Surgery Operation

The Laparoscopic Sleeve Gastrectomy

The Laparoscopic Sleeve Gastrectomy is a relatively new operation that can be done either as a standalone procedure for those who don't have much weight to lose, for those who are older or higher risk, or as part of a staged operation. The weight loss with the Sleeve Gastrectomy has been running in the range of 55% to 70% of the excess body weight, depending on your circumstances. It has been shown to have better weight loss than the Lap Banding procedures. If you are relatively young and otherwise healthy, able to exercise and are very good about following the program, you can many times exceed these averages, getting almost up to the kind of weight loss we would see with the RNY or the Dudoenal Switch. Dr. Smith has been one of the leaders in laparoscopic techniques of performing the Sleeve Gastrectomy, having done them laparoscopically as part of the Duodenal Switch operation since 1999, and continues to be involved with teaching the technique to other bariatric surgeons. This operation is the only bariatric procedure that has no malabsorption (as the RNY and DS do) and no foreign body issues (as the Lap-Band® does). There is a very low risk at the time of surgery, relative to the RNY and the DS, and an extremely low risk of needing another operation in the future, especially compared to Laparoscopic Gastric Banding procedures.

Gastric Banding Surgery for Weight Loss

Laparoscopic Adjustable Gastric Banding Surgery Laparoscopic gastric banding is the second most common weight loss surgery, after gastric bypass. Gastric banding surgery involves the following: * Using laparoscopic tools, the surgeon places an adjustable silicone band around the upper part of the stomach. * Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food. * A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter. * In this way, the band can be tightened or loosened as needed. This can reduce side effects and improve weight loss. Laparoscopic adjustable gastric banding leads to loss of about 40% of excess weight, on average. Someone people who are 200 pounds overweight could expect to lose an average of 80 pounds after gastric banding. However, these results vary widely. Gastric banding is considered the least invasive weight loss surgery. It is also the safest. The procedure can be reversed if necessary, and in time, the stomach generally returns to its normal size. Gastric banding surgery has a low complication rate. The most common problems after gastric banding surgery include: * Nausea and vomiting. These can often be reduced by adjusting the tightness of the band. * Minor surgical complications occur less than 10% of the time. These include problems with the adjustment device, wound infections, or minor bleeding. * The risk of death due to gastric banding surgery is about 1 in 2,000. Unlike gastric bypass surgery, gastric banding does not interfere with food absorption. For this reason, vitamin deficiencies are rare after gastric banding. Vertical Banded Gastroplasty (VBG) Vertical banded gastroplasty also involves a plastic band placed around the stomach. In addition, the surgeon staples the stomach above the band into a small pouch. Vertical banded gastroplasty results in less weight loss, compared with other surgeries. It also has a higher complication rate. For these reasons, vertical banded gastroplasty is less common today. Only 5% of bariatric surgeons still perform this surgery. Mixed Surgeries (Restrictive and Malabsorptive) Restrictive surgery is an important part of nearly all weight loss surgeries. In the most common weight loss surgery, gastric bypass surgery, restrictive surgery is first done on the stomach. This "stomach stapling" creates a small stomach pouch. The new stomach pouch is reconnected to a part of the small intestine further down. This leads to less food eaten (restrictive) and less food absorbed (malabsorptive).