Weight Loss (Bariatric) and Metabolic Surgery

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What to expect after Bariatric Surgery 

The estimated weight loss with sleeve gastrectomy is approximately 65% of one's excess weight.  With gastric banding estimated weight loss is approximately 40 - 50% of one’s excess weight, which may be achieved over two years.

Keep in mind that weight loss surgery is not a quick fix. To be successful, your surgery must be followed by lifestyle changes in eating and behavior.

Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass Surgery is the most common and successful combined procedure in the United States. It is considered the ‘gold standard’ of bariatric surgery.

First, we create a small stomach pouch to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs.

Most patients lose weight quickly and continue to lose for 18 to 24 months after the procedure. With the Roux-en-Y gastric bypass, many patients maintain a weight loss of 75 to 85 percent of their excess weight for 10 years or more. Because combined operations result in greater weight loss than restrictive operations, they may also be more effective in improving the health problems associated with severe obesity, such as hypertension (high blood pressure), sleep apnea, type 2 diabetes, and osteoarthritis. Combined procedures are more difficult to perform than the restrictive procedures. They are also more likely to result in long-term nutritional deficiencies. This is because the operation causes food to bypass the duodenum and jejunum, where most iron and calcium are absorbed. That is the reason why long time replacement as well as follow up with your surgeon is essential.

Laparoscopic Sleeve Gastrectomy

With the potential for greater weight loss than gastric banding and less complication than gastric bypass and gastric banding, sleeve gastrectomy is now offered at ORMC. Sleeve Gastrectomy is the most recent addition to bariatric surgery.

Laparoscopic Sleeve Gastrectomy generates weight loss by restricting the amount of food that can be eaten by removing 85% of the stomach without bypassing the intestines or causing gastrointestinal malabsorption, a common complication with traditional gastric bypass. The stomach is restricted by dividing it vertically and removing a large portion of the stomach. The stomach that remains is shaped like a long narrow tube that measures between two and five ounces.This procedure greatly reduces Ghrelin-hormone production which helps reduce appetite and the hunger sensation. Results based on a five-year and three-year case study suggest the Vertical Gastrectomy, also known as Sleeve Gastrectomy, has weight loss similar to other procedures with lower risk of complication.

Advantages:

• Minimally invasive procedure
• Shorter hospital stays – Most patients stay overnight and are discharged the next day
• No implantable devices are used
• Potential greater weight loss than gastric banding
• There is no need for adjustments – no needles
• No risk of internal hernia
• No risk of marginal ulcers

Gastric Banding

Gastric banding is a surgical procedure designed to help you lose excess body weight andimprove weight-related health problems.

Currently ORMC offers LAP-BAND® Surgery, also known as laparoscopic adjustable banding surgery. In this minimally invasive procedure a hollow band made of silicone is placed around the opening of the stomach, which creates a small pouch and a narrow passage into the larger, remainder of the stomach. This restricts the amount of food that can be consumed at one time and increases the time needed for the stomach to empty. Your surgeon can adjust the band by adding or removing saline through a port that resides just under the skin. This can be conveniently done in his or her office on an outpatient basis. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stomach to further restrict the amount of food that can be ingested. If the band is too tight, your surgeon can remove some saline to loosen the band. Watch a short video about how the band works below.