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Lite Life Surgery: Online Content 1 Home Page LLS-LOGO | VISUALS Lite Life Surgery provides obesity weight loss surgery, nutrition and exercise programs for patients throughout Southern California. We help those struggling with weight to take it off, and keep it off. We offer patients several weight loss options and our doctors can help you decide which procedure is best for you. VISUALS Lite Life Surgery: Online Content 2 About Us Meet Dr. Bhasker Rao Dr. Bobby is a graduate of Loma Linda University School of Medicine in Loma Linda, California. He completed his residency at Brookdale University Hospital & Medical Center in New York, New York. Dr. Bobby furthered his education with a Fellowship at the University of California, Davis Medical Center in Sacramento California, where he trained with world-renowned surgeons and served as a Clinical Instructor of Surgery. He is currently a proctor for new bariatric surgeons and experienced surgeons who are interested in improving their technique. Dr. Bobby has performed over 1,000 laparoscopic gastric bypass and laparoscopic adjustable gastric banding surgery with superior outcomes, far above the national average. He holds memberships in the American Society for Metabolic and Bariatric Surgery (ASMBS), American College of Surgeons (ACS), Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American Medical Association. Meet The Dietitian Dietary consulting and nutrition counseling with a registered dietitian is among the services offered through Lite Life Surgery. A dietitian nutritionist teaches patients how to lose weight and how to maintain the weight lost — enabling patients to enjoy a healthier, better-balanced lifestyle. Courtney Markey, a California registered dietitian and nutritionist, oversees the lifestyle and nutrition programs at Lite Life Surgery. Courtney’s expertise in nutrition and dietetics compliments Dr. Bobby’s comprehensive surgical weight-loss program. Courtney holds a Masters Degree from Illinois State University in Consumer Sciences. Many patients find that weight loss is more effective and less stressful when a registered dietitian is involved with their care. Our programs provide nutrition education, encouragement and support. Lite Life Surgery: Online Content 3 Obesity Solutions Obesity is an excess of total body fat, resulting from too many calories and too little energy usage. According to the Centers for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups. Obesity Surgery Our bariatric surgeries are designed to help the obese, those with a body mass index (BMI) over 40. Sometimes, lower BMI's may be considered if there is an imminent health threat. As obesity surgeons, our practice is designed to provide patients with lasting results. Whether it is duodenal switch surgery or lap band surgery, patients will often see an 80-percent reduction in their excess weight, with rapid results in the first few months and the majority of weight lost within the first two-years following the surgery. Weight loss surgery is often a permanent solution. Our nutrition and diet programs are designed to help patients maintain a healthy weight. VISUALS Lite Life Surgery: Online Content 4 ROBOTIC ROUX-EN-Y GASTRIC BYPASS Among the most popular weight loss procedures is stomach bypass surgery, more commonly called gastric bypass surgery. During the gastric bypass procedure, a small stomach pouch is created with the goal of limiting food intake. After this new pouch is made, a Y-shaped section of the small intestine is attached to the pouch. This allows food to bypass the lower stomach, the duodenum (or the first segment of the small intestine) and the first portion of the jejunum (the second segment of the small intestine). Once this bypass is made, the amount of calories and nutrients that can be absorbed is reduced, resulting in rapid weight loss. Gastric bypass surgery is designed to treat those who are morbidly obese. A person is considered morbidly obese if their BMI is more than 40. Gastric bypass surgery is also used to treat those who have lower BMI's when obesity-related illnesses such as diabetes, high blood pressure and high cholesterol are present. People who undergo this procedure can expect to lose around sixty to seventy percent of their excess weight. This weight loss typically takes place within two years. In Palm Springs, bypass surgery is done robotically, which is much more precise, minimizing the risks of surgery. This type of procedure can also limit bleeding, reduce recovery times and limit the days spent in a hospital. Laparoscopic procedures typically involve small incisions rather than a large surgical scar. In addition to the rapid weight loss that results, bypass surgery has a long and proven track record. Those who undergo laparoscopic gastric bypass surgery also tend to lose a bit more weight than those who undergo a gastric band procedure. Lite Life Surgery: Online Content 5 Though this procedure has many advantages, it does require a longer recovery time than other weight loss