Our surgeons use leading edge technology to perform innovative bariatric, general and colorectal surgeries designed to help patients achieve a healthier life.
Hernia Surgery
Hernias are simply a hole or defect in the wall of the abdominal cavity that allows protrusion of an organ or abdominal content through it. The fascia is a thick layer of tissue that keeps the contents of the abdomen in place. There are certain areas of the abdominal wall which are considered sites of weakness, these are inguinal, femoral and umbilical areas. The groin represents the area where approximately 75% of hernias develop.
Whether due to excess abdominal strain, age, genetics or congenital disorders, this tissue can weaken and intestinal contents may begin to push through. Most commonly, fatty tissue and loops of large intestine may push into, and ultimately become trapped in, the hernia defect.
GERD (Anti-Reflux Surgery)
Gastroesophageal reflux occurs when gastric juices from the stomach push up into the esophagus, irritating its sensitive lining. Gastroesophageal reflux disease or GERD is the medical term for chronic acid reflux – reflux that occurs several times per week for several weeks or months. GERD is estimated to affect upwards of 20 million Americans with millions more suffering from less frequent, but still significant, acid reflux symptoms.
GERD can occur due to intra-abdominal pressure that puts strain on the lower esophageal sphincter (LES), a muscle that acts much like a valve to keep stomach fluids where they belong. LES dysfunction can be treated with several options from lifestyle change and losing weight to surgical procedures like fundoplication or LINX Reflux Management System
Colorectal Surgery
Colorectal surgery is the subspecialty of general surgery that deals with diseases and conditions of the large intestine (also known as the colon), the rectum, and the anus. Colorectal diseases including cancer have become more prevalent in modern society, in part due to poor diets and the sedentary lifestyles most of us live. It is estimated that obese patients have a significantly higher risk of colon and rectal cancer than patients within a normal BMI.
Treatment for colorectal disorders varies based on the condition and its severity. Some concerns can be treated effectively with lifestyle changes while others may need surgery. Most importantly, you can take care of your colon by getting enough daily fiber, and staying well hydrated throughout the day, unless otherwise advised by your colorectal surgeon.
Gallbladder Disease
Typically, patients with symptomatic gallbladder disease begin to feel pain – whether dull or sharp – in the upper right quadrant of their abdomen, just under the rib cage. Gallstone issues are also characterized by an increase in pain shortly after eating. After consulting with a physician, a preliminary diagnosis typically requires a medical history and is confirmed with a simple ultrasound.
The most common symptomatic gallbladder disease involves gallstones that have blocked the outflow of bile. Gallstone attacks tend to worsen over time and as such, gallbladder removal, or cholecystectomy, is the preferred curative option. Gallbladder removal is one of the safest and most commonly performed surgical procedures in the United States.
Weight Loss Surgery
Weight loss surgery is the most effective long-term weight loss option for those suffering from morbid obesity, especially patients with a BMI over 40. While new GLP-1 agonist medications have shown promise in patients with relatively lower BMIs, weight loss surgery remains a relatively cost-effective option to help patients change their lives over the long term.
From sleep apnea to hypertension (high blood pressure) and hyperlipidemia (high cholesterol), metabolic surgery results in exceptional excess weight loss, averaging between 60 and 90% depending on the procedure. Resolution of co-morbid conditions is exceptional as well. MASJAX offers gastric sleeve, gastric bypass, and duodenal switch as our main surgical interventions for obesity.
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Lifestyle Changes Before and After Bariatric Surgery
Meet Our Team
Our surgical program has a dedicated team to follow you every step of the way. Your multi-disciplinary team includes surgeons, (bariatric) nurses, dietitians, mental health professionals, exercise specialists, bariatric advocates and other medical specialists who offer continuous compassionate support and guidance in a respectful environment.
The focus is to help each patient establish and achieve their goals.
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GLP-1 RAs: Transitioning from Meds to Surgery
GLP-1 medications have changed the way we approach weight loss, but they may not be enough for some patients. Still, they have a place in improving health outcomes both before and after bariatric surgery.
What GLP-1 RAs Can Do
GLP-1 receptor agonists (GLP-1 RAs) are changing the way many clinicians approach medical weight management. These medications work by mimicking a naturally occurring hormone that helps regulate blood sugar, slow stomach emptying, and signal fullness to the brain.
For patients with excess weight to lose, GLP-1 RAs can produce meaningful weight loss when paired with lifestyle changes such as improved nutrition and increased physical activity. In some cases, these medications help people establish healthier eating patterns and build confidence in their ability to manage weight.
