Bariatric & Weight Loss Surgery

BariatricsUnlike centers that only specialize in one type of weight loss surgery, Forest Park Medical Center specializes in five types to ensure the best outcomes for all patients. We’re certified as a Bariatric Surgery Center of Excellence, so you can rest assured that your procedure would be performed by certified experts.

Bariatric and weight loss surgery offers significant medical and social benefits, including:

  • Improvement in obesity related medical conditions, such as hypertension, high cholesterol, diabetes, degenerative arthritis, sleep apnea, urinary stress incontinence, and gastroesophageal reflux disease.
  • Increase in overall life expectancy.
  • Improvement in quality of life – Many patients find that their stamina, mood, self-esteem, and interpersonal relations improve following weight loss from bariatric surgery.

 


Gastric Banding Surgery

Gastric banding is a safe and effective weight loss procedure ideal for patients who may face a higher risk of gastric bypass post-op complications. The procedure is usually performed laparoscopically.

  • A silastic (silicon and plastic) band is wrapped around the upper part of the stomach to create a small stomach pouch.
  • Unlike gastric bypass surgery, the upper part of the stomach remains connected to the lower, larger part of the stomach through a small outlet created by the band. Food passes through the outlet slowly, limiting the amount a person can eat, reducing appetite, and slowing digestion.
  • A small access port attached to the band is implanted under the skin during surgery, allowing our surgeons to inject saline fluid into the band after surgery in order to adjust the size of the stomach pouch. This promotes effective weight loss with minimal complications.

Gastric Banding vs. Gastric Bypass Surgery

Gastric banding surgery is less invasive than gastric bypass surgery, because neither the intestine nor stomach is cut or stapled during the procedure. Unlike gastric bypass surgery, it is also completely reversible.

Benefits

  • Weight loss – Patients begin to lose weight immediately after surgery at a rate of about one to two pounds per week and lose, on average, 45 percent of their excess body fat two years after surgery.
  • The size of the stomach pouch can be adjusted without the need for revision surgery. And since the digestive system is left intact, the procedure can be reversed, if necessary.

Band Adjustment

The advantage of gastric banding surgery is that your bariatric surgeon can adjust the size of the outlet created by the band. The band is connected by tubing to a reservoir of saline that is placed beneath your skin during your initial surgery. Later, we can control the amount of saline in the band by piercing the reservoir through the skin with a fine needle. Similar to a blood pressure cuff, the inner surface of the band inflates or deflates, changing the size of the opening between the two parts of your stomach. Changing the size of the opening is a normal part of follow-up care for patients who have undergone gastric banding surgery.

Possible Risks and Complications

Risks
Gastric banding surgery carries many of the same risks as the other weight loss surgery alternatives available. However, due to the less invasive nature of the procedure, the risks of gastric banding surgery are significantly less severe than the complications associated with open gastric bypass. As a result, we often recommend gastric banding surgery to patients who run a higher risk of post-op complications.

Complications

  • Band – On rare occasions, a band can erode into a patient’s stomach. This requires an additional surgery to remove the eroded band. Occasionally, the band can lead to obstruction or perforation of the stomach. These complications may require revisional surgery. The pouch may also stretch or the restricting band may break or migrate, allowing patients to eat too much.
  • Vomiting – Overeating is painful and can lead to vomiting. Sometimes, patients must be readmitted to the hospital for fluid replacement if excessive vomiting occurs following surgery.
  • Access Port – Sometimes, the access port may be twisted or leaky and an additional procedure may be required to fix the problem.
  • Food Restrictions – After surgery, you may not be able to eat certain foods such as steak, white meat chicken, and doughy bread.

Is Gastric Banding Right for You?

Because gastric banding does not permanently alter a patient’s anatomy, it’s a good option for morbidly obese patients who are hesitant to receive gastric bypass surgery. Gastric banding may also be a safer choice for patients who are under 20 or over 60, and others who are at high risk for complications following bariatric surgery.

 


Gastric Bypass

Gastric bypass surgery helps patients lose weight because it greatly restricts the amount of food they can eat and limits absorption of some calories. During Roux-en-Y gastric bypass surgery:

  • Staples will be used to create a small pouch at the top of the stomach.
  • The pouch is connected to the lower part of the small intestine. The food will no longer pass through the lower part of the stomach or upper part of the small intestine. Instead, it will go straight from the small stomach pouch to the lower part of the small intestine.