procedures, it is permanent and can result in minor late weight gain. ROBOTIC SLEEVE GASTRECTOMY Gastric sleeve surgery is a relatively new approach to weight loss surgery. Like all weight loss surgeries, it’s geared to help the obese and morbidly obese lose an extreme amount of excess weight. The sleeve gastrectomy surgery is the first component of the duodenal switch operation (a procedure that bypasses most of the small intestines and causes the body to absorb fewer calories and fat). During the gastric sleeve surgery, over half of the stomach is partitioned with a stapling device. The end result is a stomach shaped like a tube, rather than a sack — limiting stomach volume and allowing patients to feel fuller sooner. The amount of weight lost from this procedure is typically between 40 and 60-percent of excessive weight within one to two years. The gastric sleeve surgery is performed robotically, rather than an open operation. Advantages of a robotic sleeve gastrectomy procedure are increased precision, reduced recovery times, less bleeding and infection, decreased pain and fewer chances for serious complications. Robotic procedures may even be better for patients whose health does not allow for more invasive, open operations. Gastric sleeve surgery is sometimes performed as an initial step in a two part bypass operation. Lite Life Surgery: Online Content 6 This series of procedures is often recommended if patients are extremely obese (with a BMI over 60). After the patient reaches a safer BMI, then the more radical bypass can be performed. When comparing gastric sleeve to gastric bypass, the gastric sleeve surgery is a better option for people who often travel or are simply too busy to make several follow-up appointments. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING Laparoscopic adjustable gastric banding is the least traumatic of all the weight loss surgeries. Because there is no cutting, no stapling and no stomach re-routing; this type of gastric band surgery offers a quick recovery, a reduction in pain and a shorter hospital stay than other types of weight loss surgery. Gastric band surgery is a good surgical choice for those who don’t do well with more invasive procedures. It’s also a good choice for patients wanting quick results. Though this type of surgery is minimally invasive, the results are dramatic. The laparoscopic gastric banding surgery is performed with the use of a laparoscope (a thin, lighted tube that acts as a type of guide). The laparoscope implants an inflatable silicone band into the upper abdomen of the patient. This band fastens around the upper stomach and creates a new, tinier stomach. After the adjustable gastric band surgery, the band can be adjusted by adding more or removing fluid in the band. This adjustment can make the band tighter or looser to regulate food consumption. The advantages of this type of surgery include; no intestinal rerouting, the least invasiveness of all weight loss surgeries, no Lite Life Surgery: Online Content 7 cutting or stapling and a quicker recovery. Gastric band surgery also has a lower mortality risk than other weight loss surgeries, lower risk of nutritional deficiencies and no permanency (the band can be removed at any time). ROBOTIC MODIFIED DUODENAL SWITCH A duodenal switch procedure is a type of weight loss surgery that removes over half of the stomach and bypasses a long portion of the small intestine. The result is a significant reduction in the amount of fat and calories that can be absorbed by the body. When compared to other weight loss surgeries, the duodenal switch surgery offers the most significant weight loss. The duodenal switch procedure also allows for more food to be consumed, providing the patient with the ability to enjoy the foods they love. In fact, those who undergo this procedure often find that they don't need to significantly alter their eating habits. Modified duodenal switch procedures are performed under general anesthesia. Because the duodenal switch surgery is a robotic procedure, the surgery is minimally invasive and the risks are less than more invasive procedures. Robotic procedures often also result in less pain, shorter recovery times and less bleeding than open surgeries. The duodenal switch surgery results in bypassing the majority of the small intestine. This bypass causes the body to reduce the amount of calories and fat it can absorb. Within two years of the procedure, patients typically lose 70 to 80percent of their excess weight. Lite Life Surgery: Online Content 8 Nutrition When you commit to weight loss surgery, it’s truly life changing because you’re also committing to eating differently for the rest of your life. But you’re not alone on the journey. We offer nutrition counseling with a Registered Dietitian Nutritionist to help you make the changes that ultimately change your life. Medical Weight Loss Program This three to six-month program is designed to teach healthy eating habits and nutritious food choices. This program meets the requirements issued by many insurance companies before bariatric