Surgical Solutions

The sleeve gastrectomy is performed laparoscopically, using special instruments inserted through small abdominal incisions. With this procedure, a large portion of the stomach (80-85%) is removed so that the stomach becomes a long tube or sleeve. A smaller stomach means patients eat less. There is no re-routing of the intestines. The sleeve gastrectomy procedure has been done as a stand-alone bariatric procedure for nearly a decade.

Advantages:

• Restricts the amount of food the stomach can hold
• Causes changes in gut hormones that decrease hunger, reduce appetite and improve satiety (fullness)
• If needed, anti-inflammatory medication use as directed by provider is an option

Disadvantages:

• Can lead to long-term vitamin deficiencies
• Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up visits
• Increased risk of ulcer formation with use of nicotine, excess caffeine, and alcohol

Named after Swiss surgeon Cesar Roux, the gastric bypass Roux-en-Y procedure can be performed laparoscopically as well.  A small stomach pouch is created by stapling off a section of the stomach, decreasing the amount of food taken in. Then, a Y-shaped part of the small intestine is attached to the stomach pouch, so that food can bypass the first section of the small intestine (duodenum). The bypassing of the lower stomach and portion of the small intestine makes this surgery both a restrictive and malabsorptive procedure. The gastric bypass Roux-en-Y procedure is considered the gold standard due to the fact it has been around for over 45 years.

Advantages:

• Restricts the amount of food the stomach can hold
• May create an increase in energy expenditure
• Causes changes in gut hormones that reduce appetite and improve satiety (fullness)

Disadvantages:

• Can lead to long-term vitamin deficiencies
• Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up visits
• Cannot use medications such as NSAIDS (ibuprofen), steroids, and arthritis medications
• More prone to dumping syndrome
• Significant risk of ulcer formation with use of nicotine, excess caffeine, and alcohol

Adjustable Gastric Band Management

With this procedure, a hollow band is placed around the stomach near the top, creating a small pouch that holds about two ounces of food at a time. Our surgery center does not place the gastric band but we are more than happy to assist with management of an already placed band.  If you are having complications, we are able to evaluate and discuss potential conversion surgeries.

The intra-gastric balloon is a managed weight loss system for patients with a BMI ≥30 and ≤40 kg/m², who have tried other weight loss programs, but were unable to lose weight and keep it off. It is a non-surgical outpatient procedure, where a durable gastric balloon made out of soft silicone is placed in your stomach. The balloon is filled with a sterile solution to about the size of a grapefruit. The balloon is in place for six months and it encourages your body to adapt to healthier portion sizes.

Advantages:

• Restricts the amount of food the stomach can hold
• Non-surgical procedure that is not permanent

Disadvantages:

• Requires adherence to dietary recommendations, vitamin/mineral supplementation while the balloon is in place, and follow-up visits
• Not covered by insurance 

Occasionally, patients who have had previous bariatric surgery will require additional surgery to correct problems or complications associated with their initial bariatric procedure. Our surgeons are experienced in surgeries to either repair the complications or, if the condition warrants, convert the procedure to a different one.