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Which Surgery Is Right for You?

The most important step in weight loss surgery is getting all of the information you need about the various surgical options. Ultimately your surgeon and other physicians are your best resource for information about the procedure they will recommend to you.

Weight Loss Surgery Options

There are generally three approaches that weight loss surgery takes:

  1. Restrictive procedures that decrease food intake by making the stomach capacity smaller and that do not alter the small bowel; the LAP-BAND system and sleeve gastrectomy are examples of restrictive procedures. These surgeries are usually the least invasive bariatric options.
  2. Malabsorptive procedures that alter digestion and result in weight loss primarily by lowering the absorption of calories by rerouting the small bowel; biliopancreatic diversion is an example of a primarily malabsorptive procedure.
  3. Mixed procedures that are a combination of restrictive and malabsorptive techniques in that they result in weight loss by both decreasing the capacity of the stomach and rerouting the small bowel; Roux-en-Y gastric bypass is an example of a mixed procedure.

LAP-BAND System

The LAP-BAND system is a purely restrictive procedure. This option restricts how much the stomach can hold by placing an adjustable band around the upper part of the stomach. The result is you take in less food. The LAP-BAND can be adjusted to suit your needs and can be removed if necessary. The success of this process, however, also depends on how motivated you are and how committed you are to your goal of long lasting weight loss.

Advantages:

  • The primary advantages of this restrictive procedure is that a reduced amount of well-chewed food enters and passes through the digestive tract in the usual order. This allows nutrients and vitamins (as well as the calories) to be fully absorbed into the body.

Risks (the following are in addition to the general risks of surgery):

  • Slippage of band
  • Erosion
  • Pulmonary Embolism/DVT
  • Port Problems

Sleeve Gastrectomy (aka Gastric Sleeve)

A sleeve gastrectomy is a procedure that limits the amount of food you can eat by reducing the size of your stomach. Like other metabolic surgeries, it also helps to establish a lower, healthier body fat set point by changing the signals between the stomach, brain, and liver.

During a sleeve gastrectomy, the surgeon creates a small stomach 'sleeve' using a stapling device. This sleeve will typically hold 50 ml to 150 ml and is about the size of a banana. The rest of the stomach is permanently removed. This procedure induces weight loss in part by restricting the amount of food (and therefore calories) that can be eaten without bypassing the intestines and absorbed.

Advantages:

  • Limits the amount of food that can be eaten at a meal.
  • Allows the body to adjust to its new, healthier set point.
  • Food passes through the digestive tract in the usual order, allowing vitamins and nutrients to be fully absorbed into the body.
  • No postoperative adjustments are required.
  • In clinical studies, patients lost an average of 66% of their excess weight.
  • Proven to help resolve high blood pressure (49%), obstructive sleep apnea (60%), and to help improve Type 2 diabetes (45%) and high cholesterol (77%).

Risks (the following are in addition to the general risks of surgery):

  • Complications due to stomach stapline, including separation of tissue that was stapled or stitched together and leaks from staple lines.
  • Gastric leakage.
  • Ulcers
  • Dyspepsia
  • Esophageal dysmotility
  • Nonreversible since part of the stomach is removed.