Obesity is a growing concern that has been established as a critical health issue. In the United States alone, obesity affects approximately 30% of the population and is the second leading cause of preventable death.
Physical, emotional, cultural and societal factors influence obesity. It is a disease that contributes to many medical conditions including Type 2 Diabetes, cardiovascular disease, hypertension, sleep apnea, osteoporosis, edema and clinical depression.
Comprehensive treatment of obesity is available and focuses on weight loss, medical conditions and a person’s emotional and psychological state. The Living Lighter Surgical Weight Loss Program successfully assists people on their weight loss journey by providing support to all aspects of obesity. This comprehensive program is effective for people who need to lose at least 100 pounds, or 75 pounds or more with co-morbidity factors.
Curing obesity is not just about weight loss but about regaining control. Living Lighter Surgical Weight Loss offers an effective, permanent solution for a happier, healthier, longer life.
For an overview of our surgeons and surgical options, be sure and watch the video below.
An effective and common surgical treatment for weight loss is the Roux-en-Y Gastric Bypass surgery, endorsed by the National Institutes of Health as an effective solution to permanent weight loss. This procedure requires no removal of the stomach but rather a reduction of stomach capacity. This is achieved with surgical stapling by creating a smaller stomach pouch and adding a bypass around a segment of the stomach and small intestine. Food is redirected, limiting the amount of calories absorbed. After Roux-en-Y gastric bypass, many patients find that their Type 2 Diabetes is controllable.
Adjustable Gastric Banding
An increasingly common surgical option includes Adjustable Gastric Banding, an inflatable, adjustable band placed around the upper part of the stomach. The band restricts the allowable amount of food consumption. Adjustable Gastric Banding can be modified to each individual by being adjusted or removed if necessary. The surgery is done laparoscopically and considered minimally invasive.
Our surgeons are specially trained in Bariatric Revision Surgery.
Temple Community Hospital surgeons work with each patient to determine the best available surgical option.
Laparoscopic Adjustable Gastric Banding
A gastric banding procedure that employs either the LAP-BAND System or the Realize Band is really a purely restrictive surgical treatment when a hollow band is placed round the uppermost part of the stomach, thus dividing the stomach into two portions, one small , one large portion. This guitar rock band restricts the outlet from the smaller portion towards the larger portion, slowing the emptying of food and developing a a feeling of fullness. This feeling of fullness may be the primary mechanism by which the band produces weight reduction. Because there is no “bypass” component to this process, food digestion occurs through the normal digestive and absorption process.
Benefits of Gastric Banding:
- The quantity of food that may be consumed in a meal is restricted.
- Food that is consumed passes through the digestive tract in the usual order, allowing nutrients to be fully absorbed into the body.
- In a US study, the mean weight loss at three years after surgery was 36.2% of excess weight.
- The Band can be adjusted being an office- based procedure using a port which lies just beneath your skin. Adjustments encourage the surgeon to increase or decrease restriction.
- May function as the procedure of choice for patients struggling with inflammatory bowel disease.
- The surgery is reversible.
Disadvantages of Gastric Banding:
- For optimal weight loss, regular follow-up is essential.
- Surgical risks include band slippage
- Surgical risks include band slippage out of place, band erosion into the stomach lining, and issues with the main harbour underneath the skin. These complications may need another surgery to correct.
The lap band
The lap band surgery or realize band surgery product is a silastic adjustable “belt” placed around the top of the stomach. It had been approved by the FDA for that treating obesity in 2001. The “belt” is attached to tubing which is then mounted on a port that is placed under the abdominal skin. The tightness from the “belt” is adjusted throughout a routine office visit where fluid is instilled into or removed from the main harbour. The thing is to adjust the band towards the size which allows the patient to lose about one to two pounds per week and feel full when eating solid protein.
Once the band is placed during surgery, it’s empty. Patients consume a very strict postoperative diet program after surgery. This allows this guitar rock band to heal in place before the filling of the band. Patients are noticed routinely following this six week period to adjust the tightness of the band based on how quickly the individual is slimming down and what they are eating. Throughout the patient’s lifetime, he or she will require occasional fine tuning from the band to maintain the load loss.
Maximum weight loss with the band will usually take two to three years to accomplish, which means that weight loss is slow and consistent with time if the patient adheres towards the prescribed diet. Patients that continue to eat sweets after lap band surgery will be disappointed using their weight loss.
Laparoscopic Sleeve Gastrectomy
This process reduces the stomach volume by stapling and dividing the stomach vertically, removing approximately 85% of the organ. The remaining part of the stomach resembles an extremely narrow “sleeve”. The stomach nerves and the pylorus stay in tact, allowing the stomach function to be uninterrupted, while at the same time greatly reducing its volume. Much of top of the portion of the stomach, that is responsible for producing the hunger hormone ghrelin, is taken away.
Advantages of Sleeve Gastrectomy:
- No foreign body implants.
- Restricts the amount of food that may be ingested previously.
- Helps control hunger due to removal of top of the part of the stomach.