Since the pouch can only hold a few ounces at a time, the amount of food a patient can eat is severely limited. Patients must also chew their food carefully following gastric bypass surgery.

Open vs. Laparoscopic Roux-en-Y Gastric Bypass Surgery

There are two ways to perform Roux-en-Y gastric bypass surgery. One method, called open Roux-en-Y gastric bypass surgery, involves cutting a patient open and performing surgery through an eight- to ten-inch incision in the abdomen. Another method is called laparoscopic Roux-en-Y gastric bypass surgery, the procedure that surgeons perform at Barker Bariatric Center. During laparoscopic Roux-en-Y gastric bypass surgery:

  • The surgeon makes five or six very small incisions 1/4 to 1/2 inch long.
  • They insert a small fiber optic tube, connected to a video camera, inside the incisions.
  • A television screen near the operating table gives the surgeon a view of the patient’s internal organs and allows him to perform the surgery by inserting instruments into the small abdominal incisions.

Benefits

Gastric bypass surgery has provided life-changing benefits. When post-gastric bypass surgery guidelines are followed, patients can generally expect to see the following improvements in the months and years after surgery:

Decrease in Appetite - Patients often report feeling less hungry following bariatric surgery. Many become less preoccupied with food and weight loss becomes easier.

Weight Loss - After undergoing gastric bypass surgery or gastric banding surgery, most patients begin to experience weight loss right away. Patients usually continue to lose weight for 18 months to two years. Many regain some weight after this time, though very few regain it all.

Improvement in Obesity Related Medical Conditions - Bariatric surgery often improves or eliminates many medical problems associated with obesity such as hypertension, high cholesterol, diabetes, degenerative arthritis, sleep apnea, urinary stress incontinence, and gastroesophageal reflux disease. Bariatric surgery can also increase overall life expectancy.

Quality of Life Improvements - Many patients find that their stamina, mood, self-esteem, and interpersonal relations improve following weight loss from bariatric surgery. They may also begin to feel more socially accepted.

Possible Risks and Complications

During your Roux-en-Y gastric bypass surgery consultation, we will go over the possible risks of surgery, which may include:

Blood Clot – Like all types of surgery, gastric bypass surgery poses some degree of risk. There is a small risk that a blood clot could form in a patient’s legs and lead to an embolism. We minimize this risk by giving patients a blood thinner before and after gastric bypass surgery.

Infection – There is also a slight risk that an infection may develop in the incision area following gastric bypass surgery. When this occurs, a patient must treat the wound at home by allowing it to drain and constantly applying fresh bandages.

Chronic Vomiting – Another rare complication is chronic vomiting. This can occur if excessive scar tissue forms, making the opening between the stomach and the bowel too small for food to pass through. This complication can usually be corrected through an outpatient procedure but sometimes requires revisional gastric bypass surgery.

Gallstones – Rapid weight loss can sometimes lead to gallstones. If gallstones are present when you undergo gastric bypass surgery, the doctor will remove them. He or she may also prescribe a medication that helps to prevent more gallstones from forming.

Hernias – Postoperative hernias occur about 10 percent to 20 percent of the time following open gastric bypass surgery. The risk is believed to be somewhat less following laparoscopic surgery.

Nutrient Deficiencies – Gastric bypass surgery can lead to nutrient deficiencies because it limits the absorption of some vitamins and nutrients. Such deficiencies can be avoided by taking daily vitamin and mineral supplements.

Bowel Obstruction – There is a possibility you could develop a bowel obstruction after gastric bypass surgery.

Dumping Syndrome – Patients who develop this syndrome have trouble eating sweets after gastric bypass surgery. When they eat sweets they experience symptoms such as sweating, fatigue, lightheadedness, and diarrhea. Additionally, eating large amounts of fat can result in diarrhea and abdominal cramping.

Weight Gain – About two years after gastric bypass surgery, some of our patients may experience a 10- to 30-pound weight regain.

Other Problems – Rarely, bariatric surgery may cause potentially fatal complications such as peritonitis (inflammation of the peritoneum, a membrane that lines the abdomen) and bleeding.

Is Gastric Bypass Right for You?

Not everyone is a good candidate for laparoscopic gastric bypass surgery. Please talk to our weight loss surgeons to discuss which method is appropriate for you.

