In the O.R. for Life-Changing SurgeryReducing the Size of a Stomach

Doctor: Julio Teixeira
Specialty: Bariatric Surgery
Location: St. Luke’s–Roosevelt Hospital

Dr. Teixeira: We have basic criteria to decide when someone’s a candidate for weight-reduction surgery. They have to have a body-mass index over 40 or a BMI of 35 with related health complications. This patient’s BMI was 54. She’s a 44-year-old technical writer for a brokerage firm, and she’s struggled with obesity for decades. She believes that her weight has even had a social impact on her son. She had all the hallmarks of cardiovascular disease related to her obesity: diabetes, high blood pressure, and high cholesterol. In five or six years, she could have had a heart attack.

We performed a lap-band surgery, which places a ring in the upper part of the stomach. We made a small incision of approximately two centimeters around her belly button. Once we entered the ­abdomen, we placed the band on the upper part of the stomach, leaving a small pouch the size of a golf ball above the ring. This pouch is the only part of the stomach she’ll be using; because it takes time for food to trickle through the restriction ­created by the band, the patient will experience fullness after even a small meal.

The whole surgery took less than an hour, and she’s doing fine. She’s lost twelve pounds already. I’ll be seeing her on a monthly basis because we’d like her to lose a third of her current body weight. At one or two pounds a week, that would be a three-year process. Then she’ll be in the same ballpark as the rest of us.

As told to Katie Charles.

The patient, who at the time of surgery weighed 290 pounds, meets with the anesthesiologist before her procedure. She will have a ring placed in her stomach which will reduce its size and restrict the amount of food she’ll be able to consume. Photo: Q. Sakamaki/Redux

Dr. Teixeira uses the images from a camera as his guide through the operation. The screen shows the liver, stomach, and surrounding fat. Photo: Q. Sakamaki/Redux

Dr. Teixeira, mid-surgery. Photo: Q. Sakamaki/Redux

The patient’s navel, transformed into the incision site. Photo: Q. Sakamaki/Redux

Four separate instruments are inserted through the patient’s navel. From bottom to top: the camera, the liver retractor, and two dissectors, which Dr. Teixeira will use to prepare the area where the band will go. Photo: Q. Sakamaki/Redux

The white silicone band, now around the stomach, is about to be locked into place. Photo: Q. Sakamaki/Redux

Post-surgery, the patient is able to breathe on her own. Photo: Q. Sakamaki/Redux

Dr. Teixeira on his way to speak to the patient’s family. Photo: Q. Sakamaki/Redux

In the recovery room, Dr. Teixeira talks to the patient. In two hours, she’ll go home. She has already lost twelve pounds and is expected to lose two pounds a week over three years to reach her desired weight. Photo: Q. Sakamaki/Redux

In t […]