Obesity is the second leading cause of preventable death in the U.S.A. For people who are over 100 pounds overweight and have tried and failed every diet on the market, Bariatric Surgery may be the answer. It can help reduce and sometimes eliminate the problems associated with Morbid Obesity, such are Diabetes, Hypertension, Sleep Apnea and many more.

Bariatric Surgery is a weight loss tool and an effective treatment for Morbid Obesity; the lives of patients after surgery improve dramatically; it also has its risks and it is very important to consider each risk before making a final decision. 

At our Center, we offer three Bariatric Procedure, Gastric Bypass, Lap-Band and Sleeve Gastrectomy.

Laparoscopic Gastric Bypass

The Roux-en-Y Gastric Bypass procedure involves creating a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach, duodenum and small bowel. By having a small pouch, the food intake is decreased significantly and by skipping the duodenum and part of the small bowel, fat absorption is substantially reduced. The procedure is performed laparoscopically with minimally invasive techniques. This procedure is a more complex operation with higher risk and possible side effects, but a much higher success rate, with 80% of patients losing at least half their excess weight.

The laparoscopic Gastric Bypass is considered the gold standard surgery for morbid obese patients.

Lap-Band

The Lap-Band System is the least invasive weight loss surgery available. It is an adjustable silicone ring that is placed around the upper part of the stomach creating a small pouch that only holds a small amount of food; this allows the patient to feel full faster and to eat less as a result.

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Laparoscopic Sleeve Gastrectomy

The Gastric Sleeve procedure - or Sleeve Gastrectomy - is an operation in which the left side of the stomach is surgically removed. This results in a new stomach, which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Lap-BandR procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.

For certain patients, in particular those with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a 2-stage operation. The 2-stage operation may have substantial advantages for specific individuals.

Low BMI individuals who should consider this procedure include:

• Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency.
• Those who are considering a Lap-Band® but are concerned about a foreign body inside the abdomen.
• Those who have medical problems that prevent them from having weight loss surgery such as anemia, crohn's disease, extensive prior surgery, and other complex medical conditions.
• People who need to take anti-inflammatory medications may also want to consider this. Usually, these medications need to be avoided after a gastric bypass because the risk of ulcer is higher.
• It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass. The weight loss seems to be a little better and more rapid than the lap band (60 - 70% EWL) over two years. There is still no long-term data.

What advantages does it have?

• It does not require disconnecting or reconnecting the intestines.
• It is a technically simpler operation than the gastric bypass or the duodenal switch.
• There is no foreign body inside your body.
• It does not need adjustments or fills.
• It may be a safer operations for patients with a body mass index (BMI) more than 60. It may be used as the first stage if a 2-stage operation. (see below)

What is a 2-Stage Operation?

Certain patients may have a body shape that makes their surgery more technically difficult. For example, patients with a BMI over 60 -- particularly those who carry their weight in their belly area -- may be at increased risk for bariatric surgery. If you fall into this category, you may benefit from a 2-stage bariatric surgery.

In the staged approach, a multi-step operation like the gastric bypass or the duodenal switch is broken down into 2 simpler and safer operations. In the first stage, a sleeve gastrectomy is performed. This allows to lose 80 to 100 pounds or more, which will make the second part of the operation substantially safer.

The second stage operation is usually performed 8 to 12 months after the first. The "sleeve" stomach is converted into a formal gastric bypass or duodenal switch. This will permit additional weight loss and will provide a much more permanent result than sleeve gastrectomy alone.

Both stages of the surgery can be performed laparoscopically, giving the advantage of shorter recovery, shorter incisions fewer incision-related problems and less pain.

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