

     <!-- SiteMaker 6.5 CMS (TM)
     Code created by Medseek, Inc. 2028 Village Lane, Solvang CA 93463.
     Phone 1-888 MEDSEEK. email info@medseek.com. http://www.medseek.com 
     (c) 1999-2006 Medseek, Inc. All rights reserved.-->
    








	

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
	

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
	

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
	

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
	

		
		
		
		
		
		
		
		
		
		
		
		
		
		

		
			
		
		 
		
		
		
		

		
		
		
		
		
		
		
		
		
		

		
		
		
		

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		
		
			

		
		
		
		
				
		
		
		
				
		
			
		

		
		
		
		
		
		
	
		
			
			
			
		
		
		
	
		
			
			
		

		
		
		
		
			

		

		
		
		

			
				
			
		
		
		
		
		

		
		
		
		
		
		

		
					
						
		
		
				
		
		
		
		
		
				
		
		

		
		
		
		
		
		
		
		
			
			
				
			
		
		
		
		
		
			
			
		
		
		
		
		
			
			
		

		
		
		
			
			
		
		
		

		
			

			
		
		

		
		

		
				
		 
		
			
		
		
		

		
			
			
		
		
		
			

		

		
		
		
		

		
		

		
		
		
		
		
		
		
		
		
		

		
	
		
	
	
		
	
	
	
	
	
	
	
	
	

	
	
	
	<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
	<html>
	<head>
	<title>Weight-Loss Surgery</title>
	<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
	<meta name="description" content="">
	<meta name="keywords" content="">
	<style type="text/css">
		
		@import url(default.css);
		@import url("healthsystem.css");
	</style>
<script language="javascript" src="scripts/weather.js" type="text/javascript"></script>
	<script src="scripts/AC_ActiveX.js" type="text/javascript"></script> 
	<script src="scripts/AC_RunActiveContent.js" type="text/javascript"></script>
	<script type="text/JavaScript">
	<!--
	function MM_swapImgRestore() { //v3.0
		var i,x,a=document.MM_sr; for(i=0;a&&i<a.length&&(x=a[i])&&x.oSrc;i++) x.src=x.oSrc;
	}
	function MM_preloadImages() { //v3.0
		var d=document; if(d.images){ if(!d.MM_p) d.MM_p=new Array();
			var i,j=d.MM_p.length,a=MM_preloadImages.arguments; for(i=0; i<a.length; i++)
			if (a[i].indexOf("#")!=0){ d.MM_p[j]=new Image; d.MM_p[j++].src=a[i];}}
	}
	function MM_findObj(n, d) { //v4.01
		var p,i,x;  if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
			d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
		if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n];
		for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document);
		if(!x && d.getElementById) x=d.getElementById(n); return x;
	}	
	function MM_swapImage() { //v3.0
		var i,j=0,x,a=MM_swapImage.arguments; document.MM_sr=new Array; for(i=0;i<(a.length-2);i+=3)
		 if ((x=MM_findObj(a[i]))!=null){document.MM_sr[j++]=x; if(!x.oSrc) x.oSrc=x.src; x.src=a[i+2];}
	}
	//
	function addEvent(obj, evType, fn){
		if (obj.addEventListener){
			obj.addEventListener(evType, fn, false);
			return true;
		} else if (obj.attachEvent){
			var r = obj.attachEvent("on"+evType, fn);
			return r;
		} else {
			return false;
		}
	}
	function DHTMLIframeHeight(){
		var z	=	new RegExp('lryParentmain[0-9]+');
		var x	=	new RegExp('Framelyr[0-9]+');
		var h = 0;
		var	a	=	new Array();
		var	u	=	0;
		for(y = 0; w = document.getElementsByTagName("div")[y]; y++){
			try{
				if(w.id.match(z)){
					var c	=	0;
					var d = 0;
					var t = 0;
					var e	=	document.getElementById(w.id).getElementsByTagName("iframe");
					for(i	=	0; i < e.length; i++){
						if(e[i].id.match(x)){
							c++;
							u=0;
							t=0;
							a[c] = e[i].id.substring(8,(e[i].id.length));
							l = document.getElementById('lyr'+a[c]).getElementsByTagName("a");
							e[i].style.height = "0px";
							for(h=0; classname = l[h].className; h++){
								try{
									if(classname == "clSubb1"){
										d++;
										u = 0;
										u = l[h].innerHTML.length;
										u = Math.floor(u / 16);
										if(u <= 0){u = 1;}
										u = u * 23;
										t = t + u;
										e[i].style.height = t;
									}
								}
								catch(error2) {
									//
								}
								
							}
						}
					}
				}
			}
			catch(error) {
				//
			}
		}
	}
	if(navigator.userAgent.indexOf('MSIE 6') > 0){
		addEvent(window, 'load', DHTMLIframeHeight);
	}
	//
	//-->
	</script>
	
				
<script type="text/javascript">
//<!--
var ns4 = (document.layers);
var ie  = (document.all);
var ie4 = (ie && !document.getElementById);
var ie5 = (ie && document.getElementById);
var ns6 = (!ie && document.getElementById);

var aryMoused = new Array();
var aryLayerMoused = new Array();
var aryMoImages = new Array();
var imageList = new Array();
var runMouseOvers = true;
var TimerID = null;
var iLimit = 25;
var itmp = 0;

var nbTime = 100;
var nbTimes = 2;
var nbThisLoc = 325;
var aryLayerNames = new Array();
var aryNavBarLayerInfo = new Array();
var aryNavBarLayers = new Array();

var registeredObjects = new Array();
var viz = "hide";

function MOImage() {
	var arg = MOImage.arguments;
	this.ptrImage = BillzNavBarMM_findObj(arg[0]);
	this.imageMO = new Image();
	this.imageMO.src = arg[1];
	this.HTMLname = arg[0];
	this.Moused = false;
	this.OriginalSrc = '';
	return true;
}

function BillzImagePreload() {
	// 0) html image name 1) mo image src 2)image Name for rollover key (rollover may have multiple mos for one html Image) 
	var arg = BillzImagePreload.arguments;
	nbImagePreload(arg[0], arg[1], arg[2]);
}

function nbImagePreload(img_name, mo_img_src, rollover_key_img_name) {
	var imageKey = (rollover_key_img_name.length > 0) ? rollover_key_img_name : img_name;
	imageList[imageList.length] = imageKey;
	if (!(aryMoImages[imageKey])) aryMoImages[imageKey] = new MOImage(img_name, mo_img_src);
}

