Weight Loss Surgery Procedures
At United Bariatric Center, we take a comprehensive team approach to assist you on your bariatric journey. We are led by highly trained Bariatric Surgeons, Dr. Sigi Joseph, and Dr. Shaan Akhtar who are available at all times. They’re trained in all surgical weight loss procedures and perform all of our advanced laparoscopic and robotic general surgical procedures.
Most of our weight loss procedures are performed at Centerpoint Medical Center, Independence which is a Bariatric Center of Excellence. We also perform bariatric procedures at Lee’s Summit Hospital and St Joseph Medical Center, Kansas City. We service the greater Kansas City area, eastern Jackson County, and surrounding areas including Marshall, Sedalia, Warrensburg, Carrolton, Harrisonville, and Liberty.
The Roux-en-Y Gastric Bypass — often called gastric bypass — is considered the ‘gold standard’ of weight loss surgery.
The Procedure
There are two components to the procedure. First, a small stomach pouch, approximately one ounce or 30 milliliters in volume, is created by dividing the top of the stomach from the rest of the stomach. Next, the first portion of the small intestine is divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch. The procedure is completed by connecting the top portion of the divided small intestine to the small intestine further down so that the stomach acids and digestive enzymes from the bypassed stomach and first portion of small intestine will eventually mix with the food.
The gastric bypass works by several mechanisms. First, similar to most bariatric procedures, the newly created stomach pouch is considerably smaller and facilitates significantly smaller meals, which translates into less calories consumed. Additionally, because there is less digestion of food by the smaller stomach pouch, and there is a segment of small intestine that would normally absorb calories as well as nutrients that no longer has food going through it, there is probably to some degree less absorption of calories and nutrients.
Most importantly, the rerouting of the food stream produces changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes.
What is gastric sleeve surgery?
This is the most common bariatric surgery. It’s also called sleeve gastrectomy. The surgeon removes about 80 percent of your stomach, leaving a pouch about the size of a banana. The surgery almost always uses a minimally invasive laparoscope and small incisions.
How does gastric sleeve work?
A smaller stomach means you take in less food. Your body absorbs fewer calories and nutrients. Your appetite may decline because of changes in hunger signals to your brain.
Advantages
- Gastric sleeve can lead to improvements in obesity-related conditions such as Type 2 diabetes, sleep apnea, high blood pressure, fatty liver disease, and osteoarthritis.
- It usually has fewer side effects than more complicated gastric bypass surgery.
- It does not require a foreign object in the body, as gastric banding does.
- Patients who have bariatric surgery, including gastric sleeve, have a higher life expectancy, better health, and higher quality of life than similar people who don’t.
- It is generally safe to use anti-inflammatory drugs (NSAIDs) after gastric sleeve surgery.
Risks and potential side effects
- Bleeding
- Infection
- Hernias
- Heartburn
- Narrowing of the sleeve because of scarring
- Leaking from the staple line
- New or worse acid reflux
- A few patients develop dumping syndrome when food passes too quickly through the digestive system. This can lead to nausea, vomiting, and diarrhea. It often goes away within three months. Medicine or diet changes usually help. This condition is also less common than many patients fear.
Other things to consider:
- The surgery is not reversible.
- You must take vitamin and mineral supplements and follow dietary guidelines for life.
The Biliopancreatic Diversion with Duodenal Switch – abbreviated as BPD/DS – is a procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy. Next, a large portion of the small intestine is bypassed.
The Procedure
The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach, so that when the patient eats, the food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream.
The bypassed small intestine, which carries the bile and pancreatic enzymes that are necessary for the breakdown and absorption of protein and fat, is reconnected to the last portion of the small intestine so that they can eventually mix with the food stream. Similar to the other surgeries described above, the BPD/DS initially helps to reduce the amount of food that is consumed; however, over time this effect lessens and patients are able to eventually consume near “normal” amounts of food. Unlike the other procedures, there is a significant amount of small bowel that is bypassed by the food stream.
Additionally, the food does not mix with the bile and pancreatic enzymes until very far down the small intestine. This results in a significant decrease in the absorption of calories and nutrients (particularly protein and fat) as well as nutrients and vitamins dependent on fat for absorption (fat soluble vitamins and nutrients). Lastly, the BPD/DS, similar to the gastric bypass and sleeve gastrectomy, affects guts hormones in a manner that impacts hunger and satiety as well as blood sugar control. The BPD/DS is considered to be the most effective surgery for the treatment of diabetes among those that are described here.
ORBERA™ combines a clinically tested and proven medical device, with your own customized plan and support team, to effectively manage weight loss. The comprehensive, two-part program starts with a soft balloon placed in your stomach for six months to encourage portion control. A team of support experts will then help guide you through a diet and exercise program. At six months, the balloon is removed and your support team will continue to guide you toward making healthy lifestyle choices. They will help you retrain your appetite, adopt new nutritional habits, and establish a reasonable exercise routine that will be essential to your long-term success.
Important ORBERA™ Intragastric Balloon System Safety Information
The ORBERA™ Intragastric Balloon System is a weight loss aid for adults suffering from obesity, with a body mass index (BMI) ≥30 and ≤40 kg/m2, who have tried other weight loss programs, such as following supervised diet, exercise, and behavior modification programs, but who were unable to lose weight and keep it off. To receive ORBERA™ you must be willing to also follow a 12-month program, beginning with the placement of ORBERA™ and continuing for 6 months after, that includes a healthy diet and exercise plan. If the diet and exercise program is not followed, you will not experience significant weight loss results; in fact, you may not experience any weight loss.
Losing weight and keeping it off is not easy, so you will be supervised throughout this program by a team of physicians, physiologists, and nutritionists. This team will help you make and maintain major changes in your eating and exercise habits. ORBERA™ is placed for no more than six months. Any time that the balloon is in the stomach for longer than six months puts you at risk for complications, such as bowel obstruction, which can be fatal. Some patients are ineligible to receive ORBERA™. Your doctor will ask you about your medical history and will also perform a physical examination to determine your eligibility for the device. Additionally, at the time of placement, the doctor may identify internal factors, such as stomach irritation or ulcers, which may prevent you from receiving ORBERA™.
You must not receive ORBERA™ if you are pregnant, a woman planning to become pregnant within six months’ time, or breast-feeding.
Complications that may result from the use of ORBERA™ include the risks associated with any endoscopic procedure and those associated with the medications and methods used in this procedure, as well as your ability to tolerate a foreign object placed in your stomach. Possible complications include: partial or complete blockage of the bowel by the balloon, insufficient or no weight loss, adverse health consequences resulting from weight loss, stomach discomfort, continuing nausea and vomiting, abdominal or back pain, acid reflux, influence on digestion of food, blockage of food entering the stomach, bacterial growth in the fluid filling the balloon which can lead to infection, injury to the lining of the digestive tract, stomach or esophagus, and balloon deflation. Important: For full safety information please visit orbera.com/dfu, talk with your doctor, or call Apollo Customer Support at 1-855-MYORBERA
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