Types of Procedures We offer several types of bariatric surgery procedures, as well as medical weight loss alternatives. Sleeve Gastrectomy Sleeve Gastrectomy The sleeve gastrectomy procedure is a relatively new form of weight loss surgery, abd has become one of the most popular options for bariatric surgery. Typically, the procedure involves a laparoscope and about 75% of the stomach is removed. The remaining portion of the stomach is a narrow tube or sleeve and connects to the intestines. Usually, a sleeve gastrectomy is the first step in a series of weight loss procedures and is of lower risk. It's typically followed up by gastric bypass, but in some cases, it might be the only surgery needed. For those with high BMIs, sleeve gastrectomies result in an average weight loss of 40 to 50 percent of excess weight after three years. People with lower BMIs tend to lose even more of their excess weight. Unlike gastric banding, a sleeve gastrectomy is irreversible. And, since it's relatively new, all long-term benefits and risks aren't yet known. Currently, we know that risks can include infection, leaking of the sleeve and blood clots. Roux-En-Y Roux-en-Y Gastric Bypass Roux-en-Y gastric bypass bariatric surgery is a procedure where most of the stomach is bypassed and a small stomach pouch is created. Typically, gastric bypass surgery has two parts: Creation of a small stomach pouch: During this part of the surgery, the stomach is divided into a large portion, and a much smaller portion. The small part of the stomach is then sewn or stapled together to make a small pouch. The small stomach pouch only can hold a cup or so of food. The “new” stomach size restricts food intake, resulting in the patient feeling full quickly and eating less. Roux-en-Y creation (bypass): In the second part of this surgery, known as Roux-en-Y, the small stomach pouch is disconnected from the first part of the small intestine (the duodenum). The surgeon then reconnects the stomach to a portion of intestine slightly further down (the jejunum). After a Roux-en-Y, food passes directly from the stomach into the jejunum, bypassing the duodenum. This leads to reduced absorption of calories and nutrients and the weight loss method is due to malabsorption. Weight loss after gastric bypass surgery is often dramatic. On average, patients lose 60% of their extra weight. Stomach stapling and gastric bypass are typically performed during the same surgery and the complete procedure is called a Roux-en-Y gastric bypass. Usually, gastric bypass is performed laparoscopically (through small incisions in the stomach area). After gastric bypass surgery, people typically stay in the hospital for two to three days and return to normal activity within two to three weeks. Nearly 10 percent of people have complications after gastric bypass surgery. These are usually minor and include: wound infections, digestive problems, ulcers and bleeding. It is recommended that you stay in contact with your physician and his staff and communicate progress and concerns. Lap-Assisted Gastric Band Lap-Assisted Gastric Band Laparoscopic adjustable gastric banding is bariatic surgery that decreases the size of the stomach and limits the amount of food the stomach can hold. Adjustable gastric banding takes place through several small incisions in the stomach. The physician will place small surgical tools and a camera through the incisions and wrap a device around the upper part of the stomach to form a ring. Attached to the ring is a thin tube leading to an access port that is left under the skin; the site where the physician puts in a needle to add or take away saline to allow for adjustments. After surgery, weight loss is usually gradual but steady, and you will most likely lose weight for up to two years. Some, however, will continue to lose for four to five years after surgery. It is recommended that you have regular visits after surgery with your physician so the band can be adjusted as needed. Surgical weight loss is a tool-not a quick fix. It is important that you eat right, exercise, and consult with your physician, who may recommend you work with a dietitian to plan for appropriate amounts of protein, vitamins and minerals in your daily meals. Since the adjustable gastric banding procedure does not require cutting or stapling of the stomach, it is less invasive than other common procedures. Studies have shown that people lose weight as successfully with adjustable gastric banding as they do with other weight loss methods or surgeries. Although adjustable gastric banding is considered the least invasive of the weight loss surgeries, problems can occur and include Band slippage (the band can slip out of place causing symptoms of stomach pain or heartburn) Obstruction (the band can cause something, usually food, to block the opening from the upper part of the stomach to the lower part of the stomach, causing pain, nausea, and vomiting) Gastric Balloon Gastric Balloon The Orbera™ intragastric balloon assists adult patients suffering from obesity - with a body mass index (BMI) of 30 to 40 - in losing and maintaining weight. The balloon is part of a comprehensive, low-cost, two-part program that includes a balloon filling space in a patient’s stomach to reinforce proper portion control. The balloon is placed by the surgeon in an upper endoscopy-like procedure. It usually remains in place for six months, and removed in a similar procedure. When combined with a proper diet, exercise and counseling from weight loss experts at King's Daughters, the Orbera is an excellent weight loss alternative. Data collected on the procedure in the U.S. clinical trial shows the average person lost more than three times the weight as compared with diet and exercise alone within six months. More than 220,000 Orbera balloons have been distributed worldwide in over 80 countries. To learn more about how the gastric balloon works, watch this short video.