function BillzMouseover() {
	var arg = null;
	if (runMouseOvers) {		
		arg = BillzMouseover.arguments; //args 0)ImageName 1)OriginalSrc 2)array index (caller imagename)		
		nbMouseover(arg[0], arg[1], arg[2]);
	}
	return true;
}
// args 1) ImageName 2) OriginalSrc 3) array index (caller imagename)
function nbMouseover(img_name, orig_src, img_key) {
	var imageKey = null;
	var o = null;
	if (runMouseOvers) 
	{				
		imageKey = (img_key.length > 0) ? img_key : img_name;
		if (!(aryMoImages[imageKey].ptrImage)) aryMoImages[imageKey].ptrImage = BillzNavBarMM_findObj(img_name);		
		if (aryMoImages[imageKey] && (o = aryMoImages[imageKey].ptrImage)) {
			aryMoImages[imageKey].OriginalSrc = orig_src;
			aryMoImages[imageKey].Moused = true;
			o.src = aryMoImages[imageKey].imageMO.src;
		}
	}
	return true;
}

var NavBarTempOnload = null;
if (window.onload && window.onload != null) NavBarTempOnload = window.onload;

function FullyLoaded() {
	if (NavBarTempOnload != null) NavBarTempOnload();
	runMouseOvers = true;
	return true;
}

function BillzMouseOutTimer() {
	return nbMouseOutTimer();
}

function nbMouseOutTimer() {
	if (TimerID) clearTimeout(TimerID);
	TimerID = setTimeout("nbLayerRestore()",5000);
	return true;
}

function RestoreAll() {
	nbMouseoverRestore();
	nbLayerRestore();
	return true;
}

function BillzMouseoverRestore() {
	return nbMouseoverRestore();
}

function nbMouseoverRestore() {
	var i = 0;
	var o = null;
	if (runMouseOvers) {
		for (i = 0; i < imageList.length; i++) {
			if (aryMoImages[imageList[i]].Moused && (o = aryMoImages[imageList[i]].ptrImage)) {
				o.src = aryMoImages[imageList[i]].OriginalSrc;
				aryMoImages[imageList[i]].Moused = false;
			}
		}
	}
	return true;
}

function BillzLayerRestore() {
	return nbLayerRestore();
}

function nbLayerRestore() {
	var i = 0;
	for (i = 0; i < aryLayerNames.length; i++) {
		if (!aryNavBarLayerInfo[aryLayerNames[i]].isDefault) BillzNavBarRestoreLayers(aryLayerNames[i]);	
	}
	return true;
}

function BillzArrayPushUnique(aryArray, varNewElement) { //only pushes if unique value
	var pushIt = true;
	var i = 0;
	for (i = 0; i < aryArray.length && pushIt; i++) {
		pushIt = (varNewElement != aryArray[i]);
	}
	if (pushIt) BillzArrayPush(aryArray, varNewElement);
	return pushIt;
}

function BillzArrayPush(aryArray, varNewElement) { //Implement Array Push 'cause IE cant handle it
	aryArray[aryArray.length] = varNewElement;
	return true;
}
function BillzArrayPop(aryArray) { //Implement Array Pop 'cause IE cant handle it before 5.5
	var varItemToPop = null;
	if (aryArray[aryArray.length - 1]) {
		varItemToPop = aryArray[aryArray.length - 1];
		aryArray[aryArray.length] = null;
	}
	return varItemToPop;
}

function getDivRef(id) {
	var divref;
	if(ns4) divref = document.layers[id];
	else if(ie4) divref = document.all[id];
	else if(ie5 || ns6) divref = document.getElementById(id);	
	return divref;
}

//v3.0 name changed to avoid clash with possible other JS in content, this function complements of MM Dreamweaver
function NavBarSwapRollover(swapimage,defaultimage,imageID) {
	if(imageID.length > 0 && document.getElementById(imageID))
	{
		if(swapimage.length > 0) 
			document.getElementById(imageID).src = "images/" + swapimage;
		else
			document.getElementById(imageID).src = "images/" + defaultimage;		
	}
}
function BillzNavBarMM_findObj(n, d) {
	var p,i,x;
	if (ns6) x = document.getElementById(n);
	else {		
		if (registeredObjects[n]) return registeredObjects[n];
		if (!(d)) d = document;
		try {
			p = n.indexOf("?");
		}
		catch(e) {
			p = 0;
		}
		if (p > 0 && parent.frames.length) {
			d = parent.frames[n.substring(p+1)].document;
			n = n.substring(0,p);
		}
		if (!(x = d[n]) && d.all) x = d.all[n];	
		for (i = 0; !x && i < d.forms.length; i++) {
			x = d.forms[i][n];
		}
		for (i=0; !x && d.layers && i < d.layers.length; i++) {
			if (d.layers[i].id.indexOf("external_") == -1) x = BillzNavBarMM_findObj(n, d.layers[i].document);	
		}
		registeredObjects[n] = x;
	}				
	return x;
}

function BillzArrayContains() {
	var arg = BillzArrayContains.arguments;
	var foundit = false;
	var i = 0;
	for (i = 0; i < arg[0].length && !foundit; i++) {
		foundit = (arg[1] == arg[0][i]);
	}
	return foundit;
}

function NavBarRegisterLayer() {
	var arg = NavBarRegisterLayer.arguments;
	var n = arg[0];
	var d = arg[1];
	var mo = false;
	var o = null;
	if (arg[2] && arg[2] == 'MOutLayer') mo = true;
	else mo = false;
	
	if (!(BillzArrayContains(aryLayerNames, n))) {
		if (o = BillzNavBarMM_findObj(n)) {
			aryNavBarLayers[n] = o;
			BillzArrayPushUnique(aryLayerNames, n);
			aryNavBarLayerInfo[n] = new NavBarLayer(n, d, mo);
		}
	}
	return true;
}

function BillzNavBarMM_showHideLayers() {
	//v3.0 name changed, this function complements of MM Dreamweaver with customizations by Bill Heller
	var i = 0;
	var x = "";
	var obj = null;
	var v = null;
	var p = null;
	var args = BillzNavBarMM_showHideLayers.arguments;
	
	if (args[args.length - 1] != "menu") nbMouseOutTimer();
	for (i = 0; i < (args.length - 2); i += 3) {
		if (!aryNavBarLayers[args[i]]) {
			x = (args[i + 2] == 'show') ? 'hide' : 'show';
			NavBarRegisterLayer(args[i], x);
		}
		if ((obj = aryNavBarLayers[args[i]]) != null) {
			v = args[i + 2];
			aryNavBarLayerInfo[args[i]].isDefault = false;
			if (args[args.length - 1] == "restore") v = (v == 'show') ? 'hide' : 'show';
			
			if (obj.style) obj.style.visibility = (v == 'show') ? 'visible' : ((v == 'hide') ? 'hidden' : v);
			else obj.visibility = v;
		}
	}
	return true;
}

