Our Procedures

Gastric Bypass

Gastric Bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. The most common gastric bypass surgery is a Roux-en-Y Gastric Bypass. The stomach is made smaller by creating a pouch at the top of the stomach. The smaller stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine. Most people return to their normal activities within 2 to 4 weeks after Gastric Bypass surgery. The result of the surgery is that you will feel full more quickly than when your stomach was its original size. This reduces the amount of food you eat and the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. It is important to remember surgery may require you to make several changes in how you eat, such as eating only a few ounces of food at a time because the surgery creates a much smaller stomach.

Gastric Bypass Facts: Technically a higher risk surgery. On average 70%-80% excess weight loss at one year. Faster resolution of co-morbidities. Non-reversible.

LAP-BAND^® Surgery/REALIZE^™ Band

Laparoscopic banding is the only procedure available in the U. S. that is adjustable and completely reversible.

By reducing the capacity of the stomach, the LAP-BAND/REALIZE Band restricts the amount of food that can be consumed.

Since there is no cutting, stapling or intestinal rerouting involved, this surgery is considered the least traumatic of all weight loss surgeries. The laparoscopic approach to surgery generally means less post-operative pain and quicker recovery. Like a wrist-watch, the Lap-Band is fastened around the stomach. As a result, you experience an earlier sensation of "fullness" and are satisfied with smaller amounts of food.

Because the LAP-BAND/REALIZE band is adjustable, it can work with your individual needs. For example, pregnant patients can have fluid removed from their band to allow for adequate nutrition, and patients who aren't experiencing significant weight loss can have their bands tightened.

LAP-BAND/REALIZE Band Surgery Facts: Technically lower risk. On average 36%-40% excess weight loss at one year. Average of 60%-65% excess weight loss at 3-5 years. Reversible.

What you need to know about LapBand/Realize Band: As of February 2011, the LAP-BAND system is now the first and only FDA-approved device for bariatric surgery in patients with a BMI of 30-35 and one or more obesity related co-morbid conditions.

Sleeve Gastrectomy

The Sleeve Gastrectomy (also known as Gastric Sleeve surgery) is sometimes the best solution for those who are concerned about the potential long-term side effects of a Gastric Bypass. Gastric Sleeve involves resecting the portion of the stomach responsible for making the hormone grehlin, which is a major contributing hormone to feeling hunger. Most sleeve gastrectomy patients have a markedly diminished appetite immediately after surgery. People who need to take anti-inflammatory medications may want to consider this. Typically, these medications need to be avoided after a Gastric Bypass because the risk of developing ulcers from these medications may increase.

Gastric Sleeve surgery generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by dividing it vertically. This part of the procedure is not reversible. The stomach that remains is shaped like a banana. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded.

Sleeve Gastrectomy Facts: Lower risk than Gastric Bypass. Higher risk than LAP-BAND/REALIZE Band. Long- and short-term weight loss between Band and Bypass. No dumping syndrome. No need for Band fills.

Revisional Surgery

The surgical treatment for failed or dysfunctional weight loss operations.

Revisional bariatric surgery is the surgical treatment for failed or dysfunctional weight loss operations. There are several reasons why patients may seek out revisional bariatric surgery. For some, a weight loss procedure may yield less-than-optimal results, either through inadequate weight loss, inadequate resolution of co-morbidities or by medical complications specifically related to their weight loss surgery.

The decision to undergo revisional bariatric surgery is not one to be taken lightly. As in any other procedure, the decision lies in weighing the risks against the benefits. Revisional bariatric procedures are higher risk than first-time bariatric procedures. They are typically longer procedures, often, but not always, through open incisions with greater blood loss and a higher incidence of leak and infection. The higher leak rate is thought to be a result of microscopic changes in blood flow to the stomach, induced by the original surgery.

The Result

While there are times revisional bariatric surgery is medically necessary and beneficial, revisional procedures are best approached on a highly individualized basis, tailoring weight loss surgery to the patient's unique and specific needs.

Sometimes, results of revisional procedures done to further weight loss are less than optimal because weight loss results of revisional surgeries do not seem to be as high as when the surgery was performed as a first-time procedure. This phenomenon is metabolic in nature – the body appears to undergo metabolic adaptation to the first bariatric surgery, making subsequent weight loss more difficult. Further, patients who are particularly metabolically stubborn are more likely to fail a first-time weight loss procedure in the first place.

Other Facts

• Higher risk than first time bariatric procedures
• Varied weight loss results
• Subsequent weight loss is more difficult