St. John’s Riverside Hospital: Delivering Life-Changing, Minimally Invasive Bariatric Surgery

By Josh Garcia
Tuesday, March 5, 2019

Jonathan Arad, MD, FACS, general and bariatric surgeon at St. John’s Riverside Hospital, highlights the transformational benefits of bariatric surgery.

Q: What are the key benefits of bariatric surgery?

Dr. Arad: It’s common for bariatric surgery to not only result in permanent weight loss, but also to prevent, improve or completely reverse comorbidities associated with obesity. These include diabetes, high blood pressure, sleep apnea, heart disease and depression, among others. I’ve seen a patient who had diabetes for 15 years achieve remission just three days after surgery. By effectively addressing obesity and related comorbidities, bariatric surgery often significantly lengthens patients’ lives. This distinguishes it from cosmetic procedures, such as tummy tucks.

Q: Who is a candidate for bariatric surgery?

Dr. Arad: Anyone with a BMI of 40 or higher automatically qualifies, while those with a BMI between 35 and 39.9 qualify if they have comorbidities associated with obesity.

Q: What bariatric procedures do you perform at St. John’s Riverside Hospital?

Dr. Arad: I perform vertical sleeve gastrectomy and adjustable lap-band procedures. Both are extremely safe, minimally invasive and can be performed laparoscopically or robotically. These procedures generally take less than an hour and require minimal time in the hospital. Lap-band patients usually go home the same day the procedure is performed. Sleeve gastrectomy patients return home the day following the procedure. In addition, I perform revision surgeries for people who experience complications or lackluster results from previous bariatric procedures.

“If patients need skin-removal surgery, which is rare, or if they have vein conditions or joint pain related to having been obese for years, we have specialists on-site who can treat these issues as well. We don’t need to send them in 20 different directions.”
— Jonathan Arad, MD, FACS, general and bariatric surgeon at St. John’s Riverside Hospital

Q: How do sleeve gastrectomy and lap-band procedures work?

Dr. Arad: Sleeve gastrectomy removes 65 to 70 percent of the stomach, which offers two major benefits that promote satiety: Not only is the size of the stomach restricted, but the production of ghrelin is limited as well. Ghrelin is a hunger hormone produced in the fundus, which is the section removed from the stomach during sleeve gastrectomy. The adjustable lap band is placed around the upper part of the stomach to create a small pouch, restricting the amount of food a person can eat. We adjust the band by filling it with saline for a tighter fit or removing saline to allow more food to enter the stomach.

Q: How does St. John’s Riverside Hospital promote long-term success for bariatric patients?

Dr. Arad: Patients go through months of individualized preparation with cardiologists, pulmonologists, nutritionists, social workers, mental health professionals and other specialists before surgery. This helps ensure patients are ready for their postsurgical lifestyle. After surgery, we follow up with our patients regularly to ensure they’re sticking to their new regimen. We see them every other week for 10 weeks, then once a month for a few months, then every three months for one to two years, though we encourage further follow-up if necessary.

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