About LewisGale Physicians General and Bariatric Surgery

Staffed by accomplished and highly skilled surgeons, our clinic specializes in general surgery and bariatric (weight loss) surgery. Our board-certified general surgeons treat a variety of chronic and acute conditions and injuries using minimally invasive, robot-assisted and traditional surgical procedures.

Our board-certified bariatric surgeon is highly skilled in a number of minimally invasive, laparoscopic weight-loss procedures and offers a comprehensive evidence-based clinical approach proven to provide the best long-lasting outcomes possible.

Our practice, conveniently located on the LewisGale Medical Center campus, serves the greater Roanoke Valley and other communities throughout Southwest Virginia.

For more information about our surgical services, call our office at (540) 772-3620. Schedule an appointment online by clicking on the healthcare provider of your choice.

Learn about the types of surgeries our surgeons perform:

A healthier you

Are you a candidate for bariatric surgery? Determine if you qualify with our online assessment.

About LewisGale Physicians Bariatric Surgery

Our Bariatric Surgical Program offers a comprehensive clinical approach to surgical weight loss management for morbid obesity. Our goal is to offer high-quality care and a comprehensive program that also includes nutritional counseling, support, and a follow-up plan to best accomplish weight loss after surgery.

We’re here to help.

You’re not alone in your journey. It’s only natural that you may have additional questions regarding your weight loss surgery. LewisGale Physicians, in collaboration with LewisGale Medical Center, has a dedicated bariatric team who will help support you every step of the way:

For more information about our bariatric surgery options, please contact our office at (540) 772-3620.

Weight loss procedures performed

Our bariatric team performs the following weight-loss surgical procedures.

  • Adjustable gastric band – A restrictive band is placed around the outside of the upper part of the stomach and adjusted over time to change the amount of food that will fit into the stomach.
  • Roux–en–Y gastric bypass – A small pouch is created from the stomach and connects directly to the small intestine.
  • Sleeve gastrectomy – Removes part of the stomach to make it smaller.
  • Bariatric revision surgery – Surgery performed to repair or change a previous weight loss surgery.

Learn more about these bariatric procedures, including the advantages of each.

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Patient testimonial

Check your BMI

See if you qualify for weight loss surgery by checking your BMI and taking our free bariatric surgery candidate assessment.

BMI Calculator

Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.





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All information provided by this website is intended to be general in nature and should not be used as a substitute for a visit with a health care professional. No information provided in this site may be considered medical advice. The information may not be relevant for your individual situation and may be misinterpreted. HCA assumes no responsibility for how you use information obtained from this site. Before making any decisions regarding your health care, ask your personal physician.

Weight loss surgery seminars

Join us in the Education Center Auditorium at LewisGale Medical Center for a free Weight Loss Surgery seminar to learn more about the latest surgical techniques for treating severe obesity, the procedures, and the steps necessary for you to achieve lasting weight loss. See our schedule of workshops for the remainder of this year.

Reserve your seat by calling (540) 772-3620 or registering online.

A step-by step guide to your journey toward a healthier life

The average patient researches weight-loss solutions for up to two years before committing to exploring bariatric surgery. Choosing to attend one of our workshops and an initial appointment will start your journey to improved health and wellness. You’ll receive a printed handbook at the workshop that will serve as a step-by-step guide. Click the tabs below to see a snapshot of the information we’ll cover and steps you can expect throughout your journey.

You’ll learn more about the:

  • Negative effects of obesity
  • Why it may be time to consider surgery
  • The digestive process
  • The different types of weight-loss procedures we perform, including the advantages and disadvantages of each
  • Complications and risks of all bariatric surgeries

The process leading up to surgery can vary somewhat depending on insurance requirements and the needs of the individual patient. Your pre-surgery visits will include:

  • Initial visit with your bariatric surgeon
  • At least four one-on-one visits with our registered dietitian
  • Psychological assessment and clearance with a qualified bariatric psychologist
  • At least one support group meeting which are offered monthly
  • Pre-authorization visit with your bariatric surgeon
  • Pre-op visit with your bariatric surgeon
  • Pre-surgery class
  • Additional visits as necessary
  • Pre-admission interview and diagnostic testing
  • Nicotine cessation if you smoke
  • Pre-surgical nutritional information
  • Pre-surgical diet, including behavioral changes to make before surgery
  • Pre-op vitamins
  • Additional instructions one- and two-weeks before surgery and the day before surgery

You’ll receive general guidelines on what to expect:

  • The day of surgery
  • After your surgery
  • Going home
What are the qualifications for surgery?

