The bariatric specialists at Emory Decatur Hospital’s Comprehensive Weight Loss Center offer several weight loss surgery options, providing patients with a choice in their approach to weight loss. The weight loss surgery procedure that you will undergo is carefully determined through a one-on-one consultation with your bariatric surgeon. This determination is based on specific health and safety criteria including Body Mass Index (BMI), associated medical conditions, prior history of abdominal surgery, available weight loss surgery options and other variables. Our Atlanta-based bariatric specialists will help you determine the best option. They include:
The lap Roux-en-Y gastric bypass operation is one of the most common gastric bypass surgeries. Lap Roux-en-Y gastric bypass is both a restrictive and a malabsorptive procedure. It alters digestion by limiting the amount and types of foods that you can eat. It can be performed through open surgery with one long incision or laparoscopically using multiple small incisions.
With the lap Roux-en-Y gastric bypass procedure, a small stomach pouch is created by using special staples or a vertical gastric band. This pouch is then connected to a Y-shaped segment of your small intestine which allows food to bypass the lower section of your stomach and the first segments of your small intestine. Not only is your stomach pouch too small to hold large amounts of food, but by skipping segments of your small intestine, fat absorption is substantially reduced resulting in weight loss.
On average, the lap Roux-en-Y gastric bypass surgery takes one to four hours of operating time. Most patients remain in the hospital one to three days. Some may stay longer, but it’s not an indication of how well the recovery may be going. As with any surgery, there are some risks involved with the lap Roux-en-Y gastric bypass procedure, but your surgeon will discuss these with you in detail before your procedure. There is also a detailed follow-up plan for all bariatric surgeries including the lap Roux-en-Y gastric bypass.
Restrictive operations, like laparoscopic adjustable gastric banding surgery, are used only to restrict and decrease the amount of food you eat by reducing the size of your stomach. They do not interfere with your normal digestive process.
With laparoscopic adjustable gastric banding surgery, a hollow band made of special material is placed around your stomach near its upper end through several small incisions in your abdomen. This lap band procedure creates a small pouch and a narrow passage into the larger remaining portion of your stomach.
Two different types of bands can be used for gastric banding surgery.
The small passage created by the lap band procedure reduces the amount of food that your stomach can hold at one time. It also delays the digestion (emptying of food) from the pouch and causes a feeling of fullness for a long period of time. This combination allows you to lose weight without feeling hungry.
With the lap band procedure, the band can be tightened or loosened over time to change the size of the passage. Initially, the pouch holds about 1 ounce of food and later expands to 2-3 ounces. You will need to have regular follow-up visits with your doctor after your gastric banding surgery to make sure your band is properly fitted.
On average, gastric banding surgery takes one to four hours of operating time. Minimally invasive (laparoscopic) surgery usually requires a hospital stay of one to two days, if there are no complications. As with any surgery there are some risks involved, but your surgeon will discuss these with you in detail before your gastric banding surgery. There is also a detailed follow-up plan for all bariatric surgeries.
Some patients who have had a Laparoscopic Adjustable Gastric Band placed experience problems after their procedure. These may include significant heartburn, vomiting, difficulty eating despite the band being properly adjusted and/or not achieving the weight loss they desire. Others may experience a slipped band, which can result in the band not functioning properly.
Our physicians can remove the adjustable band and convert to one of two other bariatric procedures, the Sleeve Gastrectomy or the Gastric Bypass. Either of these procedures can be done laparoscopically, and both are very good surgical alternatives for band patients who are experiencing complications or who have not reached their weight loss goals.
Sleeve Gastrectomy with Single Anastamosis Loop Duodenal Bypass (or Loop DS) is very similar to the duodenal switch (this refers to where most of the stretchable stomach is permanently removed and significantly shrinks the stomach capacity, but the basic stomach structure remains the same so calorie absorption decreases).
With this procedure, a portion of the stomach is removed (a.k.a. sleeve gastrectomy). In addition, the intestines are rerouted so calorie absorption is reduced. The intestine is attached approximately 8 -10 feet from the colon to the first part of the small intestine to the pyloric valve (which controls the flow of partially digested food from the stomach to the small intestine). This creates a loop that diverts the food stream from the top half of the small intestines, and in turn, creates a shorter channel which helps decrease the chances of weight regain by decreasing calorie absorption. Patients typically report a significant decrease in hunger and food consumption after this operation.
During a laparoscopic sleeve gastrectomy, a thin vertical sleeve of stomach is created using a stapling device, and the rest of the stomach is removed. The sleeve is approximately the size of a banana. The laparoscopic sleeve gastrectomy weight loss procedure limits the amount of food you can eat at any given time and helps you feel full sooner. Food consumed passes through the digestive tract in the usual order, allowing it to be fully processed in the body without altering the normal absorption of vitamins and minerals.
The majority of weight loss sleeve gastrectomies performed today use a laparoscopic technique, which is considered minimally invasive. Laparoscopic surgery usually results in a shorter hospital stay, faster recovery and smaller scars. Laparoscopic sleeve gastrectomy also has less pain involved than open surgical weight loss procedures.
Laparoscopic sleeve gastrectomy can be the first step before gastric bypass or it can be a single weight loss procedure. If a sleeve gastrectomy is used as part of a two-step weight loss procedure, the first step is for the surgeon to create the small stomach "sleeve." After a period of time determined by the surgeon, another weight loss procedure would be performed in which the surgeon attaches a section of the small intestine directly to the stomach pouch. This allows food to bypass a portion of the small intestine, which results in absorbing fewer calories.
The laparoscopic sleeve gastrectomy weight loss procedure significantly decreases hunger by removing the part of the stomach that produces the main stimulating hormones. It can also minimize the chance of developing ulcers. The laparoscopic sleeve gastrectomy also requires fewer office visits than the Lap Band weight loss procedure because there is no need for band size adjustments.
Surgical procedures can be performed open or minimally invasive. Only the bariatric specialists at Emory Decatur Hospital can determine which of the weight loss surgery options is best for you.
During minimally invasive (laparoscopic) surgery, our bariatric specialists will insert a small camera into your abdomen, allowing our surgeons to view the procedure on a separate video monitor. Of the weight loss surgery options available, this approach is considered a less invasive weight loss surgery option because it replaces the need for a larger incision that opens the abdomen (open surgery).
Some studies suggest that patients who have had laparoscopic weight loss surgery experienced less pain after surgery, resulting in easier breathing and lung function as well as higher overall oxygen levels. Other benefits included fewer wound complications, such as infection or hernia, and patients returning more quickly to pre-surgical levels of activity. Weight loss surgery options, such as minimally invasive surgery, should only be performed by a specially-trained bariatric surgeon.
In some cases, minimally invasive surgery is not appropriate and open surgery must be performed. This approach can also be very effective, but it may require a longer time to heal. Your bariatric surgeon will advise you about which approach is best for you. For more information about weight loss surgery options at Emory Decatur Hospital, call our experienced Atlanta-based bariatric specialists at 404.501.7081.
There are many safe and effective weight loss surgery options. However, having bariatric surgery is only one small step in your weight loss journey. If everything goes as planned, your surgery will take a short time and you will be out of the hospital in a few days; however, this is when most of the work begins. Peruse our site to learn more about weight loss management after bariatric surgery.