Welcome

Welcome to the Institute for Advanced Bariatric Surgery.  IABS has helped hundreds of patients take control of obesity and their lives all over the United States, in both adults and adolescents.  Patients report choosing services through our program based on our expertise, our quality, personal care and our safety patient record.

Our safety record is among the best, and that's because our focus is, and has always been on doing the safest surgery possible, taking the time to make sure each patient is taken care of as thoroughly and carefully as possible, before, during and after surgery.  Our program is the only in a several state area around Kansas which regularly performs advanced laparoscopic bariatric procedures,  including the duodenal switch, biliopancreatic diversion and revisional surgery, as well as the lap-band, and gastric bypass.  Please indicate to the staff if you are out-of-state – we can readily accommodate your needs.

As our name implies, we perform advanced weight loss surgery laparoscopically. We have performed hundreds of weight loss surgery operations this way.  Laparoscopy is a minimally invasive surgical technique, allowing procedures to be performed with much less trauma to the body and immune system. Morbidly obese patients undergoing weight loss surgery laparoscopically have a quicker recovery, shorter hospital stay (Lap-Band outpatient, Bypass one night), and significantly reduced post-surgical pain.

Our program is widely respected for high standards and a commitment to quality, not only in the performance of weight loss surgery but also in the aftercare, which is so vital for successful outcomes and results.  The "whole patient" care approach includes not just powerful surgical weight loss tools, but also extensive patient education and after-care programs ensuring continuity of care, with long-term surgeon follow-up, social support groups and nutritional and behavior modification counseling and classes, in a motivating environment promoting well being and good health.

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The Next Steps

Step One 

Proceeding with weight loss surgery is a very personal and often difficult decision.  Educating yourself about weight loss surgery is an important first step.  Although the information presented in our website may be very helpful, patients have repeatedly told us that attending the weight loss surgery informational seminar was the most important thing they have done. 

At the seminar you will be able to separate fact from fiction, meet the surgeons, ask questions, and hear testimonials from patients who have already undergone weight loss surgery. The patient testimonials are often the highlight of the seminar.  Individuals considering weight loss surgery enjoy talking to the patients and getting firsthand accounts of how the operations have worked for them and how it has changed their lives.  Family and friends are welcome.

We treat many patients from out-of-state.  When contacting the office, please inform the staff that you are out-of-state – the surgeon will usually like to talk to you prior to you arriving for your first visit.

Adolescents interested in weight loss surgery should be accompanied by a parent or guardian.  Our youngest patients are often the most compliant and successful.  After the seminar, introduce yourself to the surgeon with any questions or concerns you may have about weight loss surgery and adolescents.

Step two 

Please take time to explore our website.  There is general as well as very specific information about bariatric surgery.  The Weight Loss Surgery Procedures link has detailed descriptions about each procedure offered.  Under the Patient Corner link you will find the Preparatory Guide and after-surgery Diet Guides which we recommend everyone to read.  There is a lot more of information for you to peruse through; please take the time to do so.  The better educated you are the easier it will be for you to make a good decision about weight loss surgery.  For patients considering out-of-pocket coverage learn about potential Tax Deductions.  Access the Money Savings Calculator for some revealing facts about potential savings, and read about our new MISH Rewards program. 

Step Three

Once you are ready, make your first appointment to meet with the surgeon.  The visit with the surgeon has multiple purposes:  Answer your specific questions and concerns, determine your health and operative risk, determine the necessary pre-operative work-up, decide together which operation will be best for you, explain risks and benefits, start the insurance pre-approval process, schedule your surgery and more. 

You can save about 45 minutes of your time at the doctor’s office by downloading the New Patient Forms and completing them prior to coming for your appointment.  Some first visits with the surgeon can take as long as one hour.  Please reserve about one and a half to two hours of your time for your first appointment.  Family and friends are welcome and encouraged to come to the appointment with you. Please bring a copy of any medical records that you believe will be helpful.

Often we are able to schedule a tentative surgery date at your first visit.  You will also be scheduled to meet with our dietician, and possibly with the psychologist if indicated.  The surgeon will also determine what medical work-up you will be required to complete to clear you for surgery. 

