weight loss surgery without anesthesia

October 30, 2018 - by - in Bariatric Surgery

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If you’re considering weight-loss surgery, you probably have questions about what type of anesthesia your surgeon will recommend. The American Society of Anesthesiologists describes four types of anesthesia: general, IV monitored with sedation, regional and local.

  • General anesthesia is used for major procedures, where the patient is rendered unconscious and most body functions slow, which is why the anesthesiologist may use a tube to assist with breathing.
  • IV monitored with sedation is used for minor surgeries, and the anesthesiologist uses intravenously dispensed medication to sedate the patient, who may fall into a light sleep (sometimes called “twilight” sleep), or a deep sleep. Sometimes this type of anesthesia is used at the same time as regional or local anesthesia.
  • Regional anesthesia numbs an area of the body, such as the abdomen, arms or legs, during a surgical procedure. Women who’ve had an epidural to assist with childbirth have had regional anesthesia. It can be used with or without IV sedation.
  • Local anesthesia numbs a very small area of the body before a small procedure such as a skin biopsy. (If you’ve ever had part of your mouth numbed before a tooth filling, your dentist probably used local anesthesia.)

Laparoscopic Surgery and Anesthetics

This article examines weight-loss surgery options and the type of anesthetic they may require. If you have concerns about undergoing a weight-loss procedure with anesthesia, talk to your primary care physician, your weight loss surgeon and, most importantly, an anesthesiologist.

Gastric Sleeve

Today’s most popular surgery is the gastric sleeve, according to American Society for Metabolic and Bariatric Surgery. Nearly 60 percent of all weight loss surgeries performed in 2017 were gastric sleeve. This minimally invasive procedure involves making small incisions to insert laparoscopic tools into the body to remove a large portion of the stomach including the area that creates hunger-producing hormones. The smaller stomach resembles a sleeve and restricts how much food it holds. The incisions create small scars, approximately ½- to ¾-inch long.

What type of anesthesia is used for gastric sleeve surgery? Your weight-loss surgeon and anesthesiologist will likely recommend general anesthesia; however, some patients may be able to elect regional anesthesia with or without sedation.  

Endoscopic Sleeve Gastroplasty

An endoscopic sleeve gastroplasty is a non-invasive way to get the same result as the gastric sleeve. The surgeon inserts a small camera and suturing device through the throat to the stomach to create a sleeve-like structure.

What type of anesthesia is used for endoscopic sleeve gastroplasty? Your surgeon and anesthesiologist will likely recommend general anesthesia for this procedure.

Lap-Band Surgery

When a patient has lap-band surgery, a band is placed around the stomach to restrict the size of the stomach, compressing it into a small pouch. This limits a patient’s ability to take in food, and it slows digestion. The band can be removed or adjusted later. As with the gastric sleeve, small incisions are required to insert the laparoscopic instruments.

What type of anesthesia does lap-band surgery require? Your surgeon and anesthesiologist may recommend general or regional with IV sedation.

Gastric Bypass Surgery

A gastric bypass sections the stomach into two pouches, a small upper pouch and a larger lower pouch. The small intestine is rerouted to attach to both sections. The smaller pouch restricts food intake while rerouting the intestine, which causes fewer calories and nutrients to be absorbed.

What type of anesthesia does gastric bypass surgery use? Most cases use general anesthesia, but some special cases may use regional anesthesia (epidural) with sedation. Talk to your weight-loss surgeon and anesthesiologist about what option is best for you.

Gastric Balloon

The non-invasive gastric balloon inserts a deflated balloon into the stomach through the mouth. When the balloon is in position, it is inflated with a saline solution to fill up a portion of the stomach to reduce hunger and space in the stomach. The balloon is typically in place for a few months before it is removed by a doctor.

What type of anesthesia is used for gastric balloon? In most cases, an IV sedation is all that is needed; in some cases, the surgeon may recommend general anesthesia. You and your surgeon will make this decision before scheduling your procedure.

Questions to Ask About Anesthesia

If you have questions about anesthesia, talk to your family doctor, your surgeon and the anesthesiologist. Make sure you share with your anesthesiologist your full medical history, so he or she can make the best recommendation for your individual needs. You might also ask:

  • Who will administer the anesthesia?
  • How will it be administered?
  • What are the risks of complications from this type of anesthesia?
  • Will I need a breathing tube?
  • Will my medications affect my anesthesia? Should I take them before my procedure?
  • If I drink or smoke, will that affect my anesthesia?
  • Does my age affect the anesthetic?
  • Will I feel nauseated after I wake?
  • Will I feel pain after the anesthetic wears off?

If you are still on the fence about which surgery is right for you, learn more about the specific techniques, including the results you can expect by reviewing this checklist.   

If you would like to talk more about surgery and anesthesia options, the Soma Weight Loss team can help you identify your best weight loss surgery plan. Call toll free, 855-766-2411 (855-SOMA-411) or request a call from one of our weight-loss specialists.

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Dr. Joseph Naim

Dr. Joseph Naim is a bariatric surgeon serving patients in the Los Angeles, California area. After completing his undergraduate degree in biology from the University of Southern California, he attended medical school at Mount Sinai School of Medicine in New York City. Dr. Naim went on to become the chief resident at New York Methodist Hospital and completed a fellowship in minimally invasive bariatric surgery at University Medical Center in Princeton, New Jersey. Dr. Naim also served as the medical director of bariatric surgery at St. Mary Medical Center in Long Beach before starting his own practice in 2004.