Weight Loss Surgery

Sleeve gastrectomy is a non-reversible, minimally invasive procedure using laparoscopic or robotic surgery. During the procedure:

• You’ll receive general anesthesia so you don’t feel anything during the procedure.
• Your surgeon will make four to five small incisions in your abdomen to insert surgical instruments.
• Using these instruments, the surgeon will remove most of your stomach, creating a new banana-shaped pouch from your remaining stomach.

The procedure typically takes 60 to 90 minutes. Most patients stay in the hospital overnight and return home the next morning. Home Hospital also might be any option for you.

RYGB promotes weight loss by changing how your stomach and small intestine process food. The surgery has two steps:

1. Creating a smaller stomach pouch—Your surgeon forms a small upper section (about the size of a golf ball) while leaving the lower portion of the stomach in place. The upper pouch is where food will go after surgery.
2. Bypassing a part of the your small intestine—The surgeon connects a section of the small intestine to the new pouch, allowing food to bypass the upper part of the intestine. This reduces calorie absorption and lowers hunger hormone (ghrelin) production, helping you feel full faster.

At Mass General, Roux-en-Y gastric bypass surgery is usually performed minimally invasively using laparoscopic or robotic techniques. During the procedure:

• You’ll receive general anesthesia so you don’t feel anything during the procedure.
• Your surgeon will make four to five small incisions in your abdomen to insert surgical instruments.

The procedure typically takes 3 to 3.5 hours. Most patients stay in the hospital overnight and return home the next morning.

Your conversion or revisional surgery will depend on the weight loss surgery you had before and what you are being treated for. Your surgeon will discuss the details of your surgery during your consultation.

For all procedures, you will first be placed under general anesthesia, so you don’t feel anything during the surgery. Most conversion and revision surgeries at Mass General are performed with minimally invasive methods, which can help reduce pain, bleeding, and other complications after surgery.

Conversion and revision surgeries have higher risks than the first weight loss surgery you received. This is because conversional and revisional bariatric surgeries try to correct an already-existing complication with another surgery. Generally, surgeries that try to correct inadequate weight loss have lower risk for complications, while surgeries that try to correct too much weight loss have higher risk.

Your experienced Mass General surgeon will create a surgical plan that seeks to minimize your risk for complications. While no surgery is totally risk-free, the expertise of Mass General bariatric surgeons who have done conversion and revision surgeries many times before can help lower your risk of developing complications.

Our program is designed to provide you with the information you will need for successful weight loss and to reduce the risk of complications after surgery.

Many insurance companies and our Weight Center team require you to attend a pre-surgery program that helps you prepare for surgery both physically and psychologically. Program education focuses on achieving pre-surgery weight loss to reduce surgical risks and learning essential nutrition and lifestyle changes for long-term success.

As surgery approaches, you will:

• Meet with your care team to review your health.
• Attend a group nutrition class to learn about your pre- and post surgery diet and lifestyle changes for the two weeks following surgery.
• Have additional visits with your surgical team to prepare you for surgery and answer final questions.

At the Mass General Weight Center, your care team develops an individualized plan to support you after weight loss surgery. Follow-up care includes regular visits with your surgical team, registered dietitian, and psychologist for the first 18 months. They will monitor your nutrition and eating habits, addressing any vitamin or mineral deficiencies.

After 18 months, you can continue annual follow-ups with us or transition to your primary care provider if you're meeting your weight loss goals.

Please call us at 617-643-4002 to learn how to become a patient and schedule an appointment.

To be eligible for weight loss surgery, most patients must meet one of the following criteria:

• BMI greater than or equal to 40
• BMI of 35-40 with a weight-related medical condition, such as type II diabetes, high blood pressure, high cholesterol, sleep apnea

Insurance coverage for weight loss surgery varies by plan and may have different eligibility requirements. Please check with your provider for details.

You may feel some pain or discomfort as you heal. Your surgeon will provide guidance on pain management, dietary restrictions, and recovery steps.

• Gastric sleeve and gastric bypass — You should avoid lifting anything heavier than 10 pounds for four weeks after surgery. We also recommend that you take three to four weeks off work.
• Conversion and revisional surgery — Your hospital stay and recovery time will depend on the type surgery you have. Most patients are discharged within two to three days if there are no major post-surgical complications. However, full recovery may take longer.

At the Mass General Weight Center, your care team develops an individualized plan to support you after weight loss surgery. Follow-up care includes regular visits with your surgical team, registered dietitian, and psychologist for the first 18 months. They will monitor your nutrition and eating habits, addressing any vitamin or mineral deficiencies.

After 18 months, you can continue annual follow-ups with us or transition to your primary care provider if you're meeting your weight loss goals.

Metabolic and bariatric surgery is considered the most effective treatment for obesity, helping patients achieve sustained weight loss and improve other obesity-related conditions. The amount of weight you lose depends on the type of bariatric surgery you have and your commitment to post-surgical lifestyle changes.

It is important to keep all follow-up visits so your care team can monitor and support your weight loss.

The benefits of bariatric surgery include:

• Improved quality of life
• Reduced risk of other obesity-related diseases
• Longer lifespan

While any surgery carries risks, metabolic and bariatric surgery is among the safest elective procedures.

The Mass General Weight Center team performs a high volume of weight loss surgeries, which leads to:

• Lower complication rates
• Improved patient outcomes

Most patients stand and walk within hours after surgery and are discharged within 24 hours. You should avoid high-impact exercise and lifting anything heavier than 10 pounds for at least four weeks after surgery. We also recommend that you take three to four weeks off work.

In the first few weeks after surgery, you may be less energetic due to a lower-calorie intake (liquid diet). Energy levels typically return once you transition back to solid foods.

Weight loss can result in loose or sagging skin, which varies based on total weight loss, hydration and nutrition, genetics and skin elasticity, and lifestyle habits.

If you are considering plastic surgery to remove excess skin, we recommend waiting until your weight stabilizes before undergoinging a body contouring procedure.

Board-certified plastic surgeons in the Mass General Body Contouring Program specialize in reshaping the body after weight loss.

Many insurance companies cover weight loss surgery if you meet their qualification requirements. To learn more about insurance coverage, call our Weight Center staff at 617-643-4002.