Weight loss surgery is a means of addressing obesity and works by reducing the body's intake of calories and absorption of fat. Since your stomach is smaller, you feel full faster and learn to reduce the amount that you eat at any given time and to avoid high-calorie food. Mather’s Bariatric Surgery Center of Excellence offers laparoscopic Roux-en-Y gastric bypass, gastric banding and sleeve gastrectomy surgery.
Many patients realize a new and active lifestyle after successful bariatric surgery. With increased mobility and energy many of our patients are now experiencing the joy of renewed connection with their families and loved ones. They participate in activities that their previous weight and overall health limited them from enjoying such as walking on the beach, hiking, biking, dancing and even sky diving.
Come to one of our free seminars for additional information.
Surgical Options
Gastric Bypass Surgery
Gastric bypass surgery is performed to help morbidly obese patients lose significant amounts of weight – without gaining it back. It is considered the "golden standard" for obesity surgery, with a success rate of more than 80 percent. Most patients lose at least half of their excess weight and keep it off for more than five years.
The Procedure The surgeon uses suture-like staples to create a pouch in the top of the stomach. The pouch is then connected directly to a section of the stomach called the Roux limb. The smaller stomach pouch restricts the amount of food that can be digested at any time and limits the body's ability to absorb fat from food by bypassing the majority of the stomach and some of the large intestine. This combination of restrictive and malabsorptive techniques makes the Roux-en-Y procedure one of the most successful gastric bypass surgeries.
Bypass surgery may take several hours to complete, and hospital recovery lasts 4-5 days. Patients who qualify for minimally invasive (laparoscopic) surgery have smaller incision scars, lower risk of hernias, less post-operative discomfort and a shorter recovery time.
The New Stomach After surgery, the stomach can hold about a tablespoon of food. This will expand over time but will not exceed one cup. A normal stomach holds one quart. Because the stomach size is substantially reduced, patients are limited in the amount of food they can eat in a single meal. They also don't suffer from constant hunger. Smaller meals eaten throughout the day are recommended.
One risk of gastric bypass surgery is vitamin and mineral deficiency and anemia. Regular meetings with your surgeon and a dietitian will be scheduled before and after surgery to establish a diet and exercise plan to determine whether nutritional supplements are necessary.
Gastric Banding
Gastric Banding requires the placement of an adjustable gastric banding system used to facilitate gradual weight loss in morbidly obese patients. This procedure involves the placement of a hollow doughnut-shaped tube around the upper part of the stomach, which is then filled with saline (salt water) to restrict the amount of food the stomach can hold.
The band works in two ways: it reduces the size of the stomach to hold less food and it limits the amount of food that can enter the stomach. This means you feel full faster, so you eat less and lose weight. This system is the only weight loss surgery approved by the FDA and the only adjustable and reversible procedure for long-term weight loss available in the U.S. Gastric Banding is generally considered to be the safest, least invasive and least traumatic of all weight loss surgeries.
Patients who undergo Gastric Banding surgery typically lose about 1 to 2 pounds a week, and lose up to 50 percent of their excess weight within the first year of surgery. It is important to maintain a healthy life after surgery in order to maximize and fully enjoy the results of the procedure. This includes a diet that is low in fat and calories, as well as regular daily exercise.
Candidates for the Gastric Banding Procedure The Gastric Banding system is not recommended for people who have disorders of the gastrointestinal tract (such as ulcers, esophagitis or Crohn's disease), heart or lung disease, or are pregnant.
Benefits of the Gastric Banding Procedure Adjustable The Gastric Banding can be tightened or loosened over time to let more or less food pass through and to regulate each patient's rate of weight loss. Reversible Although it is intended to be a permanent weight loss solution, the Gastric Banding can be removed, as it does not involve any serious alterations to intestinal organs. Removal can often be performed using the same laparoscopic techniques used to place the band. Minimal Trauma and Fewer Risks The Gastric Banding procedure involves no stomach cutting or stapling and no gastrointestinal rerouting, as opposed to gastric bypass surgeries such as the Roux-en-Y technique. This significantly lowers the mortality risk during surgery. Gastric banding patients also experience little to no risk of the nutritional deficiencies, hair loss or "dumping syndrome" associated with other weight loss surgeries. In fact, the gastric banding procedure has the lowest complication and mortality rate of any weight loss surgery.
The gastric banding procedure can usually be performed on an outpatient basis, and patients can return to work and other regular activities within a week.
You can also learn more about the gastric banding procedure and see an animation at www.lapband.com.
Sleeve Gastrectomy
Sleeve gastrectomy is a restrictive form of bariatric surgery that shrinks the stomach to approximately 15 percent of its original size. It is commonly performed on severely obese patients who are not healthy enough to undergo a successful gastric bypass, biliopancreatic diversion or similar major surgery. The procedure enables rapid weight loss with fewer complications than the more conventional weight loss surgeries, but its effectiveness loses stride because there is no intestinal bypass.
The surgeon’s instruments enter through a small incision and staple the stomach into a long tube to accommodate a greatly reduced volume. Once the “sleeve” is examined to ensure quality and no leakage or bleeding, the excess stomach tissue is then cut away. The removal of part of the stomach has a secondary effect of reducing the secretion of the hormone Ghrelin, which is responsible for inducing hunger.
Risks and Complications of Sleeve Gastrectomy As with any surgery, there are inherent risks to under going sleeve gastrectomy. First and foremost is the risk of infection; even though the size of the incisions used for this procedure is very small, there is always a possibility that bacteria will infiltrate the body.
Specific to sleeve gastrectomy, as well as most bariatric surgeries, is the risk of leakage and bleeding. The stapling and removal of stomach tissue generally fares well while it heals within the body, but issues can arrive if the surgeon isn’t precise with his suturing or poorly reexamines the new stomach before concluding the surgery. Also, due to the huge change in the size of the stomach, the patient may over ingest so severely that food attempting to enter the reduced cavity exacerbates these conditions before it is regurgitated.
Additionally, the narrow size of the stomach may be vulnerable to large chunks of poorly masticated (chewed) food getting stuck. Finally, because this is a relatively new procedure there are many novel issues that more popular forms do not endure, relating to insurance and ability to find a suitable doctor.
Advantages and Disadvantages of Sleeve Gastrectomy The following is a summary of the pros and cons of sleeve gastrectomy compared with other bariatric techniques:
Advantages:
No malabsorptive complications or related deficiencies
No risk of ulcer
Gastric dumping syndrome is largely avoided
Usually a laparoscopic procedure, reducing recovery time
Removes gland that secretes Ghrelin, hunger hormone
No foreign bodies (bands, tubes etc) permanently inside body
No “tightening” needed for further weight loss
Disadvantages:
Considered investigational or experimental by insurance companies
Relatively few doctors perform this surgery
Weight regain more likely
Irreversible
Recovery With any bariatric surgery procedures, it is crucial to change your dietary habits. After your procedure you will not be able to eat as much as you did prior to the procedure and will need to make smart food choices in order to take in your necessary vitamins and nutrients. Early diet modification will help you to sustain the changes long term. Our staff nutritionists are always available for questions and concerns that you may have as you progress with your weight loss.
Adhering to your follow-up visits is essential to long term success. You will be advised to see your surgeon one week, one month, three months, six months, one year and then annually after your surgery. These appointments are critically important to ensure that you are progressing well after your surgery.
