Surgical Weight Loss Procedures

Before deciding on a particular surgical weight loss procedure, a consultation with the surgeon is held to determine what method will provide the best, most effective results for the patient. The following is information on the three most common procedures, gastric bypass surgery, laparoscopic gastric banding and the laparoscopic sleeve gastrectomy procedure.

Gastric Bypass Surgery
In the United States, the most commonly performed obesity surgery is called “roux-en-Y gastric bypass.” Doctors choose this particular procedure because it has a high rate of effectiveness and a lower rate of complications.

During the operation, surgeons close off part of the stomach, creating a small pouch. They then attach part of the small intestine to the pouch. This reduces the amount of nutrients and calories your body is able to absorb.

As with any type of operation, bariatric surgery does have complications that may arise, including infection, tearing or leaking of the stitches and formation of blood clots. There are also long-term complications that may occur, such as malnutrition due to the decreased capacity of the intestine to absorb nutrients.

After the surgery, you need to limit yourself to eating only ½ to 1 cup of food at a time—for the rest of your life. You also will have to strictly limit sugar and fat, because eating too much of these foods—candy and other desserts, chips, etc.—can cause you to feel severe stomach cramping.

The screening process to identify who is a good candidate for the surgery varies from doctor to doctor, but in general, most patients have to meet the following criteria to qualify:
A body mass index (BMI) of 35 to 40 with some of the complications of obesity, such as diabetes, high blood pressure, sleep apnea and high cholesterol
A BMI over 40 with no complications of obesity
Proof that you’ve tried and failed to lose weight numerous times
Bariatric surgery is a tool that people have used to get them back on track to lead a healthy lifestyle. It’s not a quick fix. But for people who have tried and failed to lose weight, over and over again, the surgery offers a new option.

Laparascopic Adjustable Gastric Band
The St. Elizabeth and St. Joseph Surgical Weight Loss Center offers gastric banding. The adjustable gastric band is designed to help patients lose excess body weight, improve weight-related health conditions and enhance quality of life.

Gastric band surgery involves placing a silicone ring around the upper part of the stomach. The band reduces stomach capacity and restricts the amount of food that can be consumed at one time. The band is adjustable allowing for individualized degree of restriction needed for ideal rate of weight-loss. The procedure is minimally invasive which means there is no large incision.

And since there is no stomach cutting, stapling, or gastrointestinal re-routing involved in the gastric banding procedure, it is considered the safest, least invasive, and least traumatic of all weight-loss surgeries. The laparoscopic approach to the surgery also has the advantages of reduced post-operative pain, shortened hospital stay, and quicker recovery.

Laparoscopic Sleeve Gastrectomy:
The sleeve gastrectomy restricts meal size by reducing the full-size stomach to a long, slender tube. The banana-shaped tube has a diameter about the size of your thumb. The remaining part of the stomach is removed during the procedure. Like any laparoscopic procedure, there are several small incisions instead of one long incision site.
Weight loss results with the sleeve will vary and can range from 33% to 83% of excess weight in the first 1 to 2 years after surgery.

One advantage of the sleeve is that there is no cutting or stapling of the intestines. The procedure also preserves the normal stomach sphincter which results in a lower incidence of ulcers than gastric bypass. Because the sleeve does not involve a bypass of the small intestine, there are generally fewer nutritional deficiencies with the sleeve than the gastric bypass.

Disadvantages of the sleeve include that it is irreversible and non-adjustable. Cutting and stapling of the stomach is involved. Some patients complains of nausea after surgery, but this can be controlled with medication.

Early risks of the sleeve gastrectomy are similar to gastric bypass and include bleeding, infection and staple line leaks. Some later risks include hernias at the incision sites, and vitamin and mineral deficiencies, especially B12 and iron. Dietary non-compliance can also lead to dehydration, severe constipation, nutritional deficiencies and malnutrition.