You must have a minimum BMI of 40, or at least 35 with medical comorbidities associated with obesity, such as diabetes, hypertension, obstructive sleep apnea, osteoarthritis, and high cholesterol. You must be committed to a lifestyle change to include dietary changes, increased activity, and long-term follow-up with your bariatric surgical team.

What are the different types of surgery offered?

Standardized operations include Gastric Banding, Roux-en-Y Gastric Bypass, and Vertical Sleeve Gastrectomy. All these surgeries are performed laparoscopically to minimize pain, hospital stay, cost, and patient recovery time. Sometimes it is also necessary to convert one surgery to another or revise a surgery to treat a complication. These are customized to meet each individual patient’s unique needs.

Which surgery is the right one for me?

The best operation for you is the one that you have chosen based on your knowledge of the risks, benefits, and alternatives. It is our job to educate and advise and to help you chose the one that will benefit you the most.

Are there better, safer alternatives?

The alternatives to surgery are those things that all patients should have diligently tried prior to considering surgery. These include diets, exercise, medications, and holistic programs that include combinations of these. When these prove ineffective at providing lasting weight loss, surgery should be considered. Even though there are risks involved with surgery, the benefits of weight loss far outweigh the risks, especially when you consider the risks of obesity itself, and the personal costs obesity brings in terms of reduction in quality of life.

How long does the process take and what are the steps?

The process includes trying to lose weight by other means first and, when this is unsuccessful, considering surgery. The first and best next step is to attend an informational workshop where we’ll discuss weight loss surgery in detail, the process, and our program. You’ll then meet with your surgeon for a complete medical and surgical history. Next, you’ll meet with a specially trained bariatric dietitian and qualified psychologist whose jobs are to prepare you for surgery and a lifestyle of success. There will be some medical workup individualized to each patient. When everyone says you are ready, you’ll meet with your surgeon to plan surgery. There is also a necessary insurance pre-approval process. The whole process, from the time you start in the surgeon’s office to the time of surgery, takes an average of six to eight months.

What are the risks of surgery?

The risks of surgery are many and include death, anesthetic complications, heart attack, stroke, pneumonia, blood clots, infection, bleeding, internal injury, surgical leaks, internal hernias, wound problems, strictures, and weight regain. We do all we can to reduce the risks of these complications, identify them accurately when they occur, and treat them appropriately and in a timely manner for the best outcomes possible. We partner with the patients and other medical practitioners to accomplish this.

What type of diet can I expect?

The diet after surgery changes over time to fulfill specific goals. Early after surgery you will be on a liquid diet consisting of protein shakes and non-calories liquids for four weeks. We then transition to soft, nutritious foods that don’t contain any sugar. We then move on to solid, high-protein, low-carbohydrate foods. The focus will be on meal-size, meal-consistency, and nutritional content. Eventually patients get to the point where they are eating three small meals per day to get all the nutrition they need to maintain health, well-being, energy levels, and weight loss. You will be eating good food - meals consisting of mostly meat and a little bit of cooked vegetables, and very little else.

What do you do with excess skin?

Our skin is our largest organ and is amazing in its ability to cover what it is supposed to cover. It grows with us and shrinks with us. Typically, as patients lose weight, the skin shrinks accordingly. The final outcome is affected by factors such as age, starting weight and shape, sex, and exercise. Many patients don’t necessarily like the looseness of the skin in the end, but most patients do not have enough to really bother with it. For those where excess skin really is a problem, skilled plastic surgeons can remove the excess. This is another major surgery with its own set of risks. We strongly recommend waiting at least two years before considering this, as this gives the skin and underlying tissues time to develop to the patient’s new, healthy, natural shape.

What is Dumping Syndrome?