GLP-1 therapies can also reduce the risk of complications linked to metabolic disease, and many individuals also see improvements in related health conditions, including high blood sugar, high blood pressure, and abnormal cholesterol levels. Patients with type 2 diabetes often benefit from improved glucose control, and some medications in this class have demonstrated cardiovascular benefits in high-risk populations.
What GLP-1 RAs Can’t Do
Despite their effectiveness, GLP-1 medications are not a cure for obesity, and their benefits typically continue only while the medication is being used. When therapy stops, appetite signals and metabolic processes gradually return to their previous state, and weight regain is likely to occur.
There are also limits in the amount of weight loss GLP-1 drugs typically produce. Results vary widely from person to person, and some individuals may not achieve the level of weight reduction needed to improve certain obesity-related conditions. Genetics, metabolic adaptation, existing health conditions, weight at the start of therapy, and long-term weight history influence how the body responds. It is also well known that many patients regain the weight after stopping GLP-1 medications.
For individuals with severe obesity or longstanding metabolic disease, medical therapy alone may not be sufficient to produce durable weight loss or fully address related health risks. In these situations, other treatment strategies may be considered.
When It’s Time for a New Approach
Body mass index (BMI) and overall health status help determine which treatment approach may be most effective. Individuals with higher BMIs – particularly those with obesity-related conditions such as type 2 diabetes, sleep apnea, or hypertension – may require more substantial and sustained weight loss to improve their health.
GLP-1 therapy helps initiate progress. Patients who use or have used GLP-1 medications consistently but are unable to reach or maintain sufficient weight reduction may benefit from exploring surgical treatments. Bariatric surgery is not a replacement for medical therapy, but rather another tool in the continuum of obesity care. It has great potential as part of a personalized strategy to achieve long-term metabolic health.
Note: GLP-1 medications need to be discontinued 10-14 days prior to bariatric surgery. Because of the effect of slowed gastric emptying, continuing these medications into surgery can raise your risk of complications. If you are taking GLP-1 drugs, let your doctor know so you can both plan your surgery accordingly.
Benefits of GLP-1 Therapy Before and After Surgery
We are increasingly seeing the benefits of GLP-1 RA use prior to bariatric surgery. Though it seems counterintuitive, some weight loss before the procedure is beneficial. Weight loss achieved through GLP-1 therapy can help lower surgical risk by improving blood sugar control, reducing liver size, and decreasing inflammation. Even modest weight reduction before surgery can make the procedure technically easier and support a smoother recovery.
GLP-1 therapy prior to weight loss surgery can also help patients build habits that support long-term success. Learning to recognize fullness cues, reduce portion sizes, and make healthier food choices prepares individuals for the lifestyle adjustments that accompany bariatric surgery.
We’re also recognizing the benefits of GLP-1 medications after surgery. Patients typically experience the most substantial weight loss in the first 12 to 18 months after surgery, along with improvements in obesity-related conditions. After this initial rapid weight loss, the body can go through metabolic adaptation. This is when the body adjusts to the lower weight by slowing metabolism and increasing hunger signals to conserve energy, and patients may notice a plateau or even weight regain.
GLP-1 RAs can help patients get back on track when this occurs. They can be used to help support additional weight loss, prevent weight regain, or address persistent metabolic conditions. When used thoughtfully, medication and surgery together can form a powerful, complementary approach to long-term weight management.
If you’ve been using GLP-1 medications but feel your progress has stalled, it may be time to explore the full range of treatment options. The bariatric specialists at MASJax will evaluate your health history, treatment goals, and current therapy to determine whether surgical care is the appropriate next step in your weight management journey. With the right combination of medical support and personalized care, lasting health improvements are possible. Reach out to the team to schedule your consultation.
MASJax is the longest-established bariatric program in the Jacksonville area, with a level of experience that sets the standard for care in the region. Our program holds a Center of Excellence designation through the American Society for Metabolic and Bariatric Surgery MBSAQIP program and is also recognized as a Blue Distinction Center for Bariatric Surgery, reflecting our commitment to the highest quality standards.
MASJax surgeons routinely perform advanced bariatric procedures, including sleeve gastrectomy, gastric bypass, duodenal switch, and complex revisional bariatric surgery. As specialists in minimally invasive techniques, we offer laparoscopic and robotically assisted procedures using the da Vinci Surgical System for appropriate patients.
