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What is Weight Loss Surgery
Weight loss surgery, also known as bariatric surgery, is a surgical procedure that significantly reduces the size of a patient’s stomach. This new stomach only allows for small amounts of food to be consumed and digested at one time. The vast majority of bariatric surgery patients experience significant weight loss.
Though there are a handful of different weight loss surgery procedures, the two most common are known as gastric banding and gastric bypass. Both of these procedures are performed at Mercy Hospitals of Bakersfield. In addition, Mercy also performs the vertical sleeve gastrectomy, a more restrictive and permanent form of weight loss surgery. If you’re a candidate for bariatric surgery, your surgeon will consult with you to determine which procedure is best.
Vertical Sleeve Gastrectomy
Vertical sleeve gastrectomy, also known as a vertical gastic sleeve, is an alternative to gastric bypass and gastric banding. In this procedure, the stomach is permanently reduced to about 15 percent of its original size by removing a large portion of the lower stomach. What’s left is a stomach pouch the size and shape of a small banana.
Vertical sleeve gastrectomy is normally reserved for extremely obese patients (BMI > 55) who may not be ideal candidates for gastric banding or gastric bypass due to possible complications. This procedure is effective as the first step of a two-step process for these patients, the second being either gastric banding or gastric bypass. However, studies show that in patients with lower BMI (30-50) the vertical sleeve gastrectomy is successful on its own.
Advantages
● Eliminates the lower portion of the stomach, which produces the hormone that causes hunger.
● Minimizes chances of common side effects from other weight loss procedures including dumping syndrome, ulcers, intestinal blockages, anemia, osteoporosis and vitamin deficiency.
● Appealing for those who have existing conditions (anemia, Crohn’s disease) that may make them too high risk for gastric banding and gastric bypass procedures.
● Can be performed laparoscopically in patients weighing over 500 pounds.
Disadvantages
● Risk of minimal weight loss, or weight regained after surgery. Procedures that do not involve intestinal bypass have a higher prevalence of insufficient weight loss.
● For patients with BMIs over 55, a second procedure (gastric banding, gastric bypass) may be necessary.
● Leaks and other complications may occur at the site of the staple.
● The procedure is not reversible.
● May not be covered by insurance (check with your provider).
Roux-en-Y Gastric Bypass Surgery
Roux-en-Y (pronounced “Roo-en-why”) gastric bypass surgery is a more permanent form of weight loss surgery that involves surgically creating a new, smaller stomach by separating the upper portion of the stomach from the larger, lower section.
This smaller pouch is then connected to a section of the small intestine, allowing food to bypass the lower stomach and the first two parts of the small intestine (see illustration). Most gastric bypass surgeries are also performed using laparoscopy, a minimally invasive procedure performed through very small incisions in the abdomen.
Advantages
● From 50 percent to 80 percent of excess body weight is lost within two years.
● Existing obesity-related health conditions, such as diabetes, high blood pressure and sleep apnea improve.
● Unlike gastric banding, no access port is placed in the abdomen, and no adjustments are necessary.
● Minimally invasive procedure means shorter recovery times: typically two to three days in the hospital. Most patients return to normal activities in 10-14 days.
Disadvantages
● Unlike gastric banding, the stomach and intestines are cut and reconnected using staples and stitches. In the rare case they tear or don’t heal properly, complications can occur.
● Scar tissue may form or intestinal twisting may occur, resulting in intestinal blockage.
● Food bypasses the small intestine, the part of the body responsible for absorbing protein, calcium and certain vitamins. Less iron absorption also occurs. Patients must take daily vitamin and mineral supplements for the rest of their lives. Blood tests must be performed frequently during the first year to check nutritional status.
Gastric Banding
Gastric banding is a surgical procedure in which an adjustable silicon band is placed around the upper portion of the stomach, creating a small pouch. This new pouch can hold only a very small amount of food. The band creates a narrow passageway between the two chambers, where food slowly passes from the smaller portion to the larger portion. This allows patients to feel fuller for a longer period of time, significantly reducing appetite and food consumption.
Advantages of Gastric Banding
● Gastric banding is the safest form of weight loss surgery. The procedure itself is minimally invasive, meaning the band can be placed on the stomach by a small surgical scope inserted through a series of tiny incisions on the abdomen.
● Patients lose from 50 percent to 65 percent of excess body weight over the first two years
● There is no cutting of the stomach or intestines or disruption of the digestive system. This eliminates the risk of intestinal leak, dumping syndrome or food intolerance.
● All nutrients are absorbed as usual so there are less strict requirements for daily vitamin or mineral supplements. Existing obesity-related health conditions, such as diabetes, high blood pressure and sleep apnea improve.
● The band is fully adjustable. It can be easily tightened, loosened or removed depending on the patient’s needs.
● Surgery takes only about one hour to perform and usually requires only one overnight hospital stay.
Disadvantages of Gastric Banding
● As in other types of weight loss procedures, patients will need to significantly adjust their eating habits. Learning portion control and adhering to a strict diet are crucial.
● The band will need to be adjusted every six to eight weeks to ensure significant long-term weight loss. This is a simple process that involves adding a saline solution to the band through an access port in the patient’s abdomen.
● There is a small risk of band slippage, which may require another surgery to reposition it.
● The tube may kink or twist, requiring minor surgery.
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