function BillzNavBarRestoreLayers() {
	var i = 0;
	var x = "";
	var obj = null;
	var v = null;
	var p = null;
	var args = BillzNavBarRestoreLayers.arguments;
	for (i = 0; i < (args.length); i++) {
		if (obj = aryNavBarLayers[args[i]]) {
			v = aryNavBarLayerInfo[args[i]].defaultVisibility;
			if (obj.style) {
				obj = obj.style;
				v = (v == 'show' ) ? 'visible' : ((v == 'hide') ? 'hidden' : v);
			}
			obj.visibility = v;
			if (!aryNavBarLayerInfo[args[i]].MOutLayer) aryNavBarLayerInfo[args[i]].isDefault = true;			
		}
	}
	return true;
}

function NavBarLayer() {
	var arg = NavBarLayer.arguments;
	this.defaultVisibility = arg[1];
	this.isDefault = true;
	this.MOutLayer = arg[2];
	return true;
}

function BillzNavMove() {
	return nbNavMove();
}

function nbNavMove() {
	var thisl = null;
	var otherl = null;
	if (thisl = BillzNavBarMM_findObj("nbScrollLayer")) {
		if (thisl.style) {
			thisl = thisl.style;
			viz = "hidden";
		} 
		thisl.top = nbThisLoc -= 3;
		if (nbThisLoc < -750) {
			nbThisLoc = 325;
			nbTimes--;
		}
	}
	if (nbTimes <= 0) {
		otherl = BillzNavBarMM_findObj("BillzLayer");
		otherl.visibility = viz;
	} else {
		setTimeout("nbNavMove()", nbTime);
	}	
	return true;
}

function NavBar_openadmin() {
	window.open('admin/','SiteAdmin','height=screen.availheight,width=screen.availwidth,scrollbars=1,toolbar=0,directories=0,status=0,menubar=0,resizable=1');
	return true;
}

window.onload = FullyLoaded;
//-->
</script>
					
<script type="text/javascript">
//<!--
function NavBar_setCookie(cookievalue,navVersion,linkID) 
{	
	var cookiename = "SLIDINGTABLE_NAVBAR" + navVersion;
	var cookieVersionname = "SLIDINGTBL_NAVBAR_VERSION";
	var cookieClear = "SLIDINGTBL_NAVBAR_CLEARCOOKIES";	
	document.cookie = cookieClear.toUpperCase() + "=false";
	if(cookievalue.length > 0)
		document.cookie = cookiename.toUpperCase() + "=" + escape(cookievalue);
	if(navVersion.length > 0)	
		document.cookie = cookieVersionname.toUpperCase() + "=" + navVersion;	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);		
}
function NavBar_setoLevelIDCookie(cookievalue,linkID,navVersion) 
{
	var name = "SLIDINGTBL_NAVBAR_OLEVELID";		
	if(cookievalue.length > 0)
		document.cookie = name.toUpperCase() + "=" + escape(cookievalue);	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;		
}
function NavBar_setPLinkIDCookie(linkID,navVersion)
{	
	document.cookie = "SLIDINGTBL_NAVBAR_PLINKID=" + linkID;	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;
}
function NavBar_deleteCookie() 
{
	// first we'll split this cookie up into name/value pairs
	// note: document.cookie only returns name=value, not the other components
	var check_name = "SLIDINGTABLE_NAVBAR";	
	var a_all_cookies = document.cookie.split( ';' );
	var a_temp_cookie = '';
	var cookie_name = '';
	var cookie_value = '';
	var b_cookie_found = false; // set boolean t/f default f	

	document.cookie = "SLIDINGTBL_NAVBAR_VERSION=0";	
	document.cookie = "SLIDINGTBL_NAVBAR_OLEVELID=";	
	for (i = 0; i < a_all_cookies.length; i++)
	{		
		a_temp_cookie = a_all_cookies[i].split( '=' );			
		cookie_name = a_temp_cookie[0].replace(/^\s+|\s+$/g, '');
		
		//expire all cookies for every slidingTable_navbar intances.			
		if (cookie_name.toUpperCase().indexOf(check_name) == 0)		
			document.cookie = cookie_name.toUpperCase() + "=";			 	
	}	
}
		
//-->
</script>
			
				
<script type="text/javascript">
//<!--
				
nbImagePreload('footer_ucla_2_1','images/footer_ucla_on.gif', '');
nbImagePreload('footer_wheelchair_2_5','images/footer_wheelchair_on.gif', '');

//-->
</script>
<script type="text/javascript">
//<!--
function NavBar_setCookie(cookievalue,navVersion,linkID) 
{	
	var cookiename = "SLIDINGTABLE_NAVBAR" + navVersion;
	var cookieVersionname = "SLIDINGTBL_NAVBAR_VERSION";
	var cookieClear = "SLIDINGTBL_NAVBAR_CLEARCOOKIES";	
	document.cookie = cookieClear.toUpperCase() + "=false";
	if(cookievalue.length > 0)
		document.cookie = cookiename.toUpperCase() + "=" + escape(cookievalue);
	if(navVersion.length > 0)	
		document.cookie = cookieVersionname.toUpperCase() + "=" + navVersion;	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);		
}
function NavBar_setoLevelIDCookie(cookievalue,linkID,navVersion) 
{
	var name = "SLIDINGTBL_NAVBAR_OLEVELID";		
	if(cookievalue.length > 0)
		document.cookie = name.toUpperCase() + "=" + escape(cookievalue);	
	if(linkID.length > 0)
		NavBar_setPLinkIDCookie(linkID,navVersion);	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;		
}
function NavBar_setPLinkIDCookie(linkID,navVersion)
{	
	document.cookie = "SLIDINGTBL_NAVBAR_PLINKID=" + linkID;	
	if(navVersion.length > 0)	
		document.cookie = "SLIDINGTBL_NAVBAR_VERSION=" + navVersion;
}
function NavBar_deleteCookie() 
{
	// first we'll split this cookie up into name/value pairs
	// note: document.cookie only returns name=value, not the other components
	var check_name = "SLIDINGTABLE_NAVBAR";	
	var a_all_cookies = document.cookie.split( ';' );
	var a_temp_cookie = '';
	var cookie_name = '';
	var cookie_value = '';
	var b_cookie_found = false; // set boolean t/f default f	

	document.cookie = "SLIDINGTBL_NAVBAR_VERSION=0";	
	document.cookie = "SLIDINGTBL_NAVBAR_OLEVELID=";	
	for (i = 0; i < a_all_cookies.length; i++)
	{		
		a_temp_cookie = a_all_cookies[i].split( '=' );			
		cookie_name = a_temp_cookie[0].replace(/^\s+|\s+$/g, '');
		
		//expire all cookies for every slidingTable_navbar intances.			
		if (cookie_name.toUpperCase().indexOf(check_name) == 0)		
			document.cookie = cookie_name.toUpperCase() + "=";			 	
	}	
}
		
