Laparoscopic Roux Y Gastric Bypass

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This is one of the two operations supported by the 1991 "NIH Consensus Conference on Surgery for Obesity". Laparoscopic Roux Y Gastric Bypass has proven, over multiple studies, to achieve significantly greater and more sustained weight loss. It is a combination of two procedures in which a restriction, or a small stomach, is created, as well as a malabsorbtion, through which not all of the small intestine "sees" the food. With this procedure, an average weight loss of excess body weight is 70 - 80% possible.

The techniques of laparoscopic (minimally invasive) surgery initially became available in 1990 for the removal of gallbladders. This type of surgery has extended to hernia surgery, removal of colon, appendix, and correction of reflux (heartburn).

Laparoscopic Roux Y Gastric Bypass is only available to a select group of patients. In addition to cosmetic advantages (reduced scarring) studies have shown that Lap has decreased hospital stays, pain, hernias, lung problems; and has increased the ability to return to work.

Gastroplasty (Vertical Banded Gastroplasty, Gastric Banding)

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The second procedure approved by the NIH Consensus Panel was Vertical Banded Gastroplasty. It is a simple restrictive procedure in which a small "stomach" pouch is created with a stapler, with the pouch outlet restricted by a silastic band.

The disadvantages of this procedure include the technical considerations involved and the fact that weight loss is difficult for "sweet eaters". Also, the possibility of sustained weight loss is only up to approximately 40 - 50% of excess body weight.

For these reasons, and since a better alternative is available at the same risk, this procedure has not been defined as the "gold standard" by the American Society of Bariatric Surgery.

Laparoscopic Adjustable Gastric Banding (Lap-Band Surgery)

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Lap band was approved by the FDA in 2001. It has a long history in Europe and so America. Similar to the Vertical Banded Gastroplasty (VBG) it only restricts the amount of food and does not control quality or type of food. The expandable band is connected to a port and needs to be adjusted every month in order to have continued success. The results are similar to the VBG with 40 -50% excess body weight. It has some failures especially in sweet eaters and with technical malfunctions.

Gastric Sleeve Resection

Gastric Sleeve Resection is the 1st step of a 2-step operation. It was created in an emergency situation when a patient had to have a more complex bariatric procedure abandoned during surgery. The patient had the sleeve performed and lost a fair amount of weight. The patient subsequently returned to surgery to have his bariatric procedure completed.

The sleeve has only restrictive properties and has only a 1-2 year history.

The American Society for Metabolic & Bariatric Surgery (ASMBS) has a formulated statement that recommends this procedure as a staged procedure for weight loss in high risk patients. Those patients need to understand that they should proceed with a second operation.

See the ASBS position statement at www.asbs.org.

Nutritional Guidelines

The following information provides instructions and information for before and after weight loss surgery.

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Always consult you doctor (surgeon) and/or registered nurse dietician before making any changes to your diet.

Our Support Group

Our Support Group is open to anyone that has had surgery for obesity and would like support. Info Sessions are for anyone interested in learning more about surgical treatment for obesity.