Bariatric surgery has come a long way since the days of "stomach stapling."
There are now a variety of options, some even performed on an outpatient
surgeons at Torrance Memorial have extensive experience in practically all the
state-of-the-art procedures currently available. You and your surgeon
can decide which one is appropriate for you.
Laparoscopic Adjustable Gastric Band
The laparoscopic adjustable gastric band is
the least invasive option, and requires substantially less recovery time. In this procedure, the surgeon gradually tightens a band around the stomach.
This will result in the sensation of being full after a much smaller meal.
There currently are two FDA-approved bands available, the LAP Band®
and the Realize Band.
- outpatient procedure, meaning no overnight hospital stay
- laparoscopy is a minimally-invasive procedure, meaning smaller incisions
and less scarring
- adjustments are done without additional surgery
- slower weight loss
- no immediate reversal of obesity-related illnesses (i.e, diabetes, hypertension)
- requires adjustments or fills
may need corrective surgery
if the band "slips"
Laparoscopic Gastric Bypass
The numbers are impressive. Gastric bypass patients can lose high percentages
of excess body weight, and many are able to permanently remain at a healthy
weight. That may be why it's the most popular bariatric surgery choice.
The gastric bypass works two ways: by physically reducing the stomach's
size, and by causing physiological changes to your digestion.
The most common bypass is called a Roux-en-Y. The stomach is divided into two parts, with the new, smaller stomach pouch
preventing large food intakes. This new stomach is then attached to the
lower portion of the small intestine, so the rest of the stomach is "bypassed"
There's another advantage to the gastric bypass. By changing the configuration
of the digestive system, fewer calories are absorbed into the body. So
you physically eat smaller portions and gain less weight from the food
you do eat.
This results in rapid weight loss following surgery.
While this is considered major surgery, the benefits are substantial. Weight-related
illnesses like diabetes may be reversed within days of surgery. And the
reduced calorie absorption makes it easier to continue losing weight.
Most gastric bypasses can be performed laparoscopically (with smaller
incisions) to cut down on pain and recovery time.
A common side effect is "dumping," which results in an inability
to eat sweets. It occurs when simple sugars enter the bloodstream too
quickly, causing nausea, diarrhea and weakness.
- rapid weight loss after surgery
- food portions are restricted
- may resolve weight-related illnesses
- most can be performed laparoscopically
- complex surgery, requiring a hospital stay
- possible vitamin and mineral deficiencies
- may cause ulcers and reflux
- may cause "dumping"
Laparoscopic Sleeve Gastrectomy
A newer option, the sleeve gastrectomy, permanently reduces the size of
the stomach so patients feel full after eating smaller portions. Surgeons
selectively remove the part of the stomach that produces the hunger-stimulating hormone
appetite automatically decreases. Since the intestines are not involved, food absorption remains the same,
helping some patients avoid mineral and vitamin deficiencies. Weight loss
outcomes have been extremely favorable with this surgical procedure.
A sleeve gastrectomy is a good option for patients who are considered too
heavy or high-risk for a gastric bypass. After some weight is lost or
the patient's health stabilizes, the patient may then have the sleeve
gastrectomy converted into a gastric bypass if more weight loss is needed.
Other candidates for the sleeve would be those with specific anatomic
concerns limiting the ability to perform the bypass such as multiple intestinal
surgeries in the past. Also, those patients concerned of the bypass but
do not want the band may be candidates.
- reduces hunger
- doesn't affect the digestive system
- doesn't lead to nutritional deficiencies
- no dumping syndrome
- most can be performed laparoscopically
- lower weight loss results than gastric bypass
- smaller stomach pouch may stretch over time, resulting in weight gain
- not reversible
- long-term data not available