//-->
</script>
			</head>
	
		
	
	
	
	
	
		
	



<style type="text/css">
#lryParentmain56 {
	display:none;
	visibility:hidden;
}
</style>
<body style="margin:0px; background-color:#7082a6;" class="body">
<table align="center" width="90%" bgcolor="#ffffff" border="0" cellpadding="0" cellspacing="0">
	<tr bgcolor="#e5ebeb">
		<td width="100%" height="28" valign="middle" style="border-bottom:1px dashed #999999;">
			<table width="100%" border="0" cellpadding="0" cellspacing="0">
				<tr>
					<td width="33%" height="28" valign="middle" style="padding-left:20px;font-size:10px;">Sun Nov 22, 2009</td>					<td width="33%" align="center" valign="middle">
						
	<!-- Begin NavBar Output  -  Version:  v0.79a 09/30/2006  -->
	
		<!-- Begin NavBar Bar #1 Content Output... -->
		<table  border="0" cellspacing="0" cellpadding="0" onclick="NavBar_deleteCookie();">
	<tr class="navbarnum1">
		<td class="navbarnum1" valign="top" align="left" title=""><a href="http://www.directory.ucla.edu"  target="_blank" onClick="NavBar_setPLinkIDCookie('10','');" class="navbarnum1">Directory</a></td>
		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>
		<td class="navbarnum1" valign="top" align="left" title=""><a href="http://www.uclahealth.org/body.cfm?id=289"  target="_blank" onClick="NavBar_setPLinkIDCookie('9','');" class="navbarnum1">Maps</a></td>
		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>
		<td class="navbarnum1" valign="top" align="left" title=""><a href="http://www.uclahealth.org/body.cfm?id=173"  target="_blank" onClick="NavBar_setPLinkIDCookie('8','');" class="navbarnum1">Calendar</a></td>
		<td class="navbarnum1" valign="top" align="left" title=""><img src='images/topnav_btwn.gif' alt=""></td>
		<td class="navbarnum1" valign="top" align="left" title=""><a href="http://www.uclahealth.org/body.cfm?id=46"  target="_blank" onClick="NavBar_setPLinkIDCookie('7','');" class="navbarnum1">News</a></td>
	</tr>
</table>
	
		<!-- End NavBar Output -->
	 

					</td>
					<td align="right" valign="middle">


	<style name="text/css" class="search">		
		td.search {background-color: clear.gif; background-image: URL(images/clear.gif); font-family: verdana,arial; font-weight: bold; font-size: 10px; font-color: 666666;}
				
	</style>

		<table border="0" cellpadding="0" cellspacing="0" background="" align= "right" class="search">		
		<form action="body.cfm?id=16" method="POST">		
		<input type="hidden" name="action" value="list">	
		<input type="hidden" name="search_areas_id" value="">	
		<input type="hidden" name="includewhat" value="">
			
			<tr class="search">							
				
					<td class="search">Search:&nbsp;&nbsp;</td>
				
				
					<td class="search"><input type="text" name="keywords" size="24" value="Search" style="background-color: FFFFFF; border-style: solid; border-color: a5acb2; border-width: 1px; font-size: 10px; padding-left:4px;"></td>
							
				
					<td class="search"><input type="IMAGE" src="images/go_button.gif" border="0" width="26" height="21" style="border:0px;"></td>
				
			</tr>
		</form>
		</table>
	 
</td>
				</tr>
			</table>
		</td>
	</tr>
	<tr>
		<td height="51" valign="top" style="background-image: url(images/logo_area_tile.gif); background-repeat: repeat-x; background-position: top left;">
			<table height="51" width="100%" border="0" cellpadding="0" cellspacing="0">
				<tr>
					<td width="1%" valign="middle"><img src="images/site/logo_top.gif" alt="UCLA Health System" border="0" hspace="18"></td>
					<td valign="bottom" width="1%" align="right" nowrap><a href="http://dgsom.healthsciences.ucla.edu" onMouseOut="MM_swapImgRestore()" onMouseOver="MM_swapImage('Research','','images/btn_schoolmed_on.gif',1)" target="_blank"><img src="images/btn_schoolmed.gif" alt="Research and Education: David Geffen School of Medicine at UCLA" name="Research" border="0"></a><a href="http://www.uclahealth.org" onMouseOut="MM_swapImgRestore()" onMouseOver="MM_swapImage('Patient Care','','images/btn_healthsystem_white_on.gif',1)" target="_blank"><img name="Patient Care" border="0" src="images/btn_healthsystem_white.gif" alt="Patient Care: UCLA Health System"></a></td>
				</tr>
			</table>
		</td>
	</tr>
	<tr> 
		<td align="center" valign="middle" style="border:2px solid #ffffff; background-color:#efc932;"><a href="default.cfm"><img src="images/site/logo_bar.gif" border="0" alt="UCLA Fit for Healthy Weight Program"></a></td>
	</tr>
    <tr> 
		<td width="100%" style="vertical-align:middle; background-color:#fff;vertical-align:top;border-top:1px solid #aab6c8;">
			<table width="100%" border="0" cellpadding="0" cellspacing="0">
				<tr valign="top">
					<td valign="top" width="186" style="border-right:1px solid #aab6c8; padding-top:6px;">
						<div style="line-height:1px; margin:1px; width:186px;"></div>
						
						
						
						
						
							
								
							
							
								
									
								
							
							
							
						
						
						

<script type="text/javascript">
<!--
				
//Begin: Graphic Mouseover functions
function slidingTbl_preloadImages()
{
var d=document;
	if(d.images)
{
	if(!d.slidingTbl_p)
		d.slidingTbl_p=new Array();		
}
   var i,j=d.slidingTbl_p.length,a=slidingTbl_preloadImages.arguments;
for(i=0; i<a.length; i++)
{
  		if (a[i].indexOf("#")!=0)
	{
		d.slidingTbl_p[j]=new Image;
		d.slidingTbl_p[j++].src=a[i];
	}
}
}
function slidingTbl_swapImgRestore()
{
var i,x,a=document.slidingTbl_sr;
for(i=0; a && i<a.length && (x=a[i]) && x.oSrc; i++)
{
	x.src = x.oSrc;
}
}
function slidingTbl_findObj(n, d)
{
var p,i,x;
if(!d) d = document;
p = n.indexOf("?");	
x = d[n];
if(p > 0 && parent.frames.length)	
{
 		d = parent.frames[n.substring(p+1)].document; 
	n = n.substring(0,p);	
}	
if(!(x) && d.all) x = d.all[n];
for (i=0;!x && i < d.forms.length;i++)
{
	x = d.forms[i][n];
}
for(i=0;!x && d.layers && i<d.layers.length;i++)
{
	x = slidingTbl_findObj(n,d.layers[i].document);
}
 if(!x && d.getElementById) x = d.getElementById(n); 
 return x;
}
function slidingTbl_swapImage()
{
var i,j=0,x,a=slidingTbl_swapImage.arguments;
document.slidingTbl_sr = new Array;
for(i=0;i<(a.length-2);i+=3)
{		
	x = slidingTbl_findObj(a[i]);			
   	if (x != null)
   	{
		document.slidingTbl_sr[j++] = x;			
		if(!x.oSrc) x.oSrc = x.src;			
		x.src = a[i+2];			
	}
}
}
//End: Graphic Mouseover functions
							
