Weight Loss Surgery Essentials
Obesity is a medical condition that affects approximately one-third of the adult population of the United States. It is a chronic disease that can increase the risk of developing other potentially life-threatening conditions, including diabetes, heart disease, and some forms of cancer. And, of course, the social and psychological impact can be devastating.
Losing weight through diet and exercise alone is optimal, but it does not work in the long-run for most severely overweight people. Approximately, 95-98% of severely obese adults who lose weight through diet and exercise alone have regained that weight (or more) at 5 years. Conversely, five years after surgery, most weight loss surgery patients have maintained successful weight loss.
If you're severely overweight, you know it's not just about willpower. The doctors of Southwest Bariatric Surgeons also know it's just not about willpower. There are physiological factors impacting your weight and, as a result, your health. We help you overcome those factors.
Weight loss surgery (aka “bariatric surgery”) is a tool to help people adopt and maintain a healthy lifestyle so they can lose weight and reduce or eliminate serious medical conditions, then sustain their improvements. It is not a “quick fix” or the “easy way out.”
The 10 skilled surgeons of Southwest Bariatric Surgeons perform weight loss surgery in Austin and Round Rock and personally provide follow-up care for their patients. They have designed a comprehensive program to support patients throughout their weight loss journey and help them maintain their success.
Weight Loss Surgery Procedures
Southwest Bariatric Surgeons performs a comprehensive array of weight loss surgery procedures, including:.
• Adjustable Gastric Banding (Lap-Band and Realize Band)
• Gastric Bypass (Roux-en-Y)
(Adjustable gastric banding and gastric bypass are currently the two most popular weight loss procedures in the US.)
• Sleeve Gastrectomy
• Revision procedures, including StomaphyX incision-free gastric bypass revision.
Adjustable Gastric Banding (Lap-Band and Realize Band)
Adjustable gastric banding surgery helps people feel full faster and stay full longer. Unlike other weight loss procedures, it is both adjustable and reversible.
- A silicone band is placed around the top of the stomach, creating a small stomach pouch approximately the size of an egg. Tubing is connected from the band to an access port located under the skin (not visible). The addition and removal of saline via the port adjusts the tightness of the band. These adjustments are performed in the office.
- How it works: The stomach pouch results in eating less food, while the small opening created by the band slows the emptying of food, causing the individual to feel full longer.
- Banding surgery is performed laparoscopically (5 small incisions).
- Both the Lap-Band and the Realize Band are FDA-approved. Adjustable gastric banding is the most frequently performed weight loss procedure outside the US.
- Because anatomy is not permanently altered, adjustable gastric banding surgery is reversible. The addition and removal of saline makes it also adjustable and customizable. For example, saline would be removed for pregnancy.
- Risks and complications: As with any surgery, there are risks, and complications may occur. The surgeon addresses risks and complications at the seminar patients attend prior to their first appointment and in patient consultations.
- The band is a tool. It can be defeated with high-calorie liquids. Success requires lifelong commitment to change and periodic long-term follow-up. Patients should take multivitamins daily.
- Hospital stay: Many Southwest Bariatric Surgeons adjustable gastric banding patients go home on the day of their surgery. Some stay 1 night in the hospital.
- Back to work: 1 week (average)
- Weight loss after band surgery is gradual over a 2-year period. A typical average is 1 to 2 pounds per week. Lost weight has been shown to stabilize at 50-70% of excess weight.
Roux-en-Y Gastric Bypass
Gastric bypass is considered the "gold standard" of weight loss surgery, and other procedures are judged by comparing results to this procedure.
- A small stomach pouch approximately the size of an egg is created near the top of the stomach. A portion of the intestines is brought up and connected to this pouch, bypassing the lower portion of the stomach and other parts of the digestive tract.
- How it works: The stomach pouch restricts food intake, while the “bypass” element decreases the absorption of glucose and fat. Additionally, “Dumping syndrome” (see below) creates an aversion to sweets in many patients.
