrics is a multidisciplinary team that works with patients to find their best approach or approaches to improved health and quality of life. Bariatric surgery is an extremely important tool to have in our toolbox for this purpose. Over 1 million bariatric surgeries have been done in North America so the risks and benefits are very well known. It can be truly transformational for patients. While various surgical approaches have been tried through the last 3-4 decades now is truly the golden age for bariatric surgery. The details of patient selection and surgical technique have been well established to get the best results. Technologic advancements in surgical staplers, energy devices, and laparoscopic equipment have propelled surgical programs to new levels of safety and excellent outcomes. Bariatric surgeries have potent positive effects on life span and quality of life with high rates of resolution for weight related disease processes (hypertension, diabetes, depression, etc).

For most patients over a BMI of 35, strong consideration should be given to bariatric surgery and what it can offer. Surgery has become a mainstay of treatment for patients struggling with obesity. It must be emphasized that though surgery has extraordinary benefits it must be done in the right way, by the right team, for the right patient to see those benefits.

In Alberta, bariatric surgery is deemed medically necessary for those that qualify. Unfortunately, limited resources have made it difficult or impractical for many patients to get the care they need through the public system. It is estimate that 250 000 Albertans would benefit from bariatric surgery. However, only about 1000 primary bariatric surgeries are done each year. The quality of care is good but the quantity is lacking.

When patients learn how safe and effective surgery can be for them they are generally extremely motivated to explore this further. In response to the limited access, many Albertans travel abroad for their bariatric surgeries. Mexico is a common destination due to the low cost. These patients soon learn that the Alberta health system is not well equipped or resourced to manage them when they return. Bariatric surgery can’t succeed and should never be offered as a standalone procedure. The lack of access to local expertise and a supportive team at home creates genuine hazards for medical tourists. Many patients travelling abroad have received a sales pitch or simplified explanation of what is truly required to have safe and effective bariatric care. Vital Bariatrics is aiming to fill that gap for Albertans.

We are not always able to care for all of the orphaned surgical patients returning from abroad but we can offer a better surgical pathway for those that need a more customized approach than can be found in the public system.

Private Care.

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We offer private bariatric surgical care within Canada in accordance with the Canada Health Act. The advantage of keeping your care in Canada:

  1. You will always have your care team available to you at home.

  2. You know you will receive a surgery that meets or exceeds the top standards in the world from a Canadian trained and licensed surgeon from your community.

  3. Your care and pre-operative preparation is with Canadian trained and licensed allied health professionals – nurse practitioners, physicians, surgeons, dietitians, and psychologists.

  4. Your surgery is done in a Canadian facility that meets or exceeds world class standards

  5. Should you have a complication, your own public health insurance will cover the costs of your care in a Canadian hospital.

Laparoscopic Sleeve Gastrectomy.

Vital Bariatrics offers the laparoscopic sleeve gastrectomy as one of our surgical options due to the excellent safety profile and well-established results. There are pros and cons to the various bariatric surgeries (including bypass, mini-gastric bypass, etc.). Not all patients are best served with a sleeve and all our patients start with a comprehensive evaluation of their individual needs and goals to make this decision together.

Good candidates for laparoscopic sleeve gastrectomy through Vital Bariatrics:

  1. Motivated, educated, and ready (we can help with this part)

  2. Willing and able to participate in their own health

  3. No unmanaged mental health diagnoses

  4. No active eating disorders

  5. Age 18-55

  6. Non-smoker

  7. BMI 35-55

  8. Minimal or no acid reflux

  9. No severe illnesses that would compromise the safety of the surgery

Laparoscopic Gastric Bypass.

We also offer laparoscopic Roux-en-y gastric bypass, which is considered to be the gold standard procedure against which other weight loss operations are measured. Gastric bypass surgery leads to a greater amount of weight loss and more sustained results, as well as more profound impacts on metabolic health problems associated with obesity such as type II diabetes and hypertension, as compared to sleeve gastrectomy. During gastric bypass, a small pouch is created out of the top of the stomach, restricting the amount of food able to be ingested. The small bowel is then joined to the stomach pouch, bypassing the remaining stomach and a portion of the small intestine, thereby decreasing the amount of calories absorbed from the ingested food. Similar to the sleeve gastrectomy, there are also impacts on the hormones that control hunger and sensation of fullness.

