Gastric bypass
Laparoscopic Roux-En-Y Gastric Bypass
The Gastric Bypass takes the stomach from roughly the size of a football to the size of a thumb. The new gastric pouch is approximately 5% of the size that it was. The remaining 95% of the stomach remains inside of the patient, but it is bypassed from seeing and storing food. The bypassed stomach still functions to make digestive juices and enzymes that will aid in digestion downstream when they meet up with food and drink that is consumed at the lower connection that looks like the letter "Y".
The Gastric Bypass takes about one-hour to perform. It is usually a same day discharge (outpatient procedure) in the properly selected patient. Patients usually return to work within one week.
The benefits are countless:
- Boasts excellent weight loss results - ~80% excess body weight loss
- Boosts metabolism
- Alters hunger hormones
Improves or resolves countless obesity related conditions, including:
- Acid reflux
- Diabetes & Insulin resistance
- PCOS
- Infertility
- Heart disease
- Sleep apnea
Sleeve
Laparoscopic Vertical Sleeve Gastrectomy
The VSG takes the stomach from roughly the size of a football to the size of a garden hose. The new stomach is 15-20% of the size that it was. Approximately 80% of the stomach is removed through a tiny incision (~1.2 cm) just to the right of the belly button.
The Sleeve takes about 20-30 minutes to perform. It is usually a same day discharge (outpatient procedure) in the properly selected patient. Patients usually return to work within one week.
The benefits are countless:
- Boasts excellent weight loss results - ~60-70% excess weight loss
- Boosts metabolism
- Alters hunger hormones
Improves or resolves countless obesity related conditions, including:
- Diabetes & Insulin resistance
- PCOS
- Infertility
- Heart disease
- Sleep apnea
REVISIONAL BARIATRIC SURGERY
Laparoscopic Sleeve to Gastric Bypass Revision
After the VSG, patients may experience new onset or worsening of acid reflux (GERD, heartburn, regurgitation) that remains uncontrolled even with maximal medical therapy with anti-reflux medications and behavioral modification like avoiding certain foods, not eating too late, or sleeping more upright. By bypassing the pylorus, it takes it from a high pressurized system to a low pressure system which improves or resolves acid reflux immediately after gastric bypass revision.
Patients may also seek revision for inadequate weight loss or weight regain. The sleeve may be wide and the pouch may need to be tightened in addition to performing a Roux-En-Y Gastric Bypass reconstruction.
Pre-operatively, patients will have an upper endoscopy and/or upper GI swallow study to assess for pathology or abnormality related to the sleeve that would require a surgical revision.
Laparoscopic Removal of Adjustable Gastric Band with Revision to Gastric Bypass
Patients who have had the adjustable gastric band may experience acid reflux, nausea, vomiting, abdominal pain, chest pain, food fear, and/or dry cough. Patients may have significant complications related to the band including band erosion, port site infection, slipped gastric band, esophagitis (irritation and inflammation of the inner lining of the esophagus), concentric pouch dilation above the band, esophageal dilation, aspiration pneumonia, or inverted access port. Patients may also seek revision for inadequate weight loss or weight regain as having the band can make it difficult to be compliant with a higher protein diet.
Pre-operatively, patients will have an upper endoscopy and/or upper GI swallow study to assess for pathology or abnormality related to the sleeve that would require a surgical revision.
Given the risk of ongoing reflux, it is recommended to remove the lap band, tubing, and subcutaneous port and revise to a gastric bypass for optimal results.