Center for Bariatrics
About Our Bariatric Procedures
Also known as weight-loss surgery, bariatric surgery requires just one surgery but offers an option between three different procedures – Gastric Bypass, Gastric Band, and Sleeve Gastrectomy – performed on patients who are morbidly obese and have failed to achieve and sustain weight loss by non-surgical methods. These methods include diet, exercise, drug therapy and combination therapy. Many of these patients have multiple severe medical problems (“co morbidities”) related to their weight. Only surgery has been shown to promote significant and sustained weight loss for these individuals and, in doing so, improve or eliminate most of these co morbidities.
Advantages of Bariatric Surgery
- A 2004 analysis of more than 22,000 patients showed that those who underwent a bariatric surgical procedure experienced complete resolution or improvement of their co-morbid conditions including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea.
- 83.7 percent of type 2 diabetes cases were resolved in the studies analyzed, the control group that didn’t have bariatric surgery was at a higher risk for type 2 diabetes: 3.7 times higher.
- Resolution of type 2 diabetes often occurred within days of the surgery.
- 96.9 percent of hyperlipidemia cases were resolved.
- 75.4 percent of hypertension cases were resolved; 87.1 percent were resolved or improved.
- Substantial weight reduction occurred; 61.6 percent of excess weight was lost.
- In 2000, a study of 500 patients showed that 96 percent of co-morbidities (the study looked specifically at back pain, sleep apnea, high blood pressure, type 2 diabetes, and depression) were improved or resolved.
- A great deal of excess weight was lost, and patients experienced resolution of co-morbidities, and improved appearance, social opportunities, and economic opportunities.
Bariatric Surgery can help patients achieve weight loss by either restricting the amount of food they can eat or by inducing a degree of malabsorption so that not all of the food eaten gets utilized. At the Bariatric Center at Southern Ocean Medical Center we offer patients those procedures which are proven to be safe and effective.
Laparoscopic Sleeve Gastrectomy: A Restrictive Procedure
Laparoscopic Vertical Sleeve Gastrectomy is a bariatric procedure that offers an excellent alternative to both gastric bypass and adjustable gastric banding. Sleeve gastrectomy works mainly by reducing stomach volume. During surgery, the stomach is divided vertically and 80 to 85 percent of it is removed. What is left is a long vertical “sleeve” that is shaped like a banana. The nerves to the stomach and the outlet valve (pylorus) remain intact to preserve the functions of the stomach while reducing the volume it is able to hold. There is no intestinal bypass with this procedure, only reduction in stomach capacity. The portion of the stomach that is removed contains cells that produce a hunger hormone, Ghrelin. By reducing Ghrelin production, a person’s appetite is markedly reduced.
Patients who may benefit from this procedure over other procedures include those who have previously had small bowel surgery, and patients who prefer not to or cannot have an implanted device (band) or a malabsorptive (bypass) procedure.
- A normally functioning stomach with reduction in size / volume allowing normal absorption of most foods and medications, unlike gastric bypass.
- The elimination of the portion of the stomach that produces a hormone that stimulates hunger.
- No “dumping syndrome.”
- Reduced chance of anemia, osteoporosis, protein deficiency, and vitamin deficiency.
- An option for people with existing anemia, Crohn’s disease, and numerous other conditions that make them too high risk for intestinal bypass procedures or procedures that require implants (gastric banding).
- The smaller portion of the stomach may stretch
- The possibility that leaks and other complications will occur since this procedure does involve stomach stapling.
- A procedure that is not reversible.
Laparoscopic Gastric Banding: A Restrictive Procedure
The Laparoscopic Adjustable Gastric Banding procedure is a purely restrictive surgical procedure in which a band is placed around the uppermost part of the stomach. This band divides the stomach into two portions: one small and one larger portion. Since the stomach is divided into smaller parts, most patients feel full faster. As the name indicates, the band is adjustable. So if the rate of weight loss is not acceptable, the band can be adjusted. Food digestion happens through normal digestion.
- Least invasive surgical option
- No intestinal re-routing
- No cutting or stapling of the stomach wall or bowel
- Small incisions and minimal scarring
- Reduced patient pain, length of hospital stay and recovery period
- Removable/ Reversible
Fewer Risks & Side Effects
- Reduced risk of hair loss
- No “dumping syndrome” related to dietary intake restrictions
- Allows individualized degree of restriction for ideal rate of weight-loss
- Adjustments performed without additional surgery
- Supports pregnancy by allowing stomach outlet size to be opened to accommodate increased nutritional needs
Risks & Disadvantages
- The access port may leak or twist, which can require an operation to correct the problem.
- Surgery may not provide the necessary feeling of satisfaction that one has had enough to eat.
- Band may erode into the stomach wall.
- Band may move or slip.
- Weight loss is slower than that following Roux-en-Y gastric bypass surgery.
Roux-en-y – Gastric Bypass Surgery: A Restrictive and Malabsorptive Procedure
According to two organizations, the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y (pronounced ROO-en-why) gastric bypass surgery is the most popular bariatric surgery in the United States.
In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” for food. The bypass allows food to skip parts of the small intestine. By skipping a large part of the small intestine, the body cannot absorb as many calories or nutrients.
- Rapid weight loss
- Maximized weight loss
- Sustained weight loss
Risks & Disadvantages
- Because the duodenum and other sections of the small intestine are bypassed, poor absorption of iron and calcium can cause low total body iron and a greater chance of having iron-deficiency anemia. Patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids should be aware of the chance of iron-deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the possibility of increased bone calcium loss. By taking a multivitamin and calcium supplements, patients can maintain a healthy level of minerals and vitamins.
- Bypassing the duodenum can cause metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hipbones. Eating foods rich in nutrients and taking vitamins can help patients avoid this.
- Chronic anemia due to vitamin B12 deficiency may occur. The problem usually can be managed with vitamin B12 pills or injections.
- A condition known as dumping syndrome can occur from eating too much sugar or large amounts of food. While it isn’t considered a serious health risk, the results can be very unpleasant. Symptoms can include vomiting, nausea, weakness, sweating, faintness, and, on occasion, diarrhea. Some patients are unable to eat sugary foods after surgery. The bypassed portion of the stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are problems such as ulcers, bleeding, or malignancy.
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