Indications for gastric bypass are similar to that of sleeve gastrectomy, but should be more strongly considered in the following patients:

  • Gastroesophageal reflux disease (GERD)

  • Poorly controlled diabetes

  • Fatty liver disease

  • Polycystic ovarian syndrome (PCOS)

  • Metabolic syndromes

SADI-S Surgery.

Comparing SADI-S to Roux-en-Y Gastric Bypass

The SADI-S procedure offers several benefits over gastric bypass surgery (RYGB), including:

  • Patients can safely take aspirin, NSAIDs, and steroids without the risk of developing marginal ulcers.

  • It is the most effective surgery for diabetes management.

  • It facilitates the greatest weight loss among bariatric procedures.

  • Decreased risk of dumping syndrome.

  • Decreased risk of bowel obstructions compared to both traditional DS and RYGB.

The SADI-S procedure, also known as the modified duodenal switch, loop DS, or SIPS (Stomach Intestinal Pylorus Sparing surgery) is an innovative procedure that is proving to be the most effective  bariatric and metabolic operation.  During this procedure, a sleeve gastrectomy is performed.  The first portion of the small intestine (duodenum) is then divided.  A single loop of down stream small intestine is then attached to the cuff of duodenum, effectively bypassing about half of the small intestine.  Studies show that two years post-SADI-S surgery, patients can lose over 95% of their excess body weight, with more than 90% achieving complete remission of diabetes.

Frequently Asked Questions.

Q: Who would be my surgeon?

A: Vital Bariatrics works with Alberta surgeons only. Dr. Adam Schofield is our medical director and does the vast majority of surgeries.

Q: Where would my surgery be done?

A: The Canada Health Act prohibits patients from paying for medically necessary care in the province they are insured. Bariatric surgery is not permitted outside of public hospital in Alberta. As such, a high volume private surgical facility in another province will be used for the surgery. The pre-op and post-op care will still be done in Alberta.

Q: How much weight would I lose?

A: In your initial consultation we can compute the typical projected weight loss for your exact circumstances with a variety of approaches including LSG.

Q: Can I choose my surgeon?

A: It may not be possible to accommodate all requests but Vital Bariatrics only works with experienced, high volume surgeons with reliably excellent outcomes so that patients don’t need to feel like they need to do any additional “research” on their surgeon. That said we can almost always accomodate specific requests.

Q: What is included?

A: Once enrolled in the surgical program you will begin a 3 month process of education and optimization. This step includes working with nurses, doctors, dieticians, and psychology to become mentally and physically optimized for success. We thoroughly investigate our patients before surgery to ensure their risk is minimized - labs, endoscopy, caridac invesitigations, etc. All of the associated costs of surgery are included with the exception of travel. A nine month surveillance and coaching program continues until discharge.

Cost.

 

Costs are of course an important consideration for all patients. When comparing programs, it is important to consider the quality of the care and outcomes you are receiving. The least expensive program is rarely the most beneficial. We have done our utmost to make our program accessible while refusing to compromise safety or quality at any point along the way.

First Installment – $2,500

Includes the costs of your initial assessment and three-month pre-operative program with our nurse practitioner, weight loss physician, registered dietitian, and psychologist.

Surgical Fee for Laparoscopic Sleeve Gastrectomy – $17,000
Surgical Fee for Laparoscopic Gastric Bypass – $19,000
Surgical Fee for SADI-S Surgery - $21,500

Includes the costs of the surgical facility, 2 night stay, nursing, anesthesiology, staplers, medications, laparoscopic equipment, surgeon time, and the complete nine month post-operative program.

To put surgical costs into perspective, the total fee of the one year laparoscopic gastric bypass program is still less expensive than three years on Jenny Craig, Weight Watchers, or weight loss drugs. The long term benefits of surgery, however, are vastly greater.