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Support Program

Frequently Asked Questions

General

Who is a candidate for weight loss surgery?

Weight loss surgery is not right for everyone. Patients must consider the commitment, effort, dedication, lifestyle change and motivation it will take after surgery. Weight loss surgery is an effective treatment for morbid obesity, although the pounds do not come off by themselves. The surgery is an aid to help achieve lasting results by limiting your food intake. You can contact AMBI to find out if you are a candidate for weight loss surgery, most patients with a BMI ≥30 will qualify for weight loss surgery. Speak to us today to assess your individual situation.

What types of weight-loss operations do you perform?

AMBI offer 3 weight loss procedures all performed laparocopically; Adjustable Gastric Banding, Sleeve Gastrectomy and Gastric Bypass. Patients who weigh in excess of 500 lbs or with complex medical problems may not be candidates for procedures performed laparoscopically. Please speak directly wit your surgeons about any concerns you may have.

How many weight loss surgeries have you performed?

To date Dr. Joffe has performed in excess of 4,000 weight loss surgeries, with over 2,500 adjustable gastric bands, over 1,500 gastric bypasses and over 300 gastric sleeve procedures. Dr. Joffe has 25 years experience as a general surgeon and has performed over 10,000 laparoscopic procedures.

Which weight-loss surgery procedure is right for me?

Typically that decision is best answered by the patient. Generally speaking the LapBand, REALIZE Personal Banding Solution or MIDBAND™ is the safest procedure, with fewer complications. However this procedure requires a high degree of patient motivation and dietary compliance. Gastric Bypass is the most common weight loss surgery procedure. Each surgery has a different mechanism of action which must be considered by the patient and doctor when selecting a weight loss surgery. Please refer to our comparison chart to help differentiate between the different types of weight loss surgery.

What type of long-term support services do you provide after I have weight-loss surgery?

AMBI offers numerous online support initiatives (Blogs, newsletters and tweets), and individualized support provided by our patient care liaisons. We also have patient support partners who meet with AMBI patients locally or organize themselves online or by phone to speak both pre and post operatively. Our surgeons and patient care liaisons are available to you by telephone for personalized support.

How much weight can I expect to lose after surgery?

Your individual weight loss will vary depending on the type of weight loss surgery, your starting weight and your compliance with diet and exercise. Generally patients who have an adjustable gastric band lose 1-2 lbs/week in the first 1-2 years patients who undergo a sleeve gastrectomy lose 2-3 lbs/week in the first 1-2 years and patients who have gastric bypass lose 2-3 lbs/week in the first 1-2 years.

How soon after my surgery will I lose weight?

Patients can lose as much as 10-20 pounds in the first few weeks after surgery and as much as 30-45 pounds in the first month.

Can I plan a pregnancy after weight loss surgery?

Bariatric surgeons recommend waiting 18 months before trying to conceive after weight loss surgery. It is important to use a form of birth control during this period even if you don't believe you can become pregnant. During this time the body is healing and may be losing weight at a fast rate. If you become pregnant in the future and you have an adjustable gastric band, it can be safely left in the body, however you should have a complete de-fill of the band to ensure you and your baby are obtaining adequate nutrition. Speak to your bariatric or family physician before planning your pregnancy.

What type of follow up care will my GP need to provide post surgery?

If you are local to AMBI, one of our surgeons will see you for your follow up appointments. If you have travelled to AMBI for your surgery and will be receiving post operative care from your local physician, you should visit your doctor upon your arrival home.

How can I pay for my surgery?

A variety of payment options are available to you. These include wire transfers, drafts and financing. Please visit the financing section of our website for more information.


Laparoscopic Adjustable Gastric Banding

Will I need a referral from my family doctor?

A referral is not necessary, you can call our offices directly at 1888 808 AMBI (2624) to book a consultation.

What types of tests are required before surgery?

During your consultation our patient care liaison will discuss your medical history and qualify you for any necessary blood or sleep tests that may be required prior to surgery.

Where can the tests be completed?

Any required testing may be completed locally to you. Please ask the blood lab or clinic to fax their results to our office at 1866 345 6168. Please leave the contact numbers with your patient care liaison for necessary follow up.

Will the port be visible from outside the skin?

The port is not visible externally as it is secured to the muscle below the skin and your abdominal wall fat.

Does the adjustable gastric band contain any latex?

