Understanding Surgical Options
Better Choices. More Victories.
Bariatric surgery or weight loss surgery is designed to help patients lose
weight quickly and safely. There are three procedures commonly performed,
the gastric bypass, the adjustable gastric band and the sleeve gastrectomy.
All can be performed using minimally invasive laparoscopic surgical techniques
the patient meets certain criteria.
The most common and successful surgical weight loss procedure is the Roux-en-Y
gastric bypass. Not only does gastric bypass generate weight loss, it
has also been recognized to resolve type 2 diabetes long before any weight
loss even takes place. During surgery, a small stomach pouch is created
to restrict food intake. Afterward, a Y-shaped section of the small intestine
is re-routed and attached to the new pouch. This allows food to bypass
the lower stomach and the upper parts of the small intestine, reducing
the amount of calories and nutrients the body absorbs. The small stomach
pouch created during surgery can hold only about two to four tablespoons
(three ounces), drastically reducing the amount of food that can be eaten
at one time. A gastric bypass patient will typically lose 75% of their
excess body weight in the first 18 months which is maintained long-term.
In most cases, the Roux-en-Y gastric bypass procedure can be achieved through
minimally-invasive laparoscopic methods.
Dr. Robert T. Marema, M.D., F.A.C.S., was a pioneer in the development of laparoscopic techniques
in bariatric surgery.
As with any laparoscopic procedure, the recovery time, patient discomfort
and risks are reduced when compared to open surgery. However, not all
patients are candidates for laparoscopic procedures. Gastric bypass surgery
carries the same risks as any other major abdominal surgery.
Shortly after surgery patients are back in their hospital room. Sitting
up in a chair or walking around is encouraged. Patients are usually discharged
approx. 2 days post surgery. Gradually, physical activity will increase,
with near-normal or normal activity resuming a few weeks after surgery.
Dr. Marema was the first surgeon in Florida and second in the world to
perform a single-incision vertical sleeve gastrectomy. He has since trained
physicians from around the globe on this procedure.
Click here to watch Dr. Marema explain sleeve gastrectomy
Vertical sleeve gastrectomy is the latest and fastest growing type of
surgical weight loss procedure, which dramatically minimizes the size
of a patient's stomach. The stomach is divided lengthwise and a narrow,
banana-shaped tube (sleeve) is created by removing 80% or more of the
stomach. The gastric tube is much smaller than the stomach's natural
size, thus restricting the amount of food that can be eaten at a given
time. The remainder of the stomach is removed and, since no bypass is
created, absorption of nutrients remains normal. The procedure takes about
30 minutes and has been reported to produce a loss of 50% or more of excess weight.
ADJUSTABLE GASTRIC BANDING
Adjustable Gastric Banding promotes weight loss by reducing the capacity
of the stomach through a band fastened around the upper stomach to create
a new, smaller pouch. As a result, patients experience a greater sense
of fullness and are satisfied with smaller amounts of food.
The current FDA-approved product is known as the LAP-BAND. The adjustable
band has an inflatable inner surface and is connected to an access port
below the skin by thin, kink-resistant silicone tubing. The port allows
the surgeon to adjust the band, impacting the amount and consumption rate
of food. This affects the patient's rate of weight loss. Adjustments
to the band are performed on an outpatient basis and are determined by
the patient's weight.