Opting for weight-loss surgery is not an easy choice, but
new treatments and safer techniques are making surgical intervention a suitable option for more people. While the goal of any bariatric procedure is ultimately to improve health through medically supervised weight loss, results will vary depending on the procedure and the individual.
Adjustable Laparoscopic Gastric Banding (Lap Band)
In recent years, Lap Band has become one of the most popular bariatric surgeries. During this minimally invasive procedure, a circular silicone band with an inflatable balloon on the inner surface is placed around the top third of the stomach to reduce the food storage area. The band can be tightened or loosened by filling or emptying the balloon with saline solution through an opening, or “port,” that is created in the wall of the abdomen just under the skin. This is done by the surgeon at their office with routine follow up visits bi-weekly or monthly until the patient is comfortable. Patients usually go home the same day.
Weight loss with Lap Band surgery typically takes longer. Smaller amounts of food are eaten, but unlike gastric bypass, digestion occurs in the normal manner. Also, Lap Band patients must be more vigilant when it comes to food choices because the band allows them to eat high calorie foods not tolerated with the gastric bypass procedure. The band is adjusted every 4-8 weeks by the surgeon or PA during the first two years following surgery, with a goal to achieve a restriction that is both physically and psychologically comfortable.
Gastric Sleeve Surgery
Gastric sleeve surgery (gastric sleeve resection) is a newer bariatric surgery option. During this laparoscopic procedure, about 85 percent of the stomach is removed so that it takes the shape of a tube, sleeve or banana. The tube-shaped stomach that is left is sealed closed with surgical staples like the gastric bypass.
Gastric sleeve patients will require long term life style dietary changes and vitamin/mineral supplementation. There are some unique bariatric surgery diet restrictions for the first four to six months. Patients are gradually coached toward a balanced diet that includes lean meats, fish, soft poached eggs, fruits, vegetables and whole grains. Gastric sleeve patients are cared for in the surgical inpatient units by specialized nurses for 2 nights.
Roux-En-Y Gastric Bypass
During gastric bypass, a small stomach pouch is created by stapling an area that holds no more than 1-2 ounces of solid food or liquid. A Y-shaped section of the small intestine is then attached to the pouch to allow food to bypass the rest of the stomach and the first part of the intestines. The other end of the small intestine is reconnected to the intestinal tract.
With gastric bypass, the body can no longer tolerate many foods that are high in saturated fat, sugar or starch—the kinds often found in commercially processed food items. The key to successful after-care is the commitment to a lifetime behavior modification and maintenance plan, which includes a structured food plan and exercise regimen, plus regular follow-up with medical, nutritional, exercise and support group resources.
All bypass patients are cared for in the surgical inpatient units by specialized nurses for 2 nights.