We offer 3 great Bariatric Procedures. Please scroll down to read related information about each of these services.

1) DUODENAL SWITCH

  A variation of BPD includes a “duodenal switch,” which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway.

This weight loss surgical procedure is an improvement of the BPD. Here again, there is a significant malabsorptive component which acts to maintain weight loss long term. The patient must be closely monitored to guard against severe nutritional deficiencies. This procedure, unlike the BPD, keeps the pyloric valve intact. That is the main difference between the BPD and the DS.

 

Weight Loss Surgery - Duodenal Switch Advantages & Disadvantages

Advantages

• More "normal" absorption of many nutrients than with BPD, including calcium, iron and vitamin B12
• Better eating quality when compared to other WLS procedures
• Eliminates or greatly minimizes most negative side effects of the original BPD
• Essentially eliminates stomal ulcer and dumping syndrome
• The DS procedure provides superior weight loss for super morbidly obese patients (BMI greater than 50).

Disadvantages

• Greater chance of chronic diarrhea
• Significant malabsorptive component
• More foul smelling stools and flatus, but less than with the BPD alone
   

2) THE LAP-BAND® ADJUSTABLE GASTRIC BANDING SYSTEM

Advantages

• No stomach stapling, cutting, or intestinal rerouting
• Low perioperative complication rates
• Low malnutrition risk
• Free of “dumping syndrome”
• Adjustable–customized per patient
• Reversible
• One-tenth the short-term mortality rates of open Roux-en-Y gastric bypass
• Minimally invasive
• Satiety-inducing procedure
• Average patient does not need an overnight stay

Disadvantages

• Slower initial weight loss than gastric bypass
• Regular follow-up critical for optimal results
• Requires implanted medical device
• Less experience in the United States

The LAP-BAND® Adjustable Gastric Banding System is the first adjustable medical device approved in the United States for individualized weight loss. The LAP-BAND® System was approved by the U.S. Food and Drug Administration in 2001 for use in weight reduction for severely obese adults with a Body Mass Index (BMI) of 40 or more, or for adults with a BMI of at least 35 plus at least one severe obesity-related health condition, such as Type 2 diabetes, hypertension and asthma. Used in more than 300,000 procedures worldwide, this simple medical device has safely helped many seriously overweight individuals successfully achieve and maintain significant long-term weight loss to reduce the health risks associated with severe and morbid obesity. Worldwide, approximately 1.6 billion adults are overweight, and it is estimated that obesity affects at least 400 million adults.1

Designed to be placed laparoscopically (via small incisions in the abdomen, usually 0.5 - 1.5 centimeters in length), the LAP-BAND® System does not require cutting or stapling of the stomach. Instead, an inflatable band is placed around the top portion of the patient's stomach, creating a small pouch that limits or reduces food consumption. The LAP-BAND® System is adjustable, which means that the inflatable band can be tightened or loosened to help the patient achieve a level of satiety while maintaining a healthy diet, supporting a patient's long-term weight loss success.

GASTRIC BYPASS ROUX-EN-Y

This operation is the most common and successful malabsorptive surgery.

First, a small stomach pouch is created 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 bypass reduces the amount of calories and nutrients the body absorbs.






Weight Loss Surgery - Roux-en-Y Gastric Bypass (RGB) Advantages & Disadvantages

Advantages

• Greatly controls food intake
• Reversible in an emergency - though this procedure should be thought of as permanent

Disadvantages

• Staple line failure
• Ulcers
• Narrowing/blockage of the stoma
• Vomiting if food is not properly chewed or if food is eaten to quickly

Gastrointestinal Surgery - "Dumping Syndrome"

Both operations may also cause “dumping syndrome.” This means that stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and sometimes diarrhea after eating. Because the duodenal switch operation keeps the pyloric valve intact, it may reduce the likelihood of dumping syndrome.

The more extensive the bypass, the greater the risk for complications and nutritional deficiencies. Patients with extensive bypasses of the normal digestive process require close monitoring and life-long use of special foods, supplements, and medications.

3) VERTICAL SLEEVE GASTRECTOMY

Laparoscopic vertical sleeve gastrectomy (VSG).

This weight loss surgical procedure generates weight loss through gastric volume restriction (reduced stomach volume) and by decreasing Ghrelin (a stomach hormone responsible for appetite and hunger).

The stomach is restricted by removing more than 75% of it. The stomach remains in the shape of a very thin banana and holds between 30 and 150 cc. The pylorus and nerves to the stomach remain intact, thereby preserving the function of the stomach.

The laparoscopic sleeve gastrectomy (VSG) is a restrictive procedure that is indicated as an alterative to the laparoscopic adjustable gastric banding (lap-band or Realize band). The laparoscopic VSG (sleeve gastrectomy) gives comparable weight loss as a gastric bypass with much lower risk.

Advantages versus gastric bypass

• Remove/reduces a major source of Ghrelin (a stomach hormone that is responsible for appetite and hunger).
• Maintains normal function of the stomach, most foods can be eaten just in small amounts.
  Reduces cravings.
• Increases feeling of fullness (satiety inducing procedure).
• Minimal risk of vitamin and/all protein deficiencies.
• Better eating quality when compared to a gastric band or a gastric bypass.
• Free of dumping syndrome.
• No marginal ulcers.
• Minimal risk of intestinal obstruction because there is no intestinal bypass.
• Lower perioperative complications and mortality than a gastric bypass.
• Minimally invasive surgery.
• Good options for those with anemia, Crohn disease and other complex medical problems.

Advantages versus the lap band

• No foreign material in the body, which eliminates the risk of infection, obstruction, erosions that the foreign body presents.
• No adjustments needed.
• Better eating quality when compared to the lap band.

Disadvantages

• Potential leaks at staple line.
• Potential inadequate weight loss or weight regain.
• Stomach is removed, so this is not reversible.