All the procedures significantly reduce stomach size. This is accompanied by an altered physiological and psychological response to food. The Vertical/Sleeve Gastrectomy, the LAP-BAND® Adjustable Gastric Band procedure, and the Roux-en-Y Gastric Bypass reduce the size of the stomach well over 90%. The Duodenal Switch also reduces the stomach size but not as much. The Duodenal Switch procedure also decreases the body's ability to absorb fat calories and nutrients to aid in successful weight loss. The normal stomach can stretch sometimes over 1000ml. The stomach pouch in these operations is usually formed from the part of the stomach which is least susceptible to stretching. When the patient ingests a small amount of food, the patient feels a sensation of fullness. The patient learns quickly that subsequent bites of food must be eaten slowly and carefully to avoid increasing discomfort and sometimes vomiting. In the Duodenal Switch, meals high in fat calories cause significant oily diarrhea and discomfort. Remember, bariatric surgery is only a tool. The patient must eat the right foods with vitamins and supplements to lose their excess weight in a healthy, nutritional manner with close follow-up. Exercise, drinking plenty of liquids and support from Dr. Feng and other patients alike are critical in this process. Eating the wrong foods, not taking the recommended vitamins and minerals, not exercising can lead to multiple problems that can result in an unhealthy, malnourished individual who is still obese. Dr. Feng specializes in minimally invasive, advanced laparoscopic bariatric surgery (weight loss surgery). Crystal Springs Surgical Associates is dedicated to patient care. With our comprehensive surgery and programs, we are here to make you feel comfortable.
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The LAP-BAND® System is placed laproscopically around the upper part of the stomach. The band divides the stomach into a small pouch above the band and larger pouch below the band. The smaller pouch limits the amount of food the patient can eat with the result of fullness after eating a small amount of food. The opening of the stomach can be increased or decreased by injecting or removing saline from the band. Dr. Feng or his Nursing staff can later control or adjust the amount of saline in the band that is a unique feature of the Lap-Band system and is a normal part of follow-up post the procedure. |
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Advantages of LAP-BAND® System Procedure
- Only procedure that can be reversed if necessary
- Usually done laparoscopically (minimally invasive)
- Easier to perform and generally safer than other weight loss options
- Outpatient surgery
- Results in fewer nutritional deficiencies
Disadvantages of LAP-BAND® System Procedure
- Successful results depend on the willingness to adopt long-term lifestyle changes
- Patients may have numerous visits with Dr. Feng during the first year to ensure proper band adjustment
- Requires the most effort from the patient to lose and maintain weight loss
- Weight loss may be slower
Risks of LAP-BAND® System Procedures
- Infection
- Inadequate weight loss
- Device malfunction
- Balloon, tube access port breakage
- Slippage or erosion of the silicone band
- Vomiting
Vertical Gastrectomy
This restrictive option has an expected Weight loss of 70-80% of excess weight
Description
This is a newer procedure that induces weight loss by restricting food intake. The Vertical Gastrectomy is also known as the Sleeve Gastrectomy, Restrictive Vertical Gastroplasty, or Vertical Sleeve Gastrectomy. The Vertical Gastretomy is essentially a newer, better version of the vertical banded gastroplasty, a procedure that has been abandoned by virtually all weight loss surgeons, due to high failure rates and complications. Dr. Feng surgically reduces the stomach in size to a long narrow, tube like, vertical pouch, between 1-4 ounces in size. There is no intestinal bypass performed. This procedure is usually reserved for high risk patients or super obese patients with the intention of performing another surgery at a later date. Nevertheless, all qualified obese patients are considered for undergoing this procedure. If necessary, the second procedure can either be a duodenal switch or gastric bypass. Most patients can lose 70 to 80% of their excess body weight over 6-12 months with sleeve gastrectomy alone. |
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Advantages of Vertical Gastrectomy Procedure
- Usually done laparoscopically (minimally invasive) in patients. Allows patients of any weight, including the super super obese and high risk patients, to undergo surgery with small incisions.
- Rapid weight loss.
- Patients do not experience diarrhea or significant “Dumping Syndrome” symptoms.
- The portion of the stomach producing hunger-stimulating hormones is removed.
