My Weight Loss
Surgery Questions

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11.	How many surgeries of this type has Dr. Johnell done in his career?
	Dr. Johnell has done about 140 GBP operations, with 95% of those performed laparoscopically.
12.	Over what period of time?
	His first GBP was in 2000.
13.	Has he lost any patients from the surgery or complications afterwards?  If so, what can you tell me about the deaths/complications?
	We have had no deaths.
14.	I’ve read about a patient who had a kinked and herniated bowel 3 weeks post-op and required additional surgery.  Is this a common complication?
	This patient  had a rare complication that so far is 1:121 in our Greeley series.
15.	I’m concerned about the possibility of infection from this surgery.  What is the incidence of Dr. Johnell’s WLS patients having post-op infections?
	Actually, the non-orthopedic surgery floors enjoy a low incidence of infection at NCMC.  We have had about 6 wound infections, 4 of which were cases that were done "open."
16.	Which surgery would Dr. Johnell recommend for me (lap vs. open) and why?  Personally, from all I’ve read, I’d prefer the open surgery.  Based on my reading, I’m NOT interested in the banding procedure.
	Dr. Johnell always recommends the laparoscopic approach unless previous gastric surgery disallows this approach.  Patients do MUCH better with the less invasive surgery.
17.	What is the difference in recovery time between lap vs. open?  In general, how long is the open incision (in inches)?
	With no complications, lap GBP patients go home the third post-op day.  Open patients go home the 4th or 6th post-op day.
18.	Explain distal and proximal.  I know it has to do with how much of the small intestine is bypassed.  How is this determined?  Per patient?  By their starting weight?  What would be done in my case?
	Dr. Johnell will only do a distal anastamosis on very large people 350-700 pounds in weight.
19.	I have read on listservs on the Internet about people being so miserable post-op and not being able to eat virtually ANY food without getting ill.  Is this common?  Does this go away with time?
	Getting ill immediately after surgery seems to be related to narcotic pain relievers.  After about 3 or 4 months post-op, most of our patients can eat anything they want as long as it does not have a lot of sugar or fat in it.  What you describe is not common.
20.	What exactly happens in your body to make the weight loss slow down and stop and you get to a stage of maintaining your new lower weight?  You can’t just keep on losing and never stop can you?  I read on a listserv on a woman who was 5’8” and had lost down to 113 lb. and said she couldn’t stop losing, even though she was eating as much as she could tolerate without getting ill.
	Patients who lose weight, and can't stop losing are rare.  There is a good reason why these patients lose too much weight.  The surgeon needs to figure out what the problem is, and address it.  Sometimes, patients cannot shed their "fat" image of themselves, and when they look in the mirror, they see themselves as fat.  In turn, they continue to try to lose more weight much as a person with anorexia nervosa.

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© 2002 Vicki S. Mossman
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mossman2@attbi.com
Last updated on 9/19/02