Once the consultation is over and insurance questions are answered, Gilmore sets up an appointment for patients to meet individually with her to talk about the three different types of weight-loss surgery available through Mayo Clinic Health System in Mankato.
“Generally they come in with a pretty good idea of what they want done,” Gilmore said.
The three available are: Laproscopic gastric banding, vertical sleeve gastrectomy, and Roux-en-Y gastric bypass.
Gilmore says lap band surgery, which once held a lot of promise as a less-invasive way to achieve results similar to gastric bypass, is seeing a decrease in the number of patients choosing it. It works by placing an inflatable band around the upper portion of the stomach to restrict consumption. It is minimally invasive, adjustable and reversible.
But results are proving on average to not be as strong as other types of surgery. While some people do indeed lose large amounts of weight with lap band, in general individual weight loss is less. Also, Gilmore said roughly 45 percent of patients who undergo lap band surgery require additional surgeries to remove the band or repair port that are sometimes installed to maintain the band.
The vertical sleeve method is the newest form of weight-loss surgery, and is being recommended more and more for patients for whom it is unsafe to do a gastric bypass. A sleeve gastrectomy reduces the stomach to about the size and shape of a banana.
Initially, Gilmore said the sleeve was designed as a step in the process for patients who would ultimately be candidates for gastric bypass. But the results from the sleeve alone have been so great that it is commonly being offered as an option on its own. The only problem with the sleeve, Gilmore says, is that they only have five years of results to gauge.