surgery. Individualized Weight Loss and Nutrition Counseling Our Registered Dietitian will evaluate your current eating habits and work with you to improve your diet. This program works well for those who haven’t had bariatric surgery. It’s also a great refresher for patients who have started to gain weight years after surgery. Eight Day Weight Loss Jump Start This program helps you quickly drop a significant amount of weight, boosting your motivation to continue with your weight loss program. Pre- and Post-surgical Dietary Education and Evaluation Eating is very different after bariatric surgery. It’s important to work with a Registered Dietitian regularly to stay on track and make good food choices to prevent stomach aches and adverse problems. Lite Life Surgery: Online Content 9 Exercise Maintaining your post-surgery weight loss comes down to two factors; exercise and good nutrition. When considering exercise, it doesn’t take a lot to reap the benefits of increased muscle strength, energy and stress reduction. Just 30-minutes of activity, every day to increase your heart rate can make a big difference. VISUALS There are many ways to get daily exercise, but one of most underrated is simply walking. For starters, 10,000 steps per day will help you maintain your weight. Using a pedometer or a phone app to monitor your steps will allow yo to track your progress and gradually build up your step count over time. For an extra boost, take the stairs, park at the end of the lot and don’t forget to have fun. Putting on some music and dancing around the house burns calories and for most of us, helps with coordination. In addition to simply moving, try focusing on strength for two days a week. Activities like yoga, Pilates, push-ups, pull-ups and lifting weights are simple and don’t require a gym membership. But if you’re so inclined, pairing up with a friend or hiring personal trainer will provide extra motivation. The fastest way to unravel the benefits of bariatric surgery is to do nothing. Not surprisingly, one of the biggest culprits to maintaining your weight loss is watching TV. It’s a sedentary, passive time-eater that too often results in expanding waistlines. So try to limit TV viewing to a less than a couple of hours every day. Lite Life Surgery: Online Content 10 Support Group All Support Groups are held on the second Monday of each month from 6:30-8:00 p.m., in the Annenberg Building at Eisenhower Medical Center, 39000 Bob Hope Dr. Rancho Mirage, California. Frequently Asked Questions What are the definitions of "obese" and "morbid obesity"? Obesity is defined as the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Morbid Obesity is defined as a serious disease in which the accumulation of fatty tissue becomes excessive and interferes with or injures bodily organs — causing serious and lifethreatening health problems known as co-morbidities. I'm considering weight loss surgery, is there anything I should know before making a final decision? The goal in managing and treating obesity is to decrease a patient's medical risk and improve the quality of life. An appropriate weight management program combines physical activity, diet, behavior modification, psychological counseling and sometimes drug therapy, to help patients achieve weight loss or prevent further weight gain. Weight loss surgery is major surgery. Although most patients enjoy an improvement in obesity-related health conditions, such as mobility, selfesteem and self image after the successful results of weight loss surgery, these results should not be the overriding motivation for having the procedure. The goal is to live better, healthier and longer. Lite Life Surgery: Online Content 11 Will having weight loss surgery mean I can eat anything and not exercise? Surgery is the beginning of a disciplinary process and exercise is included in the process. There’s a very special diet that must be followed after surgery and you must commit to the program. Surgery is simply a tool for weight loss with a life time commitment to change. How much weight should I expect to lose? Weight loss will vary depending on your weight prior to surgery. After surgery, your choice of foods and level of activity will change. The majority of patients lose one-third of their original body weight within two years of surgery. What are the risks involved in weight loss surgery? Pulmonary Embolism: One of the most common risks or complication with any surgery is a blood clot that forms in the legs and moved its way up to the lungs and blocks an artery. The result of this can be a heart attack or even death. It’s extremely important to get out of bed immediately after surgery and move around. Wound Seroma: Sometimes a mass at the site of the surgical incision forms caused by fluid within the tissue. Wound Infection: This happens when bacteria penetrates the site of a surgical incision. Gastric Fistula: This may occur when there is abnormal communication with the stomach to other organs in the body. Dehiscence: Occurs when there is an opening or splitting of the surgical suture line.