function slidingTbl_SetCookie1(cookievalue) 
{		
document.cookie = "SLIDINGTABLE_NAVBAR1=" + escape(cookievalue);	
document.cookie = "SLIDINGTBL_NAVBAR_VERSION=1";
document.cookie = "SLIDINGTBL_NAVBAR_OLEVELID=";
}
function slidingTbl_SetoLevelIDCookie1(cookievalue)
{
document.cookie = "SLIDINGTBL_NAVBAR_OLEVELID=" + escape(cookievalue);	
document.cookie = "SLIDINGTBL_NAVBAR_VERSION=1";
document.cookie = "SLIDINGTABLE_NAVBAR1=";
}
function slidingTbl_ClearCookie1() 
{			
var check_name = "SLIDINGTABLE_NAVBAR";
var a_all_cookies = document.cookie.split( ';' );
var a_temp_cookie = '';
var cookie_name = '';
for (i = 0; i < a_all_cookies.length; i++)
{		
	a_temp_cookie = a_all_cookies[i].split( '=' );		
	cookie_name = a_temp_cookie[0].replace(/^\s+|\s+$/g, '');		
	
	//expire all cookies for every slidingTable_navbar intances.
	if (cookie_name.toUpperCase().indexOf(check_name) == 0) 	
		document.cookie = cookie_name.toUpperCase() + "=";					 	
}			
}
var SlidingTableTempOnload1 = null;
if(window.onload && window.onload != null)
{
SlidingTableTempOnload1 = window.onload;
}
function initsliding1()
{
if(SlidingTableTempOnload1 != null)	
	SlidingTableTempOnload1();

document.cookie = "SLIDINGTBL_NAVBAR_VERSION=";
slidingTbl_ClearCookie1();
slidingTbl_preloadImages();			
return true;
}

window.onload = initsliding1;
//-->
</script>
<table class="leftnav" cellspacing="0" onclick="JavaScript: document.cookie='SLIDINGTBL_NAVBAR_VERSION=1';">
	<tr class="leftnav" id="pLinkTR_53_1">
		<td class="leftnav" id="pLinkTD_53_1" onclick="slidingTbl_SetoLevelIDCookie1('53^53');"><a href="default.cfm" class="leftnav">Home</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_53_1">
		<td class="leftnav" id="pBetweenTD_53_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_17_1">
		<td class="leftnav" id="pLinkTD_17_1" onclick="slidingTbl_SetCookie1('17^17');"><a href="body.cfm?id=17" class="leftnav">About Us</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_17_1">
		<td class="leftnav" id="pBetweenTD_17_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_18_1">
		<td class="leftnav" id="pLinkTD_18_1" onclick="slidingTbl_SetCookie1('18^18');"><a href="body.cfm?id=18" class="leftnav">For Patients & Families</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_18_1">
		<td class="leftnav" id="pBetweenTD_18_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_19_1">
		<td class="leftnav" id="pLinkTD_19_1" onclick="slidingTbl_SetCookie1('19^19');"><a href="body.cfm?id=19" class="leftnav">For Physicians</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_19_1">
		<td class="leftnav" id="pBetweenTD_19_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_20_1">
		<td class="leftnav" id="pLinkTD_20_1" onclick="slidingTbl_SetCookie1('20^20');"><a href="body.cfm?id=20" class="leftnav">Public Health & Research</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_20_1">
		<td class="leftnav" id="pBetweenTD_20_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_21_1">
		<td class="leftnav" id="pLinkTD_21_1" onclick="slidingTbl_SetCookie1('21^21');"><a href="body.cfm?id=21" class="leftnav">Our Team</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_21_1">
		<td class="leftnav" id="pBetweenTD_21_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_22_1">
		<td class="leftnav" id="pLinkTD_22_1" onclick="slidingTbl_SetCookie1('22^22');"><a href="body.cfm?id=22" class="leftnav">Our Services</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_22_1">
		<td class="leftnav" id="pBetweenTD_22_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_37_1">
		<td class="leftnav" id="pLinkTD_37_1" onclick="slidingTbl_SetCookie1('37^37');"><a href="body.cfm?id=37" class="leftnav">Health Resources</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_37_1">
		<td class="leftnav" id="pBetweenTD_37_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_23_1">
		<td class="leftnav" id="pLinkTD_23_1" onclick="slidingTbl_SetCookie1('23^23');"><a href="body.cfm?id=23" class="leftnav">Weight-Loss Surgery</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_23_1">
		<td class="leftnav" id="pBetweenTD_23_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_24_1">
		<td class="leftnav" id="pLinkTD_24_1" onclick="slidingTbl_SetCookie1('24^24');"><a href="body.cfm?id=24" class="leftnav">Helpful Links</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_24_1">
		<td class="leftnav" id="pBetweenTD_24_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_25_1">
		<td class="leftnav" id="pLinkTD_25_1" onclick="slidingTbl_SetCookie1('25^25');"><a href="body.cfm?id=25" class="leftnav">In the News</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_25_1">
		<td class="leftnav" id="pBetweenTD_25_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_26_1">
		<td class="leftnav" id="pLinkTD_26_1" onclick="slidingTbl_SetCookie1('26^26');"><a href="body.cfm?id=26" class="leftnav">Contact Us</a></td>
	</tr>
	<tr class="leftnav" id="pBetweenTR_26_1">
		<td class="leftnav" id="pBetweenTD_26_1"><img class='leftnav' src='images/leftnavbreak.gif'></td>
	</tr>
	<tr class="leftnav" id="pLinkTR_27_1">
		<td class="leftnav" id="pLinkTD_27_1" onclick="slidingTbl_SetCookie1('27^27');"><a href="body.cfm?id=27" class="leftnav">Directions</a></td>
	</tr>
</table> 

						
						<div style="padding:22 0 10 0; text-align:center;">
							<a href="javascript:SM1_BannerClick()" onMouseOver="return SM1_BannerWindowStatus();" onMouseOut="window.status='';SM1_MO=false;"><img src="images/bruinkids.gif" name="bottom_left_nav" Width="127" Height="135" Border="0" alt=""></a>
		<SCRIPT LANGUAGE="JavaScript" TYPE="text/javascript"> <!--
			SM1_MO=false;
			SM1_Timer = null;
			SM1_ThisBanner = 0;
			SM1_BannerItems = new Array();
			