Dumping syndrome is what occurs when patients eat foods containing too much sugar and sometimes fat. It occurs because the anatomic changes made with surgery allow rapid transit of undigested food into the small bowel. The small bowel cannot handle high concentrations of undigested sugar and/or fat and will try to get rid of it by all means necessary. This will include vomiting and diarrhea. The bowel will also draw water from the bloodstream causing cramping abdominal pain, fainting, and flushing. In addition, the sugar gets partially absorbed in its undigested form causing spikes in insulin levels. This will cause precipitously low blood sugar levels and all the symptoms associated with low blood sugar. These symptoms last until all the sugar has passed in one direction or the other. There is no treatment besides letting the symptoms pass and avoiding the foods that caused it like candy, cookies, and ice cream -- foods that should be avoided if you are trying to lose weight. This is a behavior modifier, one that forces a patient to avoid the problem foods that shouldn’t be eaten anyway.

Are there any long-term complications?

Yes, potential long-term complications are mostly nutritional. On the one side is the potential formal nutrition, vitamin and mineral deficiencies, and dehydration. On the other side is the potential for weight regain over time. All of these are avoided by good patient compliance with the diet, the taking of appropriate vitamins and minerals, follow-up with your bariatric surgeon, and nutritional labs when appropriate. All of this should be done in the setting of a multidisciplinary bariatric surgical program.

What about weight regain?

These surgeries are not fool-proof and require a compliant patient eating and drinking the way they are supposed to. There are essentially three ways a patient can overcome the restrictions of the surgery. First, they can snack their way through, and gain weight by consuming small amounts of high-calorie foods frequently. Second, they can overcome the mechanical restriction by consuming soft or liquid-type foods. Third, they can slowly stretch the stomach back to a size where they can consume enough to begin gaining weight again. All these can be avoided by maintaining proper meal frequency, consistency, size, and content.

What about low blood sugar?

The most common cause of low blood surgery after surgery is taking medications that lower blood sugar. These should be used with caution and are typically stopped completely after surgery. The next most common cause is the dumping syndrome, when patients eat something sweet, paradoxically lowering their blood sugar. The treatment is to NOT eat something sweet, as this will continue to cause the opposite effect. Drink a protein shake and wait it out - the problem will resolve itself. The answer is to avoid diabetes medicines and avoid foods that cause the dumping syndrome, thereby avoiding low blood sugars.

What if I’m having difficulty with the liquid diet?

This is a very common complaint. The answer is: this is a temporary but necessary part of the surgery process. Switch flavors. Switch brands. Play with temperature. Play with consistency. Take a break and try again in a few hours. But stick with the liquid diet. Eating food too early will make things worse. Dehydration will eventually set in and make it worse. Once this happens, you’ll have to go to the ER for evaluation and IV fluids.

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LewisGale Physicians General Surgery

Our general surgeons specialize in several types of surgical procedures for the treatment of a variety of conditions. Surgical procedures include minimally invasive, robot-assisted, and traditional methods. Surgical procedures performed by our highly skilled experts range from minor and commonly performed surgeries, such as biopsies, debridement, and hemorrhoid removal, to highly complex and specialized surgeries including Whipple and other hepato-pancreato-biliary procedures used to remove cancerous and diseased organs.

To schedule an appointment, ask your physician for a referral or call our office at (540) 772-3620.

We specialize in the following procedures:

  • Abdominal surgery
  • Adrenalectomy
  • Anti-reflux procedures
  • Appendectomy
  • Biopsy
  • Cholecystectomy
  • Colon surgery
  • Dermatology skin grafts and cancer removal
  • Endocrine surgery
  • Esophageal surgery
  • Gallbladder removal
  • Gastrectomy
  • Hemorrhoidectomy
  • Hepatobiliary procedures
  • Hernia repair
  • Laparotomy
  • Lipoma removal
  • Liver and pancreatic procedures
  • Lumpectomy
  • Mastectomy and reconstruction
  • Proctocolectomy
  • Pyloromyotomy
  • Rectal procedures
  • Sigmoidectomy
  • Small and large intestine partial removal
  • Splenectomy
  • Stomach ulcer surgery
  • Tonsillitis
  • Urinary stone procedure
  • Varicose vein procedures of lower extremity
  • Whipple surgery for pancreatic cancer
  • Wound care

Managing your care with Health Portal

Health Portal facilities better communication with your physician's and provider's office from the comfort and privacy of your home or office.

Access Health Portal

Other patient resources