Procedures Overview

• What kind of bariatric surgeries are available?
• What are the Complications?
• Which one is most indicated for you?

Sample Image When considering obesity surgery, pick a surgeon who has extensive experience in Bariatric Surgery and is certified by the American Board of Surgery. The results of the operation, the number of complications, and mortality are related to the experience of the surgeon and the institution where these procedures are performed. It is very important that the surgery be performed in a hospital that has an active bariatric surgical program and that has a team approach to the care of its patients.

There are several surgical operations for the treatment of severe obesity, and there are new procedures on the horizon. Some of procedures have been around for many years, others are evolving, and others are new to the field.

No matter what surgery a patient chooses, he/she must have realistic expectations and must be prepared to make some lifestyle changes.

 

Our Procedures

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Roux-en-Y Gastric Bypass
(Open or Laparoscopic)

The Roux-en-Y Gastric Bypass is one of the most commonly performed weight loss surgery in the United States. It involves the complete partition of the stomach, creating small pouch, which is connected to the small bowel through a tiny orifice. All of the stomach and about 2-3 feet of the intestines is completely bypassed (see diagram). All of the stomach and about 2-3 feet of the intestines is completely bypassed (see diagram).

The RNY may cure or significantly improve GERD, diabetes, hypertension, high cholesterol, obstructive sleep apnea, high triglycerides, infertility, PCOS, fatty liver, and pseudotumor cerebri. The procedure is the procedure of choice for patients with diabetes.

The RNY Gastric Bypass is associated with malabsorption of certain nutrients such as iron, calcium and B12. Without prior proper supplementation these nutrients may become deficient. With new technological advances and extensive surgeon experience, this procedure is safe and is associated with a minimal amount of complications.  The RNY takes about 1 hour to perform and requires a 24-48 hour hospital stay.

 

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Gastric Sleeve

Although the gastric sleeve is a restrictive procedure in the United States for its safety, lack of significant complications and steady weight loss. The operation involves removing a large part of the stomach that resembles a long tube (gasatric sleeve). Recent studies show that there is also a metabolic effect significant enough to help diabetic patients. Side effects include gastroesophageal reflux. This is an effective procedure for all patients with exception of those who already suffer with gastroesophageal reflux.

 

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Biliopancreatic Diversion with
Duodenal Switch (BP-DS)

The Biliopancreatic Diversion with Duodenal Switch (BP-DS) is a restrictive and malabsorptive, and metabolic surgery. Therefore, it restricts food intake and reduces calorie absorption. The first part of the operation involves removing a large part of the stomach, leaving behind a smaller stomach that resembles a long tube (gastric sleeve) and re-routing of the small bowels to create a condition where fat is not absorbed. Side effects include multiple bowel movements daily and malabsorptive deficiencies that must be closely monitored postoperatively. It is an effective surgery for patents with diabetes and lipid abnormalities.

 

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Lap-Band

Approved by the FDA in 2003. Approved by the FDA in 2003. This is a purely restrictive and minimally invasive surgery. A small artificial band is placed on the top of the stomach. This band must be constantly adjusted. This procedure is losing in popularity due to inconsistent weight loss and slow weight loss. The frequent adjustments can become a burden for the patients. For these reason, many experienced bariatric surgeons no longer perform the Lap Band. Furthermore, one of the most common revisions I perform is Lap Band to the failure of the Lap Band.