			
				
				
				
				
					
					
					
						
					
				
			
				SM1_BannerItems[0] = new Array();
				SM1_BannerItems[0][0]=new Image();
				SM1_BannerItems[0][0].src='images/bruinkids.gif';
				SM1_BannerItems[0][1]='http://uclabruins.cstv.com/ot/kids-club-about.html';
				SM1_BannerItems[0][2]='parent._blank.';
			
			
			function SM1_BannerClick(){SM1_BannerWindowStatus();
				if (SM1_BannerItems[SM1_ThisBanner][2]=="parent._blank."){
					window.open(SM1_BannerItems[SM1_ThisBanner][1]);
				// }else 	 if(!eval(SM1_BannerItems[SM1_ThisBanner][2]+'document')){
	//				window.open(SM1_BannerItems[SM1_ThisBanner][1],); 
				}else{
					eval(SM1_BannerItems[SM1_ThisBanner][2] + "location.href=SM1_BannerItems[SM1_ThisBanner][1]");
				}
			}
			function SM1_BannerWindowStatus(){SM1_MO=true;window.status=SM1_BannerItems[SM1_ThisBanner][1]; return true}
			function SM1_SwapBanner(){
				iNum=SM1_ThisBanner+1;if(iNum>=SM1_BannerItems.length)iNum=0;
				document.bottom_left_nav.src=SM1_BannerItems[iNum][0].src; 
				SM1_ThisBanner=iNum;
				SM1_Timer=setTimeout('SM1_SwapBanner()',1000);
				if(SM1_MO){SM1_BannerWindowStatus();}else{window.status='';}
			}
				
			SM1_Timer=setTimeout('SM1_SwapBanner()',1000);
		//-->
		</SCRIPT> 
								
						</div>
						<br>
						<br>
						
					</td>
					<td>						
						
						<div style="line-height:1px; margin:0px; height:1px; width:598px;">&nbsp;</div>
						<table width="100%" border="0" cellpadding="0" cellspacing="0">
							<tr>
								<td valign="top" class="breadcrumbtd">









	
	
	
		
	
	
		
		
			
			
			
			
			
			
			
		
		
	


<table cellpadding="0" cellspacing="0" class="breadcrumb">
	<tr>
		<td style="white-space:nowrap;" class="breadcrumb">
			
				
				<div style="white-space:nowrap; float:left" class="breadcrumb"><a href="default.cfm?id=1" class="breadcrumb">Home</a></div>
				<div style="white-space:nowrap; float:left" class="breadcrumb_between"><img src="images/breadcrumb_divider.gif"></div>
				
			
			
				
						
				
				<div style="white-space:nowrap; float:left" class="breadcrumb"><a href="body.cfm?id=23&amp;oTopId=23" class="breadcrumb">Weight-Loss Surgery</a></div>
							
			
		</td>
	</tr>
</table>
</td>
							</tr>
							<tr class="content">														
								<td valign="top" style="padding:12px;">
									
										
										
											
												
												
													
														<h1 class="pagetitle" id="pagetitle"><strong>Weight-Loss Surgery</strong></h1>
													
												
											
										
										
										<div id="bodycontent">
										
										











