types of procedures

bariatric SURGERY

Bariatric surgery involves altering the anatomy of the digestive tract with the intent of weight loss. Surgeons have devised various procedures that decrease the capacity of the stomach or alter the absorption of nutrients. Procedures like the gastric sleeve and gastric bypass help people achieve significant and long term weight loss with fewer complications. With the advice of your primary physician and surgeon, you can choose a procedure that helps you achieve your weight loss goals within an acceptable risk profile.

METABOLIC SURGERY

Metabolic surgery is a relatively new term, bringing attention to the fact that obesity is a systemic chronic disease that affects the entire body. In addition to weight loss, metabolic or bariatric surgery can make drastic improvements in diseases such as diabetes, hyperlipidemia, sleep apnea and hypertension. In fact, improvements in diabetes may occur with just modest degrees of weight loss. Therefore, the types of medical problems that people have play a role in the decision when choosing a procedure.

sleeve gastrectomy

Gastric sleeve surgery is a minimally invasive weight loss procedure. This procedure is lower risk than the gastric bypass, and has better results than the Lap-Band, and therefore it has quickly become the most common weight loss procedure in the United States since 2013. Currently, about 60% of weight loss procedures in the United States are the sleeve.

Gastric sleeve surgery involves the permanent removal of about 2/3 of the stomach. This turns the stomach into a long, narrow tube using a row of tiny permanent staples.  Food and nutrients quickly pass through the stomach into the un-altered small intestine. This causes metabolic hormones to change levels, leading to weight loss and improvements in comorbidities. Surgical recovery typically involves a 1-2 day hospital stay, and a few weeks off of work.  Risks can include leaking or bleeding from the staple line, but the gastric sleeve surgery generally does not have the long-term nutritional risks of the gastric bypass. This surgery is known to have a lower risk profile than other common operations, such as orthopedic joint replacements or gallbladder surgery.

Roux-en-Y gastric bypass

The roux-en-y gastric bypass uses both restriction and malabsorption to achieve weight loss, and has long been recognized as an effective, durable procedure. 

In the gastric bypass, the stomach is permanently divided to create a small gastric “pouch” that limits the size of meals. The small intestine is then connected to the upper pouch so that food “bypasses” the remainder of the stomach and the first part of the small intestine. This limits the calories and nutrients that can be absorbed, and immediately changes many of the hormones that regulate weight and weight-related comorbidities.

Unusual risks of the operation include bleeding, leaking or stricture formation at the staple lines, and intestinal obstruction. Dumping syndrome is unique to the gastric bypass, involving nausea, diarrhea, and a weak, uncomfortable feeling when eating certain sweet foods. A 1-2 night hospital stay is common after the procedure. The gastric bypass may be more effective in resolving diabetes than other procedures.