No, both the lapband, MIDBAND and the REALIZE Personal Banding Solution are latex free and safe for use in individuals with latex allergies.

How are band adjustments made?

The adjustable gastric band is adjusted by accessing the port underneath your skin with a needle. Adjustments are painless, using a local numbing agent your physician or nurse will insert the needle into the port and either “fill” the band by injecting saline or “de-fill” the band by removing saline from the band.

How often will my band need to be adjusted?

To ensure proper healing your first band adjustment should be performed 4-6 weeks post surgery. After your first adjustment, your band should be adjusted as needed based on your weight loss and food intake. Typically patients experience weight loss of 1-2 pounds per week.

Is it ok to get pregnant after having adjustable gastric band surgery?

Yes, you can support a pregnancy after having adjustable gastric band surgery, however bariatric surgeons recommend waiting a minimum of 6 months before trying to conceive after weight loss surgery. It is important to use a form of birth control during this period even if you don't believe you can become pregnant. During this time the body is healing and may be losing weight at a fast rate. If you become pregnant in the future, the band can be safely left in the body, however you should have a complete de-fill of the band to ensure you and your baby are obtaining adequate nutrition. After pregnancy and lactation, you can resume restrictive band adjustments to accommodate your weight loss requirements. Speak to your bariatric or family physician before planning your pregnancy.


Laparoscopic Sleeve Gastrectomy

Will I need a referral from my family doctor?

A referral is not necessary, you can call our offices directly at 188 808 AMBI (2624) to book a consultation.

What types of tests are required before surgery?

During your consultation our patient care liaison will discuss your medical history and qualify you for any necessary blood or sleep tests that may be required prior to surgery.

Where can the tests be completed?

Any required testing may be completed locally to you. Please ask the blood lab or clinic to fax their results to our office at 1 866 345 6168. Please leave the contact numbers with your patient care liaison for necessary follow up.

Can I opt to have the sleeve gastrectomy procedure alone rather than as a 2 step procedure?

At AMBI we provide the laparoscopic sleeve gastrectomy procedure on its own, as a single technique rather than as a first stage to a bypass or duodenal switch. Many patients are happy with the results of a sleeve gastrectomy alone. If a patient chooses, they may have a second procedure one year after the sleeve gastrectomy.

Will I need to take vitamin supplements?

If you have had the sleeve gastrectomy alone as a single technique, it is unlikely that you will not get enough nutrients from your food intake if you are following a proper diet. If you have had a second stage procedure after the gastric sleeve, such as a gastric bypass or duodenal switch, your food and nutrient absorption will be affected and you will need to take a vitamin and mineral supplement daily to prevent malnutrition or osteoporosis.

How will the procedure affect my diet?

A sleeve gastrectomy reduces the amount of food you can consume, however you can eat most things in moderation. A healthy diet is key, the surgery is a tool to help you lose weight, but it is important that you make lifestyle changes so you are eating a healthy diet.

Will I regain weight after this surgery?

A sleeve gastrectomy is a restrictive procedure, a large portion of your stomach will have been removed, so you will feel fuller sooner with smaller portions of food. Since the portion of your stomach that produces the hormone ghrelin (controls hunger) has been removed, you will no longer experience the same feelings of hunger, also helping to keep you from overeating. Weight gain is always a risk, however if you make the appropriate lifestyle changes, the restriction provided by your weight loss surgery will help you attain your weight loss goals.

Can I plan a pregnancy after a laparoscopic sleeve gastrectomy?

Bariatric surgeons recommend waiting 18 months before trying to conceive after weight loss surgery. It is important to use a form of birth control during this period even if you don't believe you can become pregnant. During this time the body is healing and may be losing weight at a fast rate. Speak to your bariatric or family physician before planning your pregnancy.


Laparoscopic Gastric Bypass

Will I need a referral from my family doctor?

A referral is not necessary, you can call our offices directly at 18xxx to book a consultation.

What types of tests are required before surgery?

During your consultation our patient care liaison will discuss your medical history and qualify you for any necessary blood or sleep tests that may be required prior to surgery.

Where can the tests be completed?

Any required testing may be completed locally to you. Please ask the blood lab or clinic to fax their results to our office at 1 866 345 6168. Please leave the contact numbers with your patient care liaison for necessary follow up.

What does Laparoscopic Gastric Bypass do?

