Penn Highlands Healthcare Marks 100 Bariatric Surgeries at PH DuBois
Kyra Gray’s friends and family are flabbergasted. Sometimes her co-workers at the DuBois Country Club and Comfort Suites walk by her and do not even recognize their Director of Sales and Events. In the past nine months, Mrs. Gray has lost 105 pounds as a result of the bariatric surgery she had at Penn Highlands DuBois in July 2022.
“I feel like a brand new person — like I am 29 again. I feel as though I am back in the body that was hiding underneath me,” exclaimed the 47-year-old mother of four and grandmother of two. “I now have a second chance in life due to the gastric bypass surgery — and especially Dr. Lundgren,” added Mrs. Gray.
Megan P. Lundgren, MD, is a general surgeon who specializes in bariatric and minimally invasive surgery at Penn Highlands Bariatric and General Surgery in DuBois. Dr. Lundgren, who recently performed the 100th bariatric surgery in DuBois, established the bariatric program in 2021 at Penn Highlands Healthcare in Northwestern/Central Pennsylvania.
“I am very happy that this program came together so well,” said Dr. Lundgren. “We have all heard the saying that it takes a village, but in order to establish this program it took so many people from various parts of our health system — who are too numerous to mention in limited space — to share a vision and make Penn Highlands Healthcare Bariatric Surgery an invaluable resource that provides positive outcomes for our patients.”
Penn Highlands Healthcare offers a comprehensive bariatric surgery program that addresses the physical and emotional needs of the individual before and after surgery. A multidisciplinary team that includes bariatric surgeons, obesity medicine physicians, registered dieticians and psychology and behavioral health specialists supports patients every step of the way. They also work closely with Penn Highlands Healthcare endocrinology, cardiology, pulmonology and sleep medicine teams to help patients achieve their weight loss goals.
“I struggled with my weight my entire life — particularly after my children were born, said Mrs. Gray. “I tried every diet and every exercise program and I would lose 10 pounds, but the weight would come right back on. The bariatric program was relatively easy, and it sets you up for success.”
Penn Highlands Healthcare offers several types of bariatric surgery, including the least invasive weight loss surgery procedures. The procedures include:
- Gastric Sleeve Surgery:Laparoscopic sleeve gastrectomy is one of the most common weight loss surgery procedures available. During a laparoscopic sleeve gastrectomy, 80% of the stomach is removed, leaving a narrow gastric sleeve. The surgeon performs the procedure by making four small incisions in the abdomen and using a video camera (laparoscope) and long instruments that are placed through these small incisions. No small intestines are removed or bypassed during gastric sleeve surgery. A laparoscopic sleeve gastrectomy procedure takes 45 minutes to complete. This procedure is not appropriate for patients with reflux of esophagitis. Patients can expect to lose 70-75% of their excess weight, which is defined as every pound above a person’s ideal body weight.
- Roux-en-Y Gastric Bypass:This procedure is the most common type of malabsorptive bariatric surgery — meaning it alters the digestive process. The Roux-en-Y gastric bypass involves connecting the stomach directly to the lower portion of the small intestine. This allows food to bypass segments of the digestive tract that absorb calories. It also makes the stomach smaller, which is considered a “restrictive” element of the surgery, making a person feel full. During a Roux-en-Y gastric bypass procedure, a bariatric surgeon creates a small pouch laparoscopically by dividing the upper portion of the stomach. That pouch is attached to a Y-shaped section of the small intestine, allowing food to bypass the lower stomach, as well as the first segment of the small intestine (duodenum) and the second segment (the first portion of the jejunum). A person can expect to lose 80-85% of their excess body weight with this surgery.
- SADI-S Surgery (single anastomosis duodenal ileal bypass with sleeve):This is a relatively new, simplified type of duodenal switch procedure endorsed by the American Society for Metabolic and Bariatric Surgery that is now available to select patients. Similar to gastric sleeve, SADI-S surgery involves a bariatric surgeon creating a smaller “tube” or “sleeve” shaped stomach. In addition, with SADI-S surgery, the bariatric surgeon attaches the smaller stomach directly to a more distal portion of the small intestine, which results in the absorption of fewer calories.
In addition, Penn Highlands Bariatric Surgery Program offers revisional surgery for appropriate candidates who experience complications from previous bariatric surgery or for those who have regained weight after a previous surgery. Laparoscopic and endoscopic approaches to revisional surgery are available depending on the patient’s situation.
In Pennsylvania, most commercial insurance companies and Medicare and Medicaid cover Gastric Sleeve Surgery and Roux-en-Y Gastric Bypass. Only one company, Cigna, covers SADI-S Surgery. Dr. Lundgren encourages anyone who is considering bariatric surgery to contact their insurance companies to be sure that their employer’s specific plan covers the surgery.
In order to determine which type of bariatric surgery is right for each individual, Dr. Lundgren talks with the patient to learn their motivation and personal goals. She considers their starting weight and BMI. She examines their complete medical history to determine if there are conditions, such as a hiatal hernia or reflux, uncontrolled diabetes or progressive fatty liver disease which would make one type of surgery a better option over another.
Three to six months prior to the surgery, people must meet with the four primary components of the program which include a surgical consult and physician-supervised weight management as well as successful completion of sessions with a registered dietitian and behavioral health professionals. In addition, all cancer screenings must be current. Additional screenings are required including sleep studies and preoperative lab studies. Use of tobacco or other ongoing substances must be stopped.
Following surgery, 99% of patients leave the hospital the next day and return to their normal activities in three to five days.
Mrs. Gray was the exception, “I felt so great after my surgery that the next day I was vacuuming my home.”
Most people feel great after surgery and experience few, if any, complications. However, excess skin is a common and almost unavoidable part of post-bariatric surgery. The sagging or excess skin is caused by several factors including the amount of weight loss, a person’s age and genetics.
“Some people experience discomfort from the excess skin. Also, rashes can develop underneath it causing painful irritation,” said Dr. Lundgren “Several of my patients are now ready for the skin removal and we refer them to a plastic surgeon.”
“I cannot over emphasize the sincerity, professionalism and kindness that Dr. Lundgren and her staff showed to me throughout the process,” said Mrs. Gray. “They all went above and beyond and helped me stay engaged. “Penn Highlands Healthcare Bariatric Surgery is a blessing!”
Dr. Lundgren continued, “The results of this program can be amazing for people who are motivated to lose excess body weight — particularly here in Clearfield County where the adult obesity rate is at 43%. I have witnessed the reversal of diabetes, high blood pressure, reflux, sleep apnea and fatty liver disease as well as the improvement of overall health and quality of life.”