Bariatric (Weight-Loss) Surgery

Like other bariatric surgery operations, gastric bypass is recommended for people who have clinically severe obesity. It has been shown to help relieve a long list of obesity-related health conditions, including type 2 diabetes, hypertension, obstructive sleep apnea and GERD (chronic acid reflux).

The Roux-en-Y procedure gets its name from the way it changes your digestive system. Roux-en-Y means in the shape of a Y. The procedure divides both your stomach and your small intestine, connecting each new segment together to form a Y shape.

First, it reduces the functional part of your stomach to a small pouch, separating it from the rest with surgical staples. This restricts the amount of food that your stomach can hold. Then, it connects the new stomach pouch to a lower segment of your small intestine.

This means that when food goes through your digestive system, it will now bypass most of your stomach and the first part of your small intestine. Because of this bypass, your digestive system won’t absorb all of the nutrients (or calories) in your food.

The Roux-en-Y procedure has been practiced, studied and refined for over 50 years. It was once the most common weight loss surgery, but in recent years it’s been overtaken by the gastric sleeve. Today the gastric bypass represents about 18% of all bariatric surgeries.

Yes. While it is considered a safe procedure, comparable to many other common surgeries, a gastric bypass is a major operation that will change your digestive system forever. Even after recovery, you will have to continue to take special care of it for the rest of your life.

If you have medically significant obesity, just losing weight can do a lot to improve your health. But gastric bypass surgery does more than that. It makes lasting changes to your metabolic system to help you manage your blood sugar, blood pressure and hunger.

It can improve or even resolve many obesity-related diseases, including:

• Hyperglycemia.
• Hyperlipidemia.
• Hypertension.
• Heart disease.
• Diabetes.
• Fatty liver disease.
• Gastroesophageal reflux.
• Sleep apnea.
• Osteoarthrosis.

At Vivaanta, it is done by laparoscopic surgery, a minimally-invasive surgery technique.It involves three to five small incisions in your abdomen, each about a half an inch. Smaller cuts mean fewer complications, less bleeding, less pain and a faster recovery. Your surgeon will perform the operation through these openings, using long, narrow tools

1. Your surgeon will give you general anesthesia, so you’ll be asleep during the procedure.
2. Your surgeon will make a small cut in your abdomen (about 1/2 inch long) and insert a port. They’ll pump carbon dioxide gas through the port to expand your abdomen.
3. Then they’ll place a small lighted video camera (laparoscope) through the port. The camera will project your insides onto a screen.
4. Through one to three additional incisions, your surgeon will insert additional ports and complete the procedure using long, narrow tools.
5. The first step in the Roux-en-Y procedure is to divide the top portion of your stomach from the remainder with a surgical stapler. The resulting pouch is about the size of an egg. The remainder of the stomach is still attached to your small intestine.
6. The next step is to divide your small intestine several feet down its length and bring the lower segment up to attach to your new stomach pouch. Your food will now pass from your stomach pouch into this segment of your lower small intestine
7. The final step is to reattach the upper branch of your small intestine to the trunk further down. Now your small intestine has two branches attached to the trunk: one leading from your stomach pouch, and the other leading from the remainder of your stomach.
8. The right side of this “Y” is the new branch, the one that your food will pass through. The left side is the original upper part of your small intestine (your duodenum). This is the part where your liver, gallbladder and pancreas deliver their digestive juices.
9. The left branch will deliver these juices into the new trunk of your small intestine, where they will mix with your food. This will enable you to properly digest your food, even though your shortened intestinal pathway will absorb fewer nutrients from it.

The procedure itself takes between two to four hours. Afterward, you’ll probably remain in the hospital for two days. You won’t be able to eat solid foods yet. Your surgeon will want to monitor you for any complications and help manage your pain.

All surgeries have some risk of complications. With sleeve gastrectomy, they occur in less than 1% of operations. Surgical complications may include bleeding,wound infection, reactions to anesthesia, leaks from the staple line, and narrowing of the sleeve (structure). Complications may include Hernias, Small bowel obstruction and Anastomotic leaks.

Long-term risks include vitamin deficiencies, dumping syndrome, and weight regain.

You’ll likely spend a day recovering in the hospital, then a few weeks recovering at home before you feel ready to go back to work. You may need to avoid strenuous activity for up to six weeks, and it may take up to twelve weeks to resume a normal diet.

