Roux-en-Y Gastric Bypass
The Roux-en-Y Gastric Bypass (RYGB) allows a patient to lose weight primarily by restricting the amount a person can eat, secondarily by decreasing the amount of calories that are absorbed. This is accomplished by creating a small, 30cc gastric pouch using stapling techniques. This pouch is attached to a portion of small bowel by a tiny opening <2cm. This bowel is then reattached to itself downstream, creating a short intestinal bypass.
The procedure takes about two hours. Hospital stay averages two days. Recovery time is about two weeks. Patients can expect to lose between 70-75% of their excess weight. Potential complications include leaks, bleeding, stricture and obstruction. The RYGB is currently the most common weight loss surgery in the United States.
To view animation of the Gastric Bypass procedure, click here.
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Bilopancreatic Diversion (BPD) with Duodenal Switch
The Biliopancreatic Diversion with Duodenal Switch (BPD-DS) is primarily a malabsorptive procedure using a long intestinal bypass to severely decrease the amount of calories a patient can absorb. It also restricts the amount of food a patient can eat, but not to the extent of the gastric bypass or the adjustable gastric band. The stomach is stapled into a narrow tube to create this restriction and is then reconnected to the extensive intestinal bypass.
The procedure typically averages 3.5 hours to perform. Hospital stay is 2-3 days and recovery time is around two weeks. The BPD-DS is considered the best long-term weight loss procedure with excess weight loss averaging 80%. Patients can also eat more normally because of the larger gastric reservoir. Potential complications include leaks, bleeding, obstruction and nutritional deficiencies.
Laparoscopic Gastric Banding (Lap-Band®)
The Lap-Band is the latest innovation in weight loss surgery. It allows a patient to lose weight primarily by restricting the amount a person can eat and controlling hunger. A plastic band with an inner balloon is wrapped around the top portion of the stomach to create a very small gastric pouch. This band is attached to tubing that is ultimately connected to a small access port sitting on the patient’s abdominal wall. Saline can be injected into or removed from the access port to inflate or deflate the band.
The procedure takes about one hour. It can be performed as an outpatient or with an overnight hospital stay. Recovery time is approximately one week. The advantages of the Lap-Band are its low risk profile (the lowest of all weight loss procedures), adjustability and reversibility. Excess weight loss averages about 55%, although long-term data continues to show improvement as programs like ours become more experienced. Potential complications include band slippage and port problems.
To view animation of the LAP-BAND procedure, click here.
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Laparoscopic Vertical Sleeve Gastrectomy
The Vertical Sleeve Gastrectomy (VSG), like the adjustable gastric band, is a restrictive procedure that limits the amount of food that a patient can eat. The stomach is converted from a “bag” into a narrow tube with stapling techniques. The VSG is primarily used as a staging procedure in patients with very severe obesity. However, it is becoming increasingly used as the only surgery in selected patients.
The procedure takes about one hour to perform. Hospital stay is typically two days and recovery time one week. Weight loss varies greatly from 25-60% excess weight loss. 20 to 30 percent of patients require a secondary procedure once their initial weight loss plateaus.
To view animation of the Sleeve Gastrectomy procedure, click here.