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Surgical Weight Loss Treatment Options
There are numerous surgical treatment options for obesity that have been described. At the Advanced Bariatric Center, we offer a choice of four surgical procedures: the laparoscopic Roux-en-Y Gastric Bypass, the Laparoscopic Adjustable Ggastric Band, the Laparoscopic Sleeve Gastrectomy and the Laparoscopic Mill and Magenstrasse.
Which operation is for you? This is a common question we encounter as these operations are technically similar and have the same goals, but contain fundamental differences. I encourage you to read further but the key information you will need to make this decision will come from our in-office seminars on Tuesdays at 1:30 pm.
The Roux-en-Y gastric bypass is considered the benchmark surgery to  which all others are compared because in addition to being performed to treat obesity for over 40 years, it leads to excellent and consistent results with very low side effects. It has been performed using laparoscopic (keyhole) surgical technique since 1994 and remains the procedure of choice of over 80% of bariatric surgeons in the country. It involves two divisions and two connections of the gut with nothing removed. The surgery lasts 60 – 90 minutes and most people leave the hospital within 2 days.
 The adjustable gastric band is placed laparoscopically during a 60 – 75 minute outpatient procedure. A mediport is placed under the skin so that we may access it later with a needle and syringe and by injecting fluid the band will tighten and by removing fluid the band will loosen. When it is filled to the right amount, the exerts a constant pressure on the stomach wall giving the patient a pleasant full feeling in which you will not be hungry or thinking about food and small amounts of food will fill you up. The band stays with you for the rest of your life and provides portion control and some degree of appetite suppression. It does need regular adjustments which are performed in our office. 
The laparoscopic sleeve gastrectomy was initially performed as a first stage of either a Duodenal Switch or a Roux-en-Y gastric bypass in very high-risk individuals. After a period of initial weight loss, the plan was to complete the final stage when risks were reduced. However, surgeons had found the results dramatic and many patients did not need a second-stage operation. In this procedure, a tube is made out of the stomach with the rest of the stomach removed. As it is a new procedure and while accepted by bariatric surgeons as safe and effective, at this point insurance companies don’t cover it. This procedure is not reversible but has fewer complications than the gastric bypass and has overall very good weight loss results.
 The laparoscopic Mill and Magenstrasse procedure, otherwise known as a “vertical gastroplasty” is similar to the sleeve gastrectomy in that a narrow tube of stomach is created however the rest of the stomach remains attached by a small channel and therefore nothing is removed. The results are similar to the sleeve but the surgery is potentially reversible.
For questions about these procedures including which procedure is right for you, please contact us or attend one of our seminars.
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