While waiting for your insurance approval, or obtaining your medical work-up start reading the Preparatory Guide and the Diet Guide for your specific operation. These will prepare you for your operation. 

Step four

Your second appointment is about 2 weeks before your surgery date. The medical work-up should be completed and received in our office by the time of your second office visit.  Your medical work-up is reviewed by the surgeon at this visit. If there are no new medical issues raised as a result of your tests and there are no prohibitive reasons against general anesthesia or surgery, the date for your operation will be confirmed.  The surgeon will also go over the consent with you, review the pre-operative instructions and answer any further questions you may have.

Step five

The clinical bariatric coordinator, a nurse, will call you the week before your surgery.  She will remind you and inform you of the various things to prepare you for your surgery day.  The Preparatory Guide will be helpful in informing you about what to expect from your hospital stay and afterwards.  Re-read the Diet Guide the week before your surgery to refresh your memory and to prepare.  Most patients undergoing the Bypass only require an overnight stay with a next day discharge, and most patients undergoing the Lap-Band are able to go home the same day. Some insurance companies require an admission to obtain pre-authorization for a Lap-Band operation.  Hospital discharge information and post-operative care will be provided for you at the time of your second office visit

Step six

You will be asked to arrive to the hospital about an hour to an hour and a half prior to your scheduled surgery time.  After completing your hospital admission paperwork, the pre-op nurse will take you back to the Pre-Op area.  Do not bring any valuables or important items with you to the pre-op area.  In pre-op you will meet the nurses, anesthesiologist, CRNA, and surgeon.  After an IV and medications are started and everyone has met with you, your family and friends can stay with you in pre-op till you are ready to go back to the operating room.  After surgery you will be taken to the recovery room.  Most outpatient surgeries with general anesthesia require 1 to 2 hours of recovery time.  Prior to discharge from the hospital you will be scheduled for an UGI or Band Study in X-ray, and a follow-up appointment with the surgeon.

Step seven

Follow-up with the surgeon is a very important part of our program.  Patients who have weight loss surgery must have lifelong medical follow-up.  Our surgeons want to meet with you on a regular basis, particularly during the first and second year when rapid weight loss occurs.  Your primary care doctor is also a very important extension of your post-operative care.  During your follow-up with the doctor they monitor you for many things such as your medications - as you start losing weight, your medical problems will start improving and you may not require the same dose of your medications.  Follow-up allows us to monitor and adjust your need for medication – the long term side effects of weight loss surgery can be subtle, and can appear months to years after the surgery.  Depending on which operation you had you are at higher or lower risk for vitamin deficiencies (calcium, iron, Vitamin B12, etc.), and nutritional deficiencies, such as protein.  Monitoring allows the doctors to adjust your need for supplements and nutrition so that true deficiencies never develop.

Post-operative support can greatly help patients improve upon their weight loss success.  Our weight loss surgery program has a comprehensive post-operative support program.  We encourage patients to take advantage of the informational seminars, nutritional classes, behavior modification classes, and social support groups offered.   One-on-one nutrition and behavior modification counseling can also be arranged when needed. The support programs are designed to motivate you, as well as continue your education in the area of nutrition, behavior modification, and your weight loss operation.

Many patients, after they lose large amounts of weight, consider Plastic Surgery.  Bariatric patients have unique plastic surgery needs. When you begin to explore the need for plastic surgery we will be happy to talk with you about your options.

We enjoy patient testimonials.  It is a wonderful way to share your experiences and help motivate others.  You may leave a Patient Testimonial via our website or during a visit at our office.  The feedback from your testimonial also helps us to continue to improve our program, and provide better care and service to our patients.  If interested, we can add you to our growing list of patient testimonials on our website under Meet Our Patients.  Many have told us they found the testimonials inspiring and helpful.  No testimonial is placed on our website without your permission, and anonymity is easily arranged.

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Nutrition

Educating our patients about general nutrition is a very important part to their successful healthy weight loss.  The education starts even before you have had surgery.  The most important lesson for our patients to understand about weight loss surgery is that it will reduce how much food can be eaten at any one time.  In most cases patient eat about 1 cup of food per meal three times a day, or about 1200 calories per day.  Thus the quality of food that they must eat will have to improve in order to ensure healthy weight loss. 