- Gastric bypass is the most frequently performed bariatric procedure in the United States. Other procedures are measured against it.
- Gastric bypass can be performed laparoscopically (6 small incisions) or open (1 long incision)
• Laparoscopic surgery reduces length of hospital stay and the incidence of many complications.
• Southwest Bariatric Surgeons performs the operation laparoscopically whenever possible – more than 98%
of cases. - Risks and complications: As with any surgery, there are risks, and complications may occur. The surgeon addresses risks and complications at the seminar patients attend prior to their first appointment and in patient consultations.
- Side effects: Dumping syndrome, an unpleasant reaction to foods high in sugar and/or fat, affects 70% of patients. Micronutrient deficiencies result in an increased need for supplementation of some, including B-12, folic acid, and iron.
- Gastric bypass is a tool. It can be defeated. Success requires lifelong commitment to change and periodic long-term follow-up.
- Hospital stay: 2 nights (average, if performed laparoscopically)
- Back to work: 2 weeks (average)
- Weight loss shown after gastric bypass: 60-80% of excess weight within two years. It is initially more rapid than with the gastric band, but levels off.
| Adjustable Gastric Band & Gastric Bypass Summary and Comparison | ||
| Gastric Bypass | Adjustable Gastric Band | |
| Procedure Type | Restrictive and malabsorptive | Restrictive |
| Laparoscopic | Preferred | Yes |
| Hospital | 2 nights (avg.) | Home same day or 1 night stay |
| Adjustable | No | yes |
| Reversible | No | yes |
| Back to work | 2 weeks (avg.) | 1 week (avg.) |
| Supplements | Vitamins plus additional B-12, folic acid, others | Vitamins |
| Weight Loss | Initially rapid | More gradual |
Sleeve Gastrectomy
aka Gastric Sleeve and Vertical Gastrectomy
- Option for patients who are very obese.
- Procedure: The stomach is divided and stapled vertically, creating a sleeve that can hold a small volume of food. Approximately 85% of the stomach is removed.
- Purely restrictive, no malabsorptive component. No portion of the intestines is bypassed. Weight loss is produced solely through restriction of the amount of food that can be eaten.
- Early studies show decreased complications in high-risk groups.
- Can perform as first stage if 2-stage procedure required.
- Rarely covered by insurance.
StomaphyX Incision-Free Gastric Bypass Revision
Despite the remarkable record of gastric bypass surgery in achieving an average of 60-80% excess weight loss, there are some patients who are unable to lose as much weight as they would like or who start to re-gain weight a few years after surgery. The StomaphyX procedure offers them help without having to undergo traditional surgery.
- Alters the small stomach pouch that was created in the original gastric bypass procedure, decreasing its volume and slowing the passage of food into the intestines.
- There are no incisions. Consequently, there are no scars.
- Procedure: While under anesthesia, the flexible StomaphyX device is gently lowered through the patient’s mouth into the stomach pouch under the visualization of an endoscope “camera” placed down the shaft of the device. Once inside the stomach pouch, sections of the stomach wall are folded with multiple suture-like fasteners, making the pouch smaller. The illustration depicts the bottom of the stomach pouch before and after the procedure.
- Approved by the FDA in 2007. Hundreds have been performed with overall risks much lower than traditional surgery.
Special Note Regarding Revision Procedures: If you’re interested in StomaphyX or other revision surgery, there is no need to attend a seminar. Please call our office at 512.334.1885 to discuss scheduling a consult with one of our surgeons.
Are You a Candidate for Weight Loss Surgery?
Surgery is not for everyone who needs to lose weight, but it can be life-transforming for some people. Please click here for basic candidacy information.
What's the Next Step in Exploring Weight Loss Surgery?
Attend a free seminar to learn more about surgery and Southwest Bariatric Surgeons. Click here to find a convenient seminar and register.