The Sleeve Gastrectomy is a laparoscopic bariatric surgery normally considered for patients with a BMI of 35+, however some exceptions are made for those with a BMI lower than 35 . Many sleeve patients experience an initial rapid weight loss and within one to two years have significantly decreased or resolved all of their co-morbid conditions.

HOW IT WORKS:

During the surgery, a portion of the stomach is removed, changing it from a kidney bean shape to more like the shape of a banana. The portion removed is responsible for secreting the hormone ghrelin, which stimulates hunger. Afterward, appetite and feelings of hunger are significantly reduced. The newly created stomach can hold less than half a cup of food at a time. With a decrease in calorie intake, weight loss follows. Food passage through the stomach is also slowed, making the patient feel full longer. Patients go home the same day or might stay in the hospital one day.

POSITIVE ASPECTS OF OPTING FOR GASTRIC SLEEVE SURGERY:

Positive aspects of the surgery include no long-term risks of erosion, slip, or infection sometimes associated with band implantation. The stomach retains normal function because the valves that control filling and emptying are left intact. With the sleeve, there is no need for the regular fills/adjustments that banded patients require. There is also a significantly faster weight loss than with the LAP-BAND (with overall weight loss at five years being the same). One of the biggest upsides is that a larger variety of foods can be tolerated than with other procedures.

THINGS TO CONSIDER WITH SLEEVE GASTRECTOMY:

A liquid diet is required before and after the surgery to assist in the surgical and healing process. Complications may arise. This will be discussed with your surgeon during the surgical consultation. Keep in mind that this is a lifestyle choice you are making, not a quick fix. It is important to remember that a Sleeve Gastrectomy is an aid to support you in achieving lasting results by limiting food intake, reducing appetite, and slowing digestion. However, for the ultimate success of the operation, you must play an active part in maintaining your ideal weight by adopting a different lifestyle and eating pattern for the rest of your life.

The LAP-BAND (Laparoscopic Adjustable Gastric Band) System is indicated for use in weight reduction for obese patients with a Body Mass Index (BMI) of at least 35. It is the only FDA-approved device for bariatric surgery in patients with a BMI greater than 35, or patients with a BMI greater than 30 with one or more obesity-related comorbid conditions.

HOW IT WORKS:

Using laparoscopic surgery, an adjustable ring is inserted around the upper portion of the stomach creating two pouches: a small top pouch where food initially is held, and the bottom larger pouch where food is digested.

Saline is then inserted into the port and the band tightens around the stomach to create restriction. This restriction makes you feel full sooner, and it controls the process of digestion leaving you satisfied longer as well. As you lose weight, the band will become slightly loose, making your check-ups vital to your success.

ADVANTAGES OF THE LAP-BAND SYSTEM:

THE PROCEDURE IS REVERSIBLE: If ever necessary, the LAP-BAND can be easily removed, and the stomach returns to its normal size.

LESS INVASIVE: Of all the procedures for severe obesity, the LAP-BAND method is considered to be the least traumatic. The procedure can usually be performed laparoscopically (using small incisions) and requires no cutting or stapling of the stomach or intestines.

ADJUSTABLE: The band can be customized to meet your individual weight loss needs.

SAFER, GRADUAL WEIGHT LOSS: Normal weight loss is 1-3 pounds per week, providing a healthy timeline and allowing the body to adjust. This also helps retain skin elasticity, decreasing the need for plastic surgery.

SAFE FOR PREGNANCY: Women can still become pregnant after the surgery, often finding that they’re more fertile than before the operation.

REDUCED HOSPITAL STAY AND FASTER RECOVERY: Patients commonly leave the hospital on the same day of surgery, and usually resume normal activities within two to three days from surgery.

THINGS YOU SHOULD CONSIDER:

A liquid diet is required before and after the surgery to assist in the surgical and healing process.

Complications may arise. This will be discussed with your surgeon during the surgical consultation.

It is important to remember that the LAP-BAND System is an aid to support you in achieving lasting results by limiting food intake, reducing appetite, and slowing digestion. However, for the ultimate success of the operation, you must play an active part in maintaining your ideal weight by adopting a different lifestyle and eating pattern for the rest of your life.

Gastric Bypass surgery promotes weight loss by altering the way your stomach and small intestine digest the food you eat.

HOW IT WORKS:

Performed either through open surgery or laparoscopically, the surgeon uses staples to divide the stomach into two sections. The top, called the pouch, is about the size of a walnut, and can hold about 1 ounce of food. With a reduction in the size of the stomach, you feel full on less food. The surgeon connects a lower part of the small intestine, called the jejunum, to a small hole in the pouch. Following this procedure, food journeys from the pouch to the jejunum. This bypassing of part of the stomach and lower intestine reduces the amount of calories the body absorbs. The hospital stay is generally three to five days.

BENEFITS:

The majority of patients are expected to lose around 75% of their excess body weight. Most patients with hypertension and/or non-insulin-dependent diabetes mellitus will no longer require medication. Also improved or eliminated are sleep apnea, joint and back pain, asthma, arthritis, and shortness of breath. Patients are also at a lower risk of high blood pressure, pulmonary disease, heart disease, and many types of cancer. Most of all is the improvement in self-image and overall quality of life.

THINGS TO CONSIDER:

A liquid diet is required before and after the surgery to assist in the surgical and healing process. With this procedure, vitamin and supplement intake is essential to long-term success.

Complications may arise. This will be discussed with your surgeon during the surgical consultation.

It is important to remember that the Gastric Bypass procedure is an aid to support you in achieving lasting results by limiting food intake, reducing appetite, and slowing digestion. However, for the ultimate success of the operation, you must play an active part in maintaining your ideal weight by adopting a different lifestyle and eating pattern for the rest of your life.

Single Anastomosis Duodenal Switch (SADI) is a type of weight loss surgery for people with severe obesity, also known as class 3 obesity. They typically have a BMI of 40 or greater and at least 100 pounds of excess weight.

HOW IT WORKS:

The SADI procedure combines sleeve gastrectomy with intestinal bypass to promote greater weight loss. It’s performed by:

• Removing about 80% of the stomach to create a tube-shaped sleeve

• Separating the top part of the small intestine (duodenum) just below the stomach

• Reattaching the duodenum to the lower section of the small intestine, shortens the intestine by about half and decreases calorie absorption

POTENTIAL BENEFITS:

• Restricting meal size

• Bypassing food away from the digestively active part of the gut, which improves metabolism

• Triggering remission of conditions like type 2 diabetes, high blood pressure, and obstructive sleep apnea in many people

• Preserving the pyloric valve (where food passes from the stomach to the intestine), which helps decrease bile reflux and stomach irritation

THINGS YOU SHOULD CONSIDER:

As with any surgery, SADI has risks you should know about. Complications may include:

• Bleeding/blood clots

• Dumping syndrome

• Gallstones

• Hernia

• Infection

• Nausea, vomiting, diarrhea or constipation

• Low blood sugar

• Malnutrition or dehydration

• Leaking

• Obstruction

• Spleen or other organ injuries

• Stenosis (narrowing)

• Ulcer (hole)

• Vitamin or mineral deficiencies

AFTER:

After the SADI procedure, you’ll need to follow certain nutritional guidelines. Your bariatric team will provide specific instructions on how much protein and fluid you need. You’ll also need to take vitamins and supplements to prevent malnutrition.

Lifelong follow-up care is required after SADI surgery.