To help you learn about general nutrition and the changes that you will experience after surgery, we have provided you with several resources. The Diet Guides provide detailed nutritional information and guidelines on how to eat after surgery.  The Preparatory Guide can also help in preparing you for the changes and the demands that may be placed on you by your weight loss operation.  By working with our patients we have learned information by PRINT alone is often not enough to help our patients understand the nutrition and eating habits changes that will be expected.  In addition to the diet and preparatory guides we also offer free monthly Nutrition Classes and Support Groups, and Group or One-on-One sessions with the dietician, to help our patients learn and understand with the assistance of the dietician.

The Nutrition Class is lead by a registered dietician, is offered monthly, and is free.  Different topics are addressed monthly, and patient input and suggestions are always welcome.  The classes are available before and after your operation.  We encourage participation, particularly early in the education process.  Half of your success will depend on how well educated you are in the use of your new “tool”.  In addition to the free nutrition classes, we also offer free monthly patient Support Groups.  The support groups are very popular, and are run by patients for patients.  Many adjustment and emotional issues are discussed in a very motivating environment.

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Behavior Modification

Awareness of our eating habits and behaviors can be a very important element in succeeding with weight loss.  It is often the first step necessary to succeed with any long term or permanent change.  We believe weight loss is no different.  To succeed with weight loss surgery long term, it is not enough to simply just have the operation, it is also necessary to make permanent eating habit and life style changes.

The surgical “Tools” help our patients make these changes in a manner they have not experienced before.   Hunger control is probably the best way to describe how the tools help our patients.  

We have several things in place to help our patients succeed.  The Diet Guides, Preparatory Guide, surgeon follow up visits, Patient Support Groups, Nutrition Classes, Behavior Modification Classes and Nutrition Classes are some of them.  

The Behavior Modification Class is lead by a Psychologist, it is offered monthly, and it is free.  Different topics are addressed monthly, and patient input and suggestions are always welcome and encouraged.  The class is meant to help our patients, thus we recommend that patients take advantage of them and raise any issues of interest specific to their needs during the class.  If the group sessions are not enough, the psychologist is also available for one-on-one consultations.

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Support Groups

Family, friends and a positive supportive environment can be an important adjunct for many during the weight loss period.  There are many changes that are occurring fast, as well as adjustment or emotional issues that may arise.  Often a person who is going thru something similar to what you are may be the best to understand and help you.  The doctors often try to facilitate patient to patient communication.  They have learned that in many cases patients can reach each other better than a doctor during an office visit.  

The Patient Support Groups have become very popular.  They are organized by patients who have already undergone weight loss surgery.  Many of the adjustment and emotional issues are discussed in a very positive and motivating environment.  Patients often exchange clothing to help control the cost of buying new clothes while in the fast weight loss phase.  Many make friends or telephone buddies.

The support groups are yet another way to help our patients to further their success with their weight loss operations.

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Adolescents

Morbid obesity with co-morbidities in the adolescent population is growing.  We are making the diagnosis of diabetes and high blood pressure in patients 16 years of age and even younger.   Weight loss surgery is now offered to young adolescents, particularly when co-morbidities are present.  The decision to proceed with weight loss surgery in this population is particularly complicated – while very personal it is also a family decision at the same time. Although the information presented in this website may be helpful, a consultation with the surgeon and attending an informational seminar or watching a Patient Information Video as a family may be the best start.

The Lap-Band is the most popular procedure in the US chosen for the adolescent patient.  There have been many concerns raised about the adolescent and weight loss surgery.  Particularly - will the younger patient be able to adhere to the guidelines and is it as effective in them as it is in adults.  Several studies have now shown that the weight loss results are very similar to those seen in adults and maybe even better.

Our younger patients are encouraged to set up the initial consultation with their family present.  If the patient and the family have not met people who have had a weight loss operation, we strongly recommend attending a nutrition or behavior modification class, a patient support group or a seminar where they can meet many patients who have undergone weight loss surgery and are at different stages after the operations.  It is a great opportunity to talk to them and ask questions.

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