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Home » Services » Bariatric Surgery » Bariatric Surgery Options

Bariatric Surgery Options

Catholic Health performs gastric bypass surgery, lap banding surgery, and vertical sleeve gastrectomy.

Roux En Y Gastric Bypass Surgery

Roux en Y Gastric Bypass is considered the gold standard in weight loss surgery procedures. Catholic Health is a leader in patient safety and surgical experience, with over 4,000 gastric bypass procedures performed.

In this procedure, the stomach is permanently divided into two. The top part becomes the stomach pouch, or the newly created stomach, and the rest is closed and remains in place, along with its lower end connection to the small intestine. This portion now becomes the bypassed portion of the stomach; it will not receive what is eaten, but it will continue to assist with digestion by producing gastric and other digestive juices.

The lower part of the small intestine is brought up and stapled to the stomach pouch to create a shortened digestive tract.

Gastric bypass causes weight loss for two reasons: calories are restricted by small stomach pouch size, and because the bypass malabsorption of nutrients occurs.

Weight loss occurs more quickly after gastric bypass than after purely restrictive procedures, but it also is considered a more invasive procedure. Although our mortality rate after gastric bypass is very low (<0.3%), the risk of serious complications should be considered.

It is critical that patients adhere to specific nutrition guidelines, which focus on:

protein at every meal,
4-6 small meals daily,
avoidance of high-fat, high-sugar foods, and
daily bariatric vitamin and mineral supplements.

Lifelong supplementation and regular follow up are required for the best outcomes.

Gastric Bypass Surgical Techniques

Open Surgery

Open surgery uses a single incision in the abdomen to perform the gastric bypass procedure. The incision enables short operating time and access to surgery in patients with large BMIs.

Laparoscopic

This technique uses small instruments guided by views from a tiny video camera to perform the surgery. Instruments are placed through small incisions on the belly. This enables fast recovery and less pain.

Robotic Assisted Laparoscopy

Dang Tuan Pham, MD, a Catholic Health surgeon at Sisters of Charity Hospital, is the first physician in Western New York to successfully perform a Roux-en-Y gastric bypass procedure using the advanced minimally invasive robotic technology of the da Vinci® Surgical System.

“Gastric bypass surgery is one of the most challenging laparoscopic surgical procedures,” says Dr. Pham. “The enhanced precision of the da Vinci® System offers several benefits for patients and enhances patient safety. It reduces the risk of complications, is less painful, and allows the patient to recover sooner than traditional gastric bypass surgery.”

Gastric Bypass Facilities

Sisters of Charity Hospital (Buffalo)

Laparoscopic Adjustable Gastric Banding (Lap Banding Surgery)

This non-invasive, restrictive and reversible procedure places a hollow, silicone ring, or band, around the main portion of the stomach, and a port is secured under the skin of the abdomen.

The band creates a small passageway between the uppermost part and the rest of the stomach. This narrow passageway restricts the amount of food required to feel "full," so less is eaten.

Weight loss occurs gradually over a period of 18 months to 3 years, as multiple adjustments to band tightness occur.

The degree of stomach restriction is controlled by the amount of fluid in the band. Band fluid is adjusted with the injection or removal of fluid through the port. Both the band and the port remain in place until surgically removed.

Patients can expect multiple adjustments and office appointments, especially during the first few years. Regular follow-up is mandatory and supplementation is commonly needed for as long as the band is present.

One of two devices may be used in restricting the stomach: the LAP-BAND® System or the REALIZE™ Adjustable Gastric Band.

Lap Banding Surgical Techniques

Laparoscopic

Single-incision Laparoscopy

SILS is a minimally invasive technique that uses a single incision to accommodate laparoscopic equipment. This small 20mm incision in the patient’s belly button, leaves little or no visible scarring.

Dang Tuan Pham, MD is the first physician in Western New York to successfully place a lap band in a patient using Single Incision Laparoscopic Surgery (SILS).

Lap Banding Facilities

Sisters of Charity Hospital (Buffalo)
Sisters of Charity Hospital, St. Joseph Campus (Cheektowaga)

Vertical Sleeve Gastrectomy

Vertical sleeve gastrectomy is a purely restrictive and irreversible procedure in which approximately 85% of the stomach is cut and removed, creating a slim banana or tubular shaped stomach.

Although normal functions of the stomach are preserved, weight is lost because the amount of calories that can be digested is drastically reduced. And patients feel fuller faster because the newly-created tubular shape creates resistance to volumes of food.

Sleeve gastrectomy can be performed as a weight loss procedure itself, but it also can be the first part of two planned procedures for very high BMI patients who may be at increased risk for other bariatric procedures like gastric banding or gastric bypass. Although this procedure is not widely performed in the United States and insurance coverage may not be available, it has demonstrated great success in other countries with weight loss, resolution of obesity-related illnesses, and patient safety.