 


Sleeve Gastrectomy

Unlike gastric bypass surgery, sleeve gastrectomy does not require interrupting and reconnecting the digestive tract. Some patients prefer sleeve gastrectomy to the REALIZE Adjustable Band or the LAP-BAND Adjustable Gastric Band surgery, as the sleeve gastrectomy does not involve leaving a foreign object (the gastric band) inside the body.

Benefits

The most important benefit of sleeve gastrectomy is that it allows patients who have been unable to control their weight through a combination of diet and exercise to achieve rapid, dramatic weight loss. Maintaining an appropriate weight is an important part of living in good health; avoiding heart disease, hypertension, diabetes, and the many other medical problems associated with obesity. Most gastric sleeve patients also enjoy dramatically improved energy and self-esteem, as they are able to fully enjoy an active, healthy lifestyle after surgery.

Gastric Sleeve Risks and Complications

Sleeve gastrectomy shares many risks with Roux-en-Y gastric bypass, the REALIZE Adjustable Band surgery, and the LAP-BAND Adjustable Gastric Band surgery, but is one of the safest surgical weight loss options available. Though sleeve gastrectomy is very safe and serious problems are rare, it is a major surgery and complications are still possible, including:Stomach Leakage – Some patients experience stomach leakage as a result of poor healing after sleeve gastrectomy, and require revisional surgery .

Gastric Sleeve Dilation – Over time, the patient’s stomach occasionally stretches, expanding in volume and allowing more food intake. Patients who experience this may regain some weight.

Gastrointestinal Problems – When gastric sleeve patients eat more than their stomach can hold comfortably they risk significant discomfort, including vomiting, diarrhea, and other gastrointestinal symptoms.

Stalled Weight Loss – Because sleeve gastrectomy is not a reversible procedure, patients must be prepared to accept a limited diet. Failing to follow the prescribed diet may cause significant problems and stall weight loss.

Is the Gastric Sleeve Right For You?

Sleeve gastrectomy is most often performed on patients who are too overweight for Roux-en-Y gastric bypass. Because the procedure does not require interrupting and reconnecting the digestive tract, as gastric bypass surgery does, the gastric sleeve option is less invasive for these patients.

If necessary, Roux-en-Y gastric bypass can be performed after patients have achieved some success with sleeve gastrectomy for additional weight loss.

 


Duodenal Switch

The restrictive part of the duodenal switch procedure is achieved through partial gastrectomy (removal of part of the stomach), which reduces the size of the stomach. The distal or pouch-like portion of the stomach is removed. Some scientists think this helps reduce chemicals produced by the stomach that trigger hunger and eating.

  • Unlike the Roux-n-Y, the duodenal switch keeps the pyloric valve between stomach and small intestine intact.
  • The malabsorptive component of the duodenal switch procedure is achieved by rearranging the small intestine so as to separate the flow of food from the flow of bile and pancreatic juices.
  • Reducing the amount of bile and pancreatic juices the food comes in contact with reduces the amount of food that is digested and decreases absorption of some calories and nutrients.
  • Further down the digestive tract, the separated portions of the small intestine are rejoined; food and digestive juices begin to mix, and limited fat absorption, essential for good health, occurs.

Benefits

  • Weight loss – The combination of moderate intake restriction with substantial calorie malabsorption results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain.
  • Normal diet – Much of the production of the hunger hormone, ghrelin, is removed with the greater curvature of the stomach. Diet following the surgery is more normal and better tolerated than with other surgeries.
  • Small intestine intact – The malabsorptive component of the surgery is fully reversible as no small intestine is actually removed, only re-routed.
  • No dumping syndrome – Because the pyloric valve between the stomach and small intestine is preserved, patients do not experience the “dumping” syndrome common with people who’ve undergone the Roux-en-Y gastric bypass surgery.

Possible Risks and Complications

Some of the surgical risks or complications include:

  • Perforation involving small bowel, duodenum, or stomach causing a leak, infection, abscess, deep vein thrombosis (blood clot), and pulmonary emboli (blood clot traveling to the lungs).
  • Longer-term risks include hernia and bowel obstruction.
  • Malnutrition is an uncommon and preventable risk after duodenal switch.

Is Duodenal Switch Right For You?

Contact us to schedule a consultation to learn if duodenal switch will best meet your needs.

 


Revisional Surgery

We also perform bariatric surgery revision to alter or repair problems with other weight loss surgeries. Please contact us for a consultation.