Specialized Anesthesia Services

Specialized Anesthesia Services

Bariatric Surgery

Anesthesia Services, P.A. has partnered with the Christiana Care Bariatric Surgery Program to achieve the highest level of accreditation from the American College of Surgeons' (ACS) Bariatric Surgery Network and received the designation of a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery (ASMBS).

What is Bariatric Surgery?

In the following sections, bariatric surgery refers to surgical procedures for patients with morbid obesity seeking weight-loss surgery. Specifically, these procedures include Roux-en-Y gastric bypass and gastric banding (LapBand) techniques (either as open procedures or laparoscopically). At Christiana Care Health System (CCHS), we adhere to the National Institute of Health guidelines for weight-loss surgery. These guidelines refer to patients who weigh more that 100 pounds over their ideal body weight or whose Body Mass Index (BMI) exceeds 40 kg/m2 or greater than 35 kg/m2 with significant obesity-related medical problems (diabetes, high blood pressure, sleep apnea, degenerative joint disease, advanced cardiovascular disease). Morbid obesity is when you body weight threatens either your health or life.

What are the risks of Morbid Obesity?

Patients who are considered morbidly obese have a significantly higher chance of the following (as compared to individuals who are not overweight):

  • Developing significant medical problems, including diabetes, high blood pressure, lung disease, and premature heart disease.
  • Developing certain types of cancer such as colon, breast, and uterine.
  • Developing premature degenerative joint disease and/or joint pain, limiting mobility and activity.
  • Developing Obstructive Sleep Apnea (which leads to pulmonary hypertension and right heart failure).
  • Dying prematurely.

When will I meet my anesthesia providers?

Your Anesthesia Care Team will meet you in the prep and holding area of the operating room. After you meet the Anesthesiologist and Certified Registered Nurse Anesthetist, you can discuss an questions you may have about general anesthesia or your specific anesthesia care plan. If you have questions that need to be addressed prior to your scheduled surgery date, you can schedule an appointment (by telephone or in person) with out Pre-Anesthesia Evaluation Process (PEP) team.

In our quest to supplement CCHS' application for a Bariatric Center of Excellence, the Department of Anesthesiology has identified a group of individuals with an interest in anesthesia ofr bariatric surgery.

What kind of anesthesia will I receive?

For laparoscopic or open bariatric surgery procedures, we deliver general anesthesia. Almost uniformly, your anesthesia will be delivered through an intravenous (IV) catheter that is placed after your arrival to the prep and holding area. Once you have an IV in place, you can receive pre-operative sedation medications. The IV catheter will be used during the operation to deliver antibiotics, medications for muscle relaxation, pain medication, and anti-nausea medications. You will continue to receive intravenous medications during your recovery and can expect to have your IV in place until you are able to tolerate a liquid diet and oral medications.

Although the majority of patients will only require an IV for the start of general anesthesia, some individuals may require further monitoring for safety or because of significant co-existing medical problems.

Once you enter the operating room, the anesthesia providers will attach standard monitors to evaluate your heart and lung function. You will also have a monitor (BIS) placed on your forehead that allows us to tailor your depth of anesthesia during the entire operation. After a brief period of breathing 100% oxygen, the IV will be used to begin your general anesthesia. Typically, a breathing tube will be placed in your breathing pipe to safely deliver oxygen and anesthesia during the surgery after you are asleep. Occasionally, your anesthesia providers may feel it is necessary to place a breathing tube using an instrument called a fiberoptic bronchoscope. If this technique is used, you will be sedated and numbing medicine will be sprayed down your throat so this procedure can be done safely and easily. In the majority of cases, this breathing tube will be removed before you are completely awake in the operating room at the end of surgery. Occasionally, a breathing tube may need to remain in your windpipe after surgery to assist your breathing. If you require this assistance, medications will be given through your IV to assure your comfort.

How long will I be asleep?

Laparoscopic gastric bypass or banding normally takes approximately 75 to 90 minutes. You can expect to be asleep for the entire procedure. It is not uncommon for patients to have little memory of the operating room or early recovery period in the Post Anesthesia Care Unit (PACU).

How long will I be in the recovery area?

You can expect to be in the recovery area (PACU) for approximately 90 to 120 minutes. You will then be transported to your scheduled hospital unit.

Insurance coverage for Bariatric Surgery

Information coming soon.

On-line sites to visit:

The following is a list of websites that you may find helpful as you research your choice to undergo bariatric surgery:

  • www.chrias.com - The website for CCHS's bariatric surgeons: Gail M. Wynn, M.D., FACS; Isaias Irgau, M.D., FRCS (Ed); Michael J. Peters, M.D.
  • www.wlsinde.com - A website for weight-loss surgery in Delaware, includes a free BMI calculator
  • www.asbs.org - This website for the American Society of Bariatric Surgery
  • www.obesity.org - The official website of the American Obesity Association
  • www.obesitysurgerybook.com - A website where you can purchase a book detailing the specifics of obesity surgery