Gastric Bypass is both a restrictive and malabsorptive procedure. Your stomach will be divided into a small upper pouch, which is then connected to your small intestine. The smaller stomach pouch will only hold a small amount of food. The remaining stomach no longer holds food and is sutured from the rest of the stomach; it acts to produce digestive juices and hormones. Since food now bypasses most of the stomach and part of the small intestine, fewer nutrients and calories are absorbed. After gastric bypass, patients are able to consume smaller amounts, feel full sooner and absorb less calories. It is important to remember patients must make permanent diet modifications to prevent malnutrition and dumping syndrome.

What is dumping syndrome?

Dumping syndrome occurs when patients who have had gastric bypass surgery consume too many simple carbohydrates (sugary sweets) and high fat foods. It is caused by foods passing too quickly through the small intestine, particularly sweets and high fat foods can irritate the small intestine. Eating too much at one time can also cause dumping syndrome. Symptoms include nausea, cramping, diarrhea, weakness, sweating, and vomiting. Common foods to avoid that cause dumping syndrome are cakes, sweets, sugar drinks, ice cream and cookies. Eating smaller meals, 6 a day and avoiding liquid consumption with meals can help to prevent dumping syndrome.

How will my diet be affected?

Gastric bypass surgery requires that you make permanent changes to your diet. You will need to follow a healthy diet, eating small meals and avoiding sugary sweets and high fat foods. It is also important to consume adequate protein. AMBI will provide you with a post operative diet and support tools to help you make permanent diet modifications.

Will I need to take a Vitamin and Mineral Supplement?

Yes, once you have gastric bypass surgery it is essential that you take a daily multivitamin and multi-mineral supplement to prevent malnutrition and osteoporosis.

How much weight can I expect to lose?

Generally patients lose approximately 70-80% of their excess weight. This estimate varies from patient to patient and can be impacted by compliance. Following a balanced diet and exercising regularly will help to maintain your weight loss.

Can I plan a pregnancy after a laparoscopic gastric bypass?

Bariatric surgeons recommend waiting 18 months before trying to conceive after weight loss surgery. It is important to use a form of birth control during this period even if you don’t believe you can become pregnant. During this time the body is healing and may be losing weight at a fast rate. Speak to your bariatric or family physician before planning your pregnancy.


The Intragastric Balloon

Will I need a referral from my family doctor?

A referral is not necessary, you can call our offices directly at 1888 808 AMBI (2624) to book a consultation.

How much weight can I expect to lose?

On average patients lose between 15-20kg. Individual success depends on how well you adhere to diet and lifestyle modifications. Used in conjunction with diet and exercise, the intragastric balloon can be an excellent weight loss tool.

Will I feel the balloon in my stomach?

During the first few days post procedure, you may feel uncomfortable as you adjust to the feeling of satiety created by the balloon.

What is recovery like?

Although placement of the intragastric balloon is non-surgical, you should plan approximately 3 days of inactivity after the procedure. Depending on how your body adjusts you will may require more or less rest. Do not plan any heavy activity the first week after your procedure.

What happens if the intragastric balloon leaks?

If you have the saline filled balloon, you will notice a change in your urine colour, it will become greenish. It is unlikely that the intragastric balloon will deflate, however should you notice a change in your urine colour, contact your doctor immediately as it will need to be removed.

Can I consume alcohol?

Alcohol consumption in moderation is acceptable, it is however recommended to pay attention to any liquid calories that do not provide nourishment.

How will the procedure affect my diet?

An intragastric balloon reduces the amount of food you can consume, however you can eat most things in moderation. A healthy diet is key, the balloon is a tool to help you lose weight, but it is important that you make lifestyle changes so you are eating a healthy diet.

What is the difference between the air filled or saline filled intragastric balloon?

The air filled balloon is very light (less than 30g), the light weight device helps the body tolerate the device. The air filled device also has a decreased risk of deflation.


Travelling to AMBI

How can I have a consultation?

Our ambi patient care liaison are happy to arrange a telephone consultation for you. We can also set up a telephone consultation with one of our doctors at your convenience by calling 1888 808 AMBI (2624).

Do I need a passport to enter Mexico?

Yes, as of June of 2009 Passports are required to enter Mexico.

Who takes care of my travel arrangements?

You AMBI patient liaison will make all your travel arrangements and send you a copy of your itinerary. All your ground transportation from the airport to hotel and hospital and back will be handled by an AMBI representative.