	<h2>GASTRIC BYPASS </h2>
<p align="center">
<img class="sm6generalwizard" src="images/Surgery%20Pictures/UCLA%20U-Loop%20Gastric%20Bypass%20v2.jpg" border="0" width="238" height="175" /> 
</p>
<p>
<em><strong>What is the gold-standard weight-loss operation?</strong></em>&nbsp; <br />
Most doctors consider the gastric bypass (RYGB or roux-en-Y gastric bypass) to be the gold-standard.&nbsp; The UCLA technique for gastric bypass (UCLA U-Loop) has been presented internationally, has been performed in more than 1,000 adults and is associated with a low complication rate.&nbsp; Furthermore, the procedure has a proven track record for long-term weight-loss.&nbsp; Other procedures that have been performed for weight-loss include: 
</p>
<ol>
	<li>biliopancreatic diversion</li>
	<li>sleeve gastrectomy</li>
	<li>banding</li>
</ol>
<p>
The biliopancreatic diversion has excellent weight-loss results but also has higher complication rate and post-operative nutritional deficiencies. 
</p>
<div style="text-align: center">
<img class="sm6generalwizard" src="images/Surgery%20Pictures/Bandages---WebFormat.gif" border="0" width="233" height="175" /> 
</div>
<p>
<em><strong>Can these procedures be performed laparoscopically with minimal incisions?</strong></em>&nbsp; <br />
Yes.&nbsp; Almost all weight-loss surgeries at UCLA are performed laparoscopically using minimally-invasive tools. 
</p>
<hr />
<h2>LAPAROSCOPIC BAND </h2>
<p>
<em><strong>Why not perform a laparoscopic band for adolescents?</strong></em>&nbsp; <br />
The gastric band is still considered investigational for adolescents.&nbsp;&nbsp; Enrollment of patients in a study evaluating the gastric band in adolescents has been completed, and long-term results are awaited.&nbsp; The Food and Drug Administration (FDA) has not approved the device for patients younger than 18 years.&nbsp; The procedure is also losing favor in Europe because of poor long-term outcomes.&nbsp; We have the following concerns with the gastric band: 
</p>
<ol>
	<li>Less weight-loss than with other surgeries</li>
	<li>Decreased quality-of-life as a consequence of vomiting and nausea</li>
	<li>Need for ongoing follow-up visits to adjust the band</li>
	<li>Bands are frequently removed because of long-term complications (including infection, migration and erosion)</li>
	<li>The band can injure the stomach, which can impact the risk of future weight-loss surgeries</li>
	<li>There is a potential for long-term injury of the esophagus and lower esophageal sphincter </li>
</ol>
<hr />
<h2>SLEEVE GASTRECTOMY </h2>
<p style="text-align: center">
<img class="sm6generalwizard" src="images/Surgery%20Pictures/Sleeve-Gastrectomy---FUSED-2-Web-Format.gif" border="0" width="405" height="175" /> 
</p>
<p>
<em><strong>What is a sleeve gastrectomy?</strong></em>&nbsp; <br />
A sleeve or vertical gastrectomy is a procedure in which the majority of the stomach is removed, leaving behind a stomach tube.&nbsp; 
</p>
<p>
<em><strong>Does the sleeve gastrectomy cause malabsorption?</strong></em>&nbsp; <br />
No, because the intestines are not bypassed, sleeve gastrectomy should theoretically not cause malabsorption of food and nutrients.&nbsp; However, some vitamin and protein supplements may be required after the operation.&nbsp; 
</p>
<p>
<em><strong>Why is sleeve gastrectomy being considered by some surgeons as a good option for overweight adolescents?</strong></em> 
</p>
<ol>
	<li>Short-term results suggest that sleeve gastrectomy is more effective than banding and nearly as good as gastric bypass and other surgeries.</li>
	<li>Because the intestine is NOT bypassed, the likelihood of having nutritional deficiencies and the life-long need for nutritional supplements is reduced.&nbsp; For the adolescent who is still growing, may get pregnant and has his/her whole life ahead of him/her, this is an attractive option.</li>
	<li>Sleeve gastrectomy doesn&#39;t &quot;burn any bridges&quot;.&nbsp; If the procedure is NOT effective on its own at achieving adequate weight loss and treating other medical problems related to excess weight (e.g. diabetes, hypertension, liver disease), a second-stage operation can be added without significantly increasing the risk of the operation.&nbsp; In fact, the sleeve gastrectomy is the first part of the duodenal switch operation and it is often done in high-risk patients as a staged operation prior to gastric bypass.&nbsp; Many patients don&#39;t end up needing the second-stage operation because they achieve enough weight loss and improve their overall health with sleeve gastrectomy alone.&nbsp; </li>
</ol>
<p>
<em><strong>How does the sleeve gastrectomy work?</strong></em>&nbsp; <br />
While not completely understood, sleeve gastrectomy appears to have three main effects: 
</p>
<ol>
	<li>It reduces the capacity of the stomach.</li>
	<li>It decreases production of a hormone (ghrelin) involved in stimulating appetite and likely has other hormonal effects.</li>
	<li>It improves emptying of the stomach.&nbsp; Patients describe having less hunger between meals and feel full sooner during meals. </li>
</ol>
<p>
<em><strong>Will the sleeve gastrectomy &lsquo;cure&#39; my diabetes?</strong></em>&nbsp; <br />
The rate of resolution of diabetes has been noted to be as quick as with gastric bypass.&nbsp; Sleeve gastrectomy also appears to significantly improve other health problems, with the exception, perhaps, of dyslipidemias. 
</p>
<p>
<em><strong>Is the complication rate for sleeve gastrectomy higher or lower than gastric bypass?</strong></em>&nbsp; <br />
Because the operation requires fewer connections between bowels, there is probably an overall lower risk of complications during one&#39;s lifetime.&nbsp; 
</p>
<p>
<em><strong>Will I get &lsquo;dumping syndrome&#39;?</strong></em>&nbsp;&nbsp; <br />
Dumping syndrome refers to symptoms (which may include cramping, abdominal pain, nausea, diarrhea, dizziness, sweating and palpitations) that can occur in patients who undergo stomach bypass or stomach reduction surgery.&nbsp; &lsquo;Dumping&#39; occurs in approximately one-third to one-half of patients who undergo gastric bypass.&nbsp; It has not been reported following sleeve gastrectomy. 
</p>
<p>
<em><strong>Who will need a second-stage operation?</strong></em>&nbsp; <br />
Patients with a BMI of greater than 50 or 60 may not achieve enough weight loss to &quot;cure&quot; their diabetes and other health problems.&nbsp; They may require an additional &quot;malabsorptive&quot; procedure to improve their overall health. 
</p>
<p>
<em><strong>What are the major complications associated with sleeve gastrectomy?</strong></em>&nbsp; <br />
The main concern is a leak.&nbsp; It is estimated to occur in less than 1 of every 100 patients undergoing the procedure and can be problematic.&nbsp; Some leaks can be treated with drains or simple surgical repair, but some will require stenting or more aggressive surgical therapy, including removal and bypass of the stomach.&nbsp; Narrowing of the stomach tube can also occur and this usually responds to dilator therapy with endoscopy.&nbsp; On occasion, reoperation is required.&nbsp; If a serious complication is noted at the time of surgery, sleeve gastrectomy becomes unsafe and a gastric bypass or other surgery is required. 
</p>
<p>
<em><strong>What are the disadvantages of the sleeve gastrectomy?</strong></em> 
</p>
<ol>
	<li>There are no long-term (greater than 5&nbsp;year) data available on the sleeve gastrectomy.</li>
	<li>Because a portion of the stomach is removed, it cannot be replaced; thus, the procedure is considered &quot;non-reversible.&quot;</li>
</ol>
<p>
<em><strong>What are the nutritional deficiencies from sleeve gastrectomy?</strong></em>&nbsp; <br />
The long-term nutritional consequences are not well known for sleeve gastrectomy, but they are likely to be less than that with other weight-loss procedures because there is no significant malabsorption.&nbsp; Close follow-up is advised. 
</p>
<hr />
<h2>CRITERIA, HOSPITALIZATION and POST-OPERATIVE CARE</h2>
<p>
<em><strong>What is the youngest age that is considered for weight-loss surgery?</strong></em>&nbsp; <br />
At our institution, we do not have strict age restrictions or criteria.&nbsp; Each patient is treated individually and offered both medical and surgical options depending on their multidisciplinary evaluation.&nbsp; The sleeve gastrectomy avoids malabsorption and might be considered in younger patients.&nbsp; For gastric bypass, current guidelines established for adolescents advise performing the surgery on patients who have gone through puberty and are physically mature.&nbsp; In general, this age is 13 in girls and 15 in boys.&nbsp; Guidelines have not been made for the sleeve gastrectomy procedure. 
</p>
<p>
<em><strong>What is the oldest age that is being considered for weight-loss surgery?</strong></em>&nbsp; <br />
In general, we refer patients 21 and over to the Adult Bariatric Program. 
</p>
<p>
<em><strong>What do I need to do to become a candidate for weight-loss surgery?</strong></em> 
</p>
<ol>
	<li>Complete a detailed registration form.</li>
	<li>Be evaluated by our multidisciplinary team involving surgeon, pediatricians, dietitian and psychologist.</li>
	<li>Be enrolled in a medically supervised intervention program for a minimum of six months.</li>
	<li>Demonstrate knowledge and understanding of the procedure and its risks.</li>
	<li>Be committed to the post-operative diet and life-long follow-up.</li>
	<li>Be committed to avoid pregnancy for at least one year after the operation.</li>
	<li>Provide informed consent. </li>
</ol>
<p>
<strong><em>Will my insurance company cover weight-loss surgery?&nbsp; Will they cover the sleeve gastrectomy.&nbsp; Why not?&nbsp; What can I do?</em>&nbsp; <br />
</strong>UCLA has been certified as a Center of Excellence by the major accrediting body, the American Society of Bariatric and Metabolic Surgery (ASBMS), as well several health plans.&nbsp; If your child qualifies for weight-loss surgery, we will do everything possible to help you obtain insurance approval.&nbsp; The ASBMS recently reviewed results of the sleeve gastrectomy and reported that the three year results are comparable to other weight-loss surgeries and better than the gastric band with a lower complication rate.&nbsp; Nonetheless, many insurance companies will demand long-term results prior to funding the sleeve gastrectomy.&nbsp; We feel that children with compromised health can&#39;t afford to wait.&nbsp; Even if we are able to achieve short-term results, there is hope of making lifestyle changes during the important &quot;formative&quot; years of&nbsp;adolescence that can last a lifetime.&nbsp; Furthermore, the sleeve gastrectomy procedure doesn&#39;t &quot;burn any bridges&quot;.&nbsp; Other malabsorptive operations can be &quot;added&quot; to help reduce weight and improve overall health in the future. 
</p>
<p>
<em><strong>How long will I stay in the hospital?</strong></em>&nbsp; <br />
Most patients will be in the hospital for two days. 
</p>
<p>
<em><strong>What will I be able to eat after the operation?</strong></em>&nbsp; <br />
Clear liquids are started the day after surgery.&nbsp; Full liquids and protein shakes are started two days after surgery.&nbsp; Well-chewed solid food can be started a few weeks after surgery.&nbsp; Surgery is only an aid, and strict diet-adherence must be maintained.&nbsp; Patients who have long-term success will restrict portions to 1/3 normal serving size for their lifetime. 
</p>
<p>
<em><strong>What medications do I need to take after the operation?</strong></em>&nbsp; <br />
We recommend an anti-ulcer medication (proton pump inhibitor) for a minimum of&nbsp;three months after the operation to help with symptoms.&nbsp; Vitamins supplements will also be given if there are preoperative deficiencies.&nbsp; Birth control may also be prescribed to avoid pregnancy for at least one to two years after the operation.<br />
&nbsp;<br />
<em><strong>How much weight can I expect to lose?</strong></em>&nbsp; <br />
The average expected excess body weight loss is 60% after one to two years.&nbsp; For example:<br />
Preoperative body weight: 250 lbs<br />
Ideal body weight: 125 lb&nbsp;<br />
Excess body weight: 125 lbs<br />
60% of excess body weight:&nbsp; 75 lbs<br />
Average expected postoperative weight after two Years: 175 lbs&nbsp; 
</p>
<p>
<em><strong>How quickly does it take to lose the weight?</strong></em>&nbsp; <br />
The majority of weight loss occurs during the first&nbsp;six months after surgery.&nbsp; The weight loss begins to plateau around one to two years after the surgery.&nbsp; There may be a small weight increase after that time. 
</p>

