Laparoscopic Sleeve Gastrectomy
Laparoscopic vertical sleeve gastrectomy or "gastric sleeve" is a procedure where approximately 75-80% of the stomach is removed. This surgery is typically performed through 5 small incisions. The sleeve is considered a restrictive surgery which limits the amount of food a person is able to eat. It is also a metabolic surgery as it removes from the person the majority of the cells responsible for secreting a hormone called Ghrelin which is responsible for making people feel hungry. After having the sleeve gastrectomy patients benefit from excellent weight loss, but also are often times able to reduce or even put into remission other diseases associated with obesity including hypertension (high blood pressure), type 2 diabetes, and sleep apnea.
Roux-en-Y Gastric Bypass
Roux-en-Y gastric bypass has been around since the 1960s. It is the gold standard for weight loss surgery due to its long record of good results. In this procedure a small portion of the stomach which is attached to the esophagus is separated from the rest of the stomach and connected directly to the small intestine. This allows food to “bypass” the majority of the stomach and the first part of the intestine. This procedure is restrictive in the sense that the new stomach or “pouch” is very small which limits the amount of food that can be consumed at each meal. It is also considered a malabsorptive surgery as the food has less time to be digested before it is excreted. Finally, this surgery is a metabolic surgery as it alters gut hormones and significantly improves or sometimes even puts into remission type 2 diabetes, high blood pressure, and sleep apnea.
Intragastric Balloon
Intragastric balloons were recently approved for use in the United States but have been popular in other countries for several decades. The procedure introduces a large balloon into the stomach, which reduces the amount of food a person can eat during a meal. This allows patients to eliminate between 30-50% of their excess weight. The balloon remains in the stomach for 6 months and must be removed after this amount of time to prevent it from being digested by the stomachs potent acid. This procedure offers a minimally invasive way for people to get a jumpstart on their weight loss without having surgery. This may be particularly appealing to patients that have been asked by other physicians to lose weight in preparation for surgery related to hip and knee replacements, spine surgery, and hernia surgery.
Revisional Bariatric Surgery
Revisional bariatric surgery is performed on patients with previous weight loss procedures that are unsatisfied with their results or are experiencing complications related to their previous procedures. Most commonly this is a revision of a gastric band or lap band to one of the other previously mentioned procedures. This is often suggested when people are suffering from difficulty swallowing due to their lap band, weight regain, and band erosion into the stomach.