Bariatric, or weight-loss surgery, is a comprehensive solution that incorporates lifestyle changes with a surgical procedure to help you lose weight and keep it off. At Ascension Seton Surgical Group, we offer three types of bariatric surgery.
Laparoscopic Gastric Bypass
- 70 percent average excess body weight loss over a two-year period.
- Procedure is not adjustable/not reversible.
- Hospital stay is two nights.
Gastric bypass is the gold standard of weight-loss surgery. It has been performed since the late 1960s and there is significant data supporting the long-term success of this bariatric procedure. It has been performed laparoscopically since 1993, and at Ascension Seton Surgical Group Williamson, we perform this procedure mainly through this minimally invasive technique.
This operation consists of two key elements. The first involves dividing the stomach and creating a new small stomach pouch that is about the size of an ounce and completely separate from the remainder of the stomach. The second part is the “bypass,” which reroutes food from this small stomach pouch directly into the small intestine, bypassing the rest of the stomach and the first part of the small intestine. A second connection allows gastric acids, bile and pancreatic enzymes to mix with the food further downstream. This operation works by two different mechanisms: first by restricting the amount of food that can be consumed, and second by malabsorption, meaning not all of the calories consumed are absorbed.
This operation is in effect irreversible. Most patients stay two nights in the hospital after this procedure and can return to work after approximately two weeks.
This surgery is very effective when patients follow the post-operative diet recommendations and most patients will lose 70-80% of their excess body weight by 18 months after surgery. There are risks and potential complications of any surgical procedure including gastric bypass.
Glenn's Weight Loss Story
Laparoscopic Sleeve Gastrectomy
- 60 percent average excess body weight loss over a two-year period.
- Procedure is not adjustable/not reversible.
- Hospital stay is one night.
The sleeve gastrectomy is the newest of the weight-loss surgeries. It was initially performed as a first step in a staged procedure for high-risk patients who were super-obese (with BMIs > 60) with the intent to lose enough weight to safely convert later to gastric bypass. Many patients were very satisfied with this procedure and lost enough weight and improved their medical conditions such that they never desired conversion to gastric bypass. It then became seen as a standalone procedure that could be offered to any patient who was a candidate for bariatric surgery. The operation consists of removing the reservoir portion of the stomach leaving a small tubular stomach. This works in a restrictive capacity only, as there is no rerouting of the intestines. Food follows the normal path from the stomach into the small intestine.
This operation is irreversible in that the reservoir portion of the stomach is removed but it can be converted to a gastric bypass. Most patients stay overnight in the hospital after sleeve gastrectomy. One disadvantage to this operation being the newest of the bariatric surgeries is that many insurers that cover weight-loss surgery do not cover sleeve gastrectomies. For example, Medicare, Medicaid and Tricare currently only cover gastric bypass and adjustable gastric bands.
This surgery is very effective when patients follow the post-operative diet recommendations and most patients will lose 60-70% of their excess body weight by 24 months after surgery. There are risks and potential complications of any surgical procedure including sleeve gastrectomy.
Laparoscopic Adjustable Gastric Banding
- 40 percent average excess body weight loss over a two-year period.
- Procedure is adjustable/reversible.
- Hospital stay is same day or one night.
The laparoscopic adjustable gastric band has been performed in the United States since 1993. There is some longer-term data from Europe and Australia regarding this procedure but the long-term success has not been matched in the U.S. This procedure involves placement of a silicone band with an interior inflatable balloon around the upper part of the stomach. It mechanically divides the stomach into a smaller upper stomach pouch and the larger reservoir portion of the stomach. It works in a restrictive capacity limiting that amount of food that can be eaten. The band is placed empty and requires multiple in-office adjustments over several months to tighten the band to achieve weight loss.
This surgery can be effective when patients follow the post-operative diet and exercise recommendations and keep their follow-up appointments for appropriate adjustments. The weight lost is more variable with the adjustable gastric band and most patients can lose 40-50% of their excess body weight by 24 months after surgery. There are risks and potential complications of any surgical procedure including the adjustable gastric band.