 

										
										</div>
									
								</td>
							</tr>
						</table>
						<p>&nbsp;</p>
						
					</td>
					<td width="176" style="border-left:1px solid #aab6c8; padding:6px;">
						<img src="images/pix.gif" width="176" height="5"><br>
						
						
						<div style="text-align: center">
<a href="body.cfm?id=29&amp;oTopID=18"><img src="images/site/bmi-calc.gif" border="0" alt="BMI Calculator" title="BMI Calculator" width="169" height="187" /></a> <br />
<div id="rightbox" style="margin-top: 8px">
<img class="sm6generalwizard" src="http://fitprogram.ucla.edu/images/site/pedsupdate08_snapshot.jpg" border="0" width="152" height="200" /><br />
Read more about the UCLA FIT Program<br />
in the <a href="workfiles/documents/PedsUpdateSpring08.pdf" target="_blank" title="UCLA Pediatric Update - UCLA Program Helps Overweight Children">UCLA Pediatric Update</a> publication 
</div>
</div>

						 
<br><br>
						
						
					</td>					
				</tr>
			</table>
		</td>
	</tr>
	<tr>
		<td valign="top" bgcolor="#e5ebeb">
			<table width="100%" border="0" cellpadding="0" cellspacing="0">
				<tr>
					<td width="960" height="34" align="center" valign="middle" style="border-top:1px dashed #999999; padding-bottom:2px;" class="navbarnum4">
						
	<!-- Begin NavBar Output  -  Version:  v0.79a 09/30/2006  -->
	
		<!-- Begin NavBar Bar #2 Content Output... -->
		<table  border="0" cellspacing="0" cellpadding="0" onclick="NavBar_deleteCookie();">
	<tr class="navbarnum4">
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="http://www.ucla.edu"  target="_blank" onMouseOver="RestoreAll();nbMouseover('footer_ucla_2_1','images/footer_ucla.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('15','');" class="navbarnum4"><img src="images/footer_ucla.gif" border="0" alt="UCLA Home" id="footer_ucla_2_1" name="footer_ucla_2_1"></a></td>
		<td class="navbarnum4" valign="bottom" align="left" title="">&nbsp;&nbsp;&nbsp;&nbsp;</td>
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="http://www.uclahealth.org"  target="_blank" onClick="NavBar_setPLinkIDCookie('58','');" class="navbarnum4">UCLA Health System</a></td>
		<td class="navbarnum4" valign="bottom" align="left" title="">&nbsp;&nbsp;&nbsp;&nbsp;</td>
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="http://www.ucla.edu/terms.html"  target="_blank" onClick="NavBar_setPLinkIDCookie('14','');" class="navbarnum4">Terms of Use / ©2009 UC Regents</a></td>
		<td class="navbarnum4" valign="bottom" align="left" title="">&nbsp;&nbsp;&nbsp;&nbsp;</td>
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="http://www.uclahealth.org/body.cfm?id=57"  target="_blank" onClick="NavBar_setPLinkIDCookie('13','');" class="navbarnum4">Privacy Practices</a></td>
		<td class="navbarnum4" valign="bottom" align="left" title="">&nbsp;&nbsp;&nbsp;&nbsp;</td>
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="http://www.accessweb.ucla.edu"  onMouseOver="RestoreAll();nbMouseover('footer_wheelchair_2_5','images/footer_wheelchair.gif','');" onMouseOut ="nbMouseoverRestore();" onClick="NavBar_setPLinkIDCookie('12','');" class="navbarnum4"><img src="images/footer_wheelchair.gif" border="0" alt="Disability Resources" id="footer_wheelchair_2_5" name="footer_wheelchair_2_5"></a></td>
		<td class="navbarnum4" valign="bottom" align="left" title="">&nbsp;&nbsp;&nbsp;&nbsp;</td>
		<td class="navbarnum4" valign="bottom" align="left" title=""><a href="body.cfm?id=11"  onClick="NavBar_setPLinkIDCookie('11','');" class="navbarnum4">Sitemap</a></td>
	</tr>
</table>
	
		<!-- End NavBar Output -->
	 

					</td>
				</tr>
			</table>
		</td>
	</tr>
</table>
</body>
</html>