Goal: Lose 50+ lbs
There are two options: sleeve gastrectomy and adjustable gastric banding if your weight loss goal is more than 50 pounds. These two options may also help to eliminate weight-related health problems such as type 2 diabetes, gastric reflux, sleep apnea, joint pain, high blood pressure and other weight-related conditions. We’ll work closely with you to develop a comprehensive, individualized plan that not only helps you to lose the weight, but also to achieve a healthy new way of living. Our credentialed, multidisciplinary team offers medical management, advanced nutrition and exercise plans, counseling, behavior modification and group support as part of every surgical weight loss program.
Sleeve gastrectomy restricts the amount of food than can be eaten by removing 85 percent of the stomach. The surgeon creates a small, sleeve-shaped stomach — larger than the stomach pouch created during Roux-en-Y gastric bypass — about the size of a banana. The idea is to preserve the functions of the stomach while significantly reducing its volume and without bypassing the intestines or causing any gastrointestinal malabsorption. There also appear to be some metabolic effects with the sleeve, adding to its potential benefit.
Sleeve gastrectomy is an approximately 60-minute surgery involving an average hospital stay of one to two days. The recovery period is two to three weeks. Potential complications include leaks and stricture. This non-reversible surgery may be a standalone bariatric procedure or be performed as the first procedure in a two-part treatment for patients with a BMI of 60 or higher. The second part of the treatment is duodenal switch or a possible Roux-en-Y gastric bypass.
Life After Sleeve Gastrectomy
In our experience, patients typically lose 50 to 60 percent of their excess weight following sleeve gastrectomy, and most of the weight is lost during the first year post-surgery.
Like any bariatric procedure, sleeve gastrectomy can help you feel satisfied sooner and with less food, but it won’t eliminate the desire to eat. To reach your goals, you will need to follow the specific diet and exercise guidelines provided by your health care team. Required diet changes include smaller meals focusing on protein intake.
For more information about the effect of surgery on weight-related co-morbid conditions, see Results of Bariatric Surgery.
Adjustable gastric banding is a surgical procedure that uses restriction to reduce calories. Adjustable gastric banding is considered the least invasive bariatric surgery because it does not require resectioning — that is, removal of tissue or organs. The surgery can be reversed if necessary, although we recommend patients consider it a lifelong procedure.
This procedure uses two medical components that are implanted in the patient: a silicone band and an injection port. The silicone band is placed around the upper part of the stomach and molds the stomach into two connected chambers. The injection port is attached to the abdominal wall, underneath the skin. The port is connected to the band with soft, thin tubing.
Adjustable gastric banding creates a small pouch of stomach above the band. When the band is adjusted properly, the patient feels satisfied with less food. Adjustments to the band can be made during office visits using a needle to inject saline solution into the band through the port. Adding saline increases the amount of restriction provided by the band, helping patients feel fuller sooner and with less food. Potential complications can include band slippage, band erosion and port-related problems.
In 2011, the FDA approved gastric banding surgery for patients with a body mass index (BMI) of 30-35 with at least one co-morbid condition (such as diabetes, hypertension, sleep apnea or high cholesterol) or a BMI of 35+ without a co-morbidity. For other bariatric surgical procedures, the requirement remains a BMI of 35 for patients with a co-morbidity, and a BMI of 40 for patients without a co-morbidity.
Life After Gastric Banding
Gastric banding patients on average lose 40 percent to 50 percent of their excess weight. Usually performed on an outpatient basis, this surgery averages about 45 minutes operating time. Patients leave the hospital the same day and typically have a two- to three-week recovery period. Weight loss is gradual and can take up to five years. Patients return to have their bands adjusted on a regular bases, with longer intervals as they reach their goal weight. Long-term success with the band stands at about 70 percent.
Like any bariatric procedure, gastric banding can help you feel satisfied sooner and with less food, but it won’t eliminate the desire to eat. To reach your goals, you will need to follow your specific diet and exercise guidelines provided by your health care team. Required diet changes include reducing daily calories to 800-1,000 per day including 40-60 grams of protein. A daily multivitamin should include 18 mg zinc and 400 mg folic acid.
Gastric banding requires more intensive follow-up care than most other bariatric surgeries. This is mostly because the band is adjustable. Keep in mind that even after reaching and maintaining your success weight, you may still need to see your health care professional for further adjustments.
For more information about the effect of gastric banding on weight-related co-morbid conditions, see Results of Bariatric Surgery.