- The stomach maintains normal function with no rearrangement of the intestines, reducing risks of protein and vitamin deficiency.
- Minimal patient effort to lose and maintain weight loss.
Disadvantages of Vertical Gastrectomy Procedure
- Successful results depend on willingness to adopt long-term lifestyle changes.
- Weight loss may be slower than combined restrictive/malabsorption procedures.
Risks of Vertical Gastrectomy Procedure
- Leakage
- Weight regain
- Nausea/vomiting
- May require second surgery for complete weight loss
- Combined Restrictive Mal-absorption Surgery Options- Combined operations restrict food intake as well as calorie and nutrient absorption. May also be more effective in improving obesity related health problems.
Combined Restrictive/Mal-absorption Operations
Combined operations restrict calorie/nutrient absorption and food intake. These operations may also be more effective in improving health problems related to obesity.
Roux-en-Y Gastric Bypass Procedure
This combined restrictive and mal-absorption option, the Roux-en-Y gastric bypass Procedure, has an expected weight loss of 75-80% of excess weight.
Description
Most common weight loss surgery performed in the U.S. and considered the gold standard of weight loss surgery. Dr. Feng creates a small, upper stomach pouch about 1 ounce in size, dividing it from the lower stomach. This significantly restricts the volume of food that can be eaten. He then divides the small intestine to create a Y-shaped section to attach to the stomach pouch. The lower stomach and a portion of the small intestine is bypassed. This reduces the amount of calories that can be eaten. The procedure minimally limits the nutrients the body can absorb because of the bypass. |
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Click Here to watch an interactive video of the Roux-en-Y Gastric Bypass Procedure
Advantages of Roux-en-Y Gastric Bypass Procedure
- May be more effective in improving obesity-related health problems than restrictive procedures.
- Minimal patient effort to lose and maintain long-term weight loss.
- Rapid weight loss.
Disadvantages of Roux-en-Y Gastric Bypass Procedure
- Patients may experience long-term nutritional deficiencies.
- May require lifetime use of special foods and medications.
- Decreased absorption of calcium may bring on osteoporosis and related bone diseases.
- “Dumping Syndrome” reaction usually occurs when meals high in sugars, carbohydrates, or fats are consumed.
Risks of Roux-en-Y Gastric Bypass Procedure
- Vitamin and mineral deficiencies
- Gallstones
- Leakage
- Infection
- Anemia
- Bowel Obstruction
- Dumping syndrome
- Abdominal hernia
- Combined operations are more likely to lead to complications then restrictive operations
- Weight regain
Duodenal Switch
This combined restrictive and mal-absorption option, the Duodenal Switch, has an expected weight loss of 80-90% of excess weight.
Description
This procedure offers the ability to eat larger portions foods than gastric bypass or adjustable gastric banding and has reliable and long lasting weight loss. You may experience more bowel movements and need to closely monitor your vitamin, protein and mineral levels. The stomach is reduced in size to a long, tube like vertical pouch, 4-5 ounces in size with moderate restriction of food intake. Dr. Feng divides the small intestine to separate food from the digestive juices, causing significant malabsorption. This surgery is best for patients with BMI of 50 and above. |
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Click Here to watch an interactive video of Duodenal Switch
Advantages of Duodenal Switch Procedure
- Patients are able to consume larger meals.
- Stomach function remains intact with normal stomach emptying, and thus “Dumping Syndrome” seldom occurs.
- Minimal patient effort to lose and maintain long-term weight loss.
- The portion of the stomach producing hunger-stimulating hormones is removed.
- Rapid weight loss.
Disadvantages of Duodenal Switch Procedure
- Some patients lose too much weight.
- May require lifetime use of special foods and medications.
- Patients may experience long-term nutritional deficiencies.
- More invasive surgery.
- Foul-smelling stools/gas after surgery.
- Patients experience a higher incidence of complications.
Risks of Duodenal Switch Procedure
- Excessive weight loss
- Diarrhea
- Anemia
- Bowel obstruction
- Dumping syndrome
- Leakage
- Infection
- Gallstones
- Vitamin and mineral deficiencies
- Abdominal hernia
- Combined operations are more likely to lead to complications then restrictive operations
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