- Digestion occurs normally since there is no “bypass”.
- This procedure might be safer for that extremely dangerously obese patient and people suffering from numerous health risks.
Disadvantages of Sleeve Gastrectomy:
- This is really a relatively new procedure.
- Sleeve Gastrectomy is non-reversible.
- Sleeve Gastrectomy isn’t adjustable.
The Laparoscopic Sleeve Gastrectomy (LSG)
The Laparoscopic Sleeve Gastrectomy (LSG) is a surgical option that induces weight reduction by restricting food intake. With this procedure, approximately 70 to 80 percent from the stomach is taken away laparoscopically so the stomach takes the form of a tube or “sleeve” that is roughly the dimensions and shape of a hot dog. The portion of stomach that’s removed is among the key areas that produce grehlin, a hormone which stimulates hunger and appetite.
Because the operation does not involve any “rerouting” or reconnecting of the intestines, it’s a easier operation compared to gastric bypass or even the duodenal switch. In addition, unlike the Lap-Band® procedure, the sleeve gastrectomy doesn’t need implantation of an artificial device within the abdomen.
Studies show weight reduction is all about just like a Roux n Y Gastric Bypass. This weight reduction happens quickly (over one to 1.5 years – just like RnY Gastric Bypass). The complication rate is slightly less than the RnYGB. The LSG has only five years of published data behind it.
Individuals who should think about the Gastric Sleeve procedure include the following:
- Those people who are concerned about the possibility long-term side effects of an intestinal bypass
- Those who are worried about a foreign object inside the abdomen (band).
- Anyone who has significantly higher risk of complications after operation depending on BMI (more than 60 for example) or serious medical conditions
- People who should always take anti-inflammatory medications or are awaiting transplant (and will need to take anti-rejection meds)
Gastric Sleeve as a Step Toward Gastric Bypass
For patients with a body mass index greater than 60, the sleeve gastrectomy could be the first a part of a two-stage operation. Some patients possess a body shape that may make bariatric surgery more technically difficult – specially those patients who carry their weight in their belly. Should you fall into this category, you may take advantage of a two-stage bariatric surgery.
In the first stage, a sleeve gastrectomy is performed. This allows a patient to lose 80 to 100 pounds or more, making the 2nd part of the operation substantially safer.
The Roux-en-Y Gastric Bypass
The Roux-en-Y Gastric Bypass is recognized as by many doctors to be the present “gold standard” process of bariatric surgery. It is the most frequently performed weight loss procedure in the United States. In this procedure, stapling creates a small stomach pouch. The remainder of the stomach is not removed, but is totally stapled shut and divided in the lower stomach pouch. The outlet out of this newly formed pouch empties into the lower part of the intestine (the jejunum), thus bypassing the duodenum and reducing calorie absorption. The length of the “bypass” can be increased to produce lower or higher levels of malabsorbtion.
Benefits of Gastric Bypass:
- The average excess weight loss in the Roux-en-Y procedure is usually higher in a compliant patient compared to purely restrictive procedures.
- One year after surgery, weight reduction can average 77% of excess body weight.
- Studies show that after 10 to 14 years, 60% of excess body weight loss continues to be maintained by patients.
- Provides appetite suppression inside a large percentage of patients.
- Requires less behavioral modification.
- Less tolerance for foods full of fat and sugar, this cuts down on the chance of “cheating.”
- Does not require the permanent implantation of the foreign body.
- Time tested procedure with follow up data exceeding 15 years.
Disadvantages of Gastric Bypass:
- Bypassing the main small intestine can lead to poor absorption of certain vitamins, including iron and calcium.
- The surgery isn’t reversible.
- “Dumping Syndrome” may appear, a condition that leads to the rapid emptying of the stomach into the small intestine. This usually only happens when too much sugar or large amounts of food are ingested. The results of dumping syndrome include nausea, weakness, sweating, faintness, and/or diarrhea after eating.
The Roux-en-Y Gastric Bypass surgery is the most popular weight loss surgery within the U.S. It was initially performed over 40 years ago and has been modified numerous times. It’s considered the “Gold Standard” within the U.S. as compared to other common weight loss operations. Our surgeons are highly trained and skilled to perform the Gastric Bypass surgery using non-invasive surgery techniques, also called laparoscopic surgery.
The restriction of intake of food as the result of a bypass is accomplished by dividing the stomach into two parts. One part is extremely small (the brand new pouch), and also the other area, while much larger, isn’t subjected to food again. The brand new stomach, or pouch, holds under one ounce, which translates into about 2 or 3 bites of food.
Once the bypass is surgically complete, the process of digesting one’s food is slightly changed. Whenever a patient swallows food, it passes with the esophagus and also the new stomach pouch into a segment from the small intestine called the “Roux limb.”
The changed anatomy from the stomach and intestines can be seen in the picture above, such as the new stomach pouch and also the Roux limb. Once the surgeon completes the bypass and prior to the surgery is finished, we execute a blue dye pressure test to make sure no leakage from the newly joined parts of this enzymatic system occurs.