Weight-Loss Surgery Options
While there are several weight-loss procedures available, no single procedure is the best choice for all cases. A patient's medical history, current medical conditions and other factors must be assessed carefully. Long-term success with any weight-loss procedure also depends on the patient’s adaptation to a healthier lifestyle, which includes eating smaller portions, exercising daily and taking vitamins and supplements.
The weight-loss surgeons at Doctors Hospital offer the following surgical options:
Laparoscopic Roux-en-Y Procedure (Gastric Bypass)
Laparoscopic gastric bypass is a minimally invasive procedure in which a one-ounce stomach pouch is created and attached to the small intestine. This restricts patients to eating smaller portions of food, increasing satiety and reducing absorption. Most patients can expect to reduce their excess body weight by 80 to 85 percent over 18 months.
Medical conditions such as diabetes, hypertension, hyperlipidemia and sleep apnea are often dramatically improved. Patients who have this procedure may experience negative effects if they eat too many simple sugars, fats or overly processed foods. There is a one percent risk of ulcer formation in the pouch, especially if the patient takes NSAIDs (non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen) or smokes. The risk of iron deficiency in menstruating women is possible.
Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy has proven to be a very successful minimally invasive procedure in which 70 to 80 percent of the stomach is removed. This reduces hunger and increases satiety with smaller portions of food. Patients may expect an excess body weight loss of 70 percent. There is less than one percent chance of leakage within the first 30 days. The advantage of a gastric sleeve over gastric banding surgery is that there is no foreign body implanted, and unlike gastric bypass, there is less change in the absorptive capacity of nutrients. The sleeve offers dramatic improvements in health, often including diabetes and hypertension resolution.
Laparoscopic Adjustable Gastric Band
Laparoscopic Adjustable Gastric Banding surgery is the least invasive bariatric procedure and does not require the surgeon to cut or reattach any part of the stomach or small intestine. This procedure helps patients lose weight by limiting the amount of food their stomachs can hold using an adjustable band. Most patients can expect to lose 55 to 60 percent of their excess body weight over 18 months. With weight reduction, patients may also see an improvement in obesity-related medical conditions such as diabetes or sleep apnea. In some cases, the surgeon may even remove the band once the patient's target weight is reached.
With this procedure, there is no effect on the absorption of nutrients. The restrictive capacity of the band may be adjusted by injecting or withdrawing fluid through the port. The success of this device depends greatly on good patient compliance and maintenance. Potential complications include band slippage, erosion and failure of the device.
Duodenal Switch Surgery
In this procedure, surgeons remove a portion of the stomach and create a smaller stomach pouch, similar to sleeve gastrectomy. Next, the distal (last portion) of small intestine is then brought up and connected to the newly created stomach. When a patient eats, about three-fourths of the small intestine is bypassed by the food stream. The part of the small intestine that is bypassed is reconnected to the last portion of the small intestine so they can eventually mix with the food stream. Like other weight-loss surgeries, duodenal switch helps reduce the amount of food consumed; however, this effect lessens over time and patients can eventually eat near “normal” meals. This procedure has a greater complication rate and requires a longer hospital stay.
Because weight-loss surgery reduces the stomach size, excessive weight gain caused by a lapse in dietary or exercise regimes or problems from the surgery itself, is not good for the patient. Excessive weight can cause the stomach pouch or enlarged stomach outlet to stretch, causing harm to the body. In these cases, surgeons may recommend revision surgery to correct the original weight-loss procedure or convert the existing surgery to another form of bariatric treatment.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if bariatric surgery is right for you.
Doctors Hospital Weight Loss and Wellness Center
230 Calle del Norte