Bariatric Weight Loss Surgery Options

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There are two main types of bariatric surgery that help with weight loss:

  • Restrictive: This type of surgery limits the amount of food the stomach can hold. Restrictive surgeries include the gastric band (also known as lap band) and vertical sleeve gastrectomy (gastric sleeve).
  • Restricitve and Malabsortive: This type of surgery reduces the amount of food the stomach can hold and the amount of nutrients and calories that are absorbed. Gastric bypass is both restrictive and malabsortive.

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

Vertical Sleeve Gastrectomy

Vertical sleeve gastrectomy is a restrictive and irreversible procedure. It removes approximately 85% of the stomach, creating a slim banana-shaped stomach.

Although normal functions of the stomach are preserved, weight is lost because the amount of food that can be consumed is drastically reduced helping you feel fuller faster.

Roux En Y Gastric Bypass Surgery

In this procedure, the stomach is permanently divided into two. The top part becomes the newly created and smaller stomach, and the rest is closed and remains in place. 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 acid and other digestive juices.

The “new” smaller stomach is connected directly to the middle portion of the small intestine, thus bypassing the rest of the stomach and the upper portion of the small intestine.

Gastric bypass causes weight loss for two reasons:

  1. the amount of food you are able to eat at one time is restricted by the small stomach size
  2. food bypasses a portion of the small intestine where the absorption of nutrients occur

Weight loss occurs more quickly after gastric bypass than after purely restrictive procedures, but it also is considered a more invasive procedure.

Life-long follow up and strict adherence to the dietary guidelines set by your doctor and nutritionist are critical to a healthy and successful outcome.

Laparoscopic Adjustable Gastric Banding (Lap Banding Surgery)

This non-invasive, restrictive 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, which promotes weight loss.

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 regular office appointments, as adjustments to band tightness may be needed. 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.

This procedure is reversible.

Biliopancreatic Diversion with Duodenal Switch (BPD-DS) 

This procedure is offering new hope for some of the area’s heaviest and most at-risk patients. Sisters Hospital is the only local hospital where this complex procedure is performed.

BPD-DS is a restrictive and malabsorptive procedure that has two components. First, it restricts food by removing a large portion of the stomach and creating a small, tube-like stomach pouch similar to the popular sleeve gastrectomy procedure. Next, a large portion of the small intestine is bypassed which reduces the amount of calories, fat, protein and nutrients the body absorbs.

This surgery is usually performed on individuals who are classified as “super-obese,” those with a Body Mass Index (BMI) greater than 50 or a BMI of 40 with uncontrolled type-2 diabetes. The advantages of this procedure are that it not only changes the capacity of the stomach, but also reduces the hormones that affect hunger and increases the effects of feeling full. This procedure is very effective at improving existing health conditions like diabetes, and high blood pressure, and can provide a weight loss between 65 and 80% of the excess body weight.