The procedure typically lasts 60 to 90 minutes. Afterward, you will stay overnight at our comfortable surgical facility following surgery, and you will be discharged the next day.. You won’t be able to eat solid foods yet. Your surgeon will want to monitor you for any complications and help manage your pain.

While both the mini and full gastric bypass procedures help patients lose weight by rerouting the digestive system, there are key differences to consider. The full gastric bypass—also known as Roux-en-Y gastric bypass—creates a small stomach pouch and reroutes the small intestine in a Y-shaped configuration. This approach significantly limits food intake and reduces calorie absorption.

Roux-en-Y is typically recommended for patients with more complex health needs, such as severe acid reflux, type 2 diabetes, or a higher body mass index (BMI). It may also be preferred for those who’ve had previous abdominal surgeries or need more substantial long-term weight loss. While the mini bypass is less invasive and involves a shorter surgical time, it may not be as effective for individuals who require a more comprehensive metabolic reset.

The gastric band is an adjustable, inflatable tube made of soft silicone. It’s placed around the upper portion of your stomach to form a ring. This inflatable ring is connected to a port that is placed underneath your skin. Your surgeon can tighten the fit of the band by accessing the skin port and injecting with saline fluid, enough to allow a small outlet between the upper portion of your stomach and the lower part. When you eat, this upper stomach pouch will fill up quickly, making you feel fuller faster.

Compared to other bariatric procedures, the gastric band has the lowest complication rate after surgery, and there is no division of stomach or intestines. It can also be removed if needed. However, the Lap-Band leads to less weight loss than other bariatric procedures. It also requires several frequent follow-up office visits and adjustments, especially over the first year.

Currently, other bariatric surgery procedures, like the sleeve gastrectomy and the roux-en-Y gastric bypass, are more widely used. However, the gastric band may still be a good option for some patients, especially those who prefer a reversible procedure or have specific health considerations.

The average weight loss with Lap-Band is about 40% of excess weight over two years. That means if you were 100 lbs. overweight, you’d lose 40 lbs. Results can vary, depending on how much you change your habits after surgery. Weight loss with the gastric band is typically less than with other bariatric surgeries.

This is a subjective question. However, the procedure and recovery time are relatively short, and like most bariatric surgeries, you can have the adjustable gastric band installed by minimally-invasive surgery methods (laparoscopic surgery). This means that instead of one large incision across your abdomen, your surgeon can perform the entire operation through a few small “keyhole” incisions. This results in less pain, fewer complications, and a faster recovery.

1. Your surgeon will give you general anesthesia, so you’ll be asleep during the procedure.
2. Laparoscopic surgery begins with a single keyhole incision in your abdomen. Your surgeon will use this first keyhole to install a tiny pump and inflate your abdomen with carbon dioxide gas. This allows for your surgeon to see, and for there to be room to perform the surgery.
3. Your surgeon will install the laparoscope — a tiny lighted video camera. The laparoscope will project your organs onto a screen. Your surgeon will use long, narrow tools to access your stomach through additional keyholes.
4. Your surgeon will secure the gastric band around the top portion of your stomach and tighten it to form a pouch. Your stomach will look a bit like an hourglass, with a narrow channel between the top and bottom portions.
5. Your surgeon will secure the gastric band around the top portion of your stomach and tighten it to form a pouch. Your stomach will look a bit like an hourglass, with a narrow channel between the top and bottom portions.
6. The gastric band has a hollow channel that can be filled with fluid. This is what makes it adjustable. Your healthcare provider will be able to adjust the pressure of the gastric band by adding or extracting fluid through this port.
7. The gastric band is attached to a small plastic tube that will run just under your skin and into a port. After surgery, your healthcare provider will be able to access the port with a special fine needle to inject or extract fluid as needed.
8. When everything is in place, your surgeon will release the gas from your abdomen and close your keyhole incisions.

The procedure takes about 30 to 60 minutes, making it one of the shortest bariatric surgeries. Afterward, you’ll probably remain in the hospital for one day afterward. This way, they can help manage your pain and any temporary side effects of surgery, such as nausea.

The Lap-Band is designed to last a lifetime, but whether it does isn’t yet proven. Studies show that 35% to 40% of people may have their gastric bands removed after 10 years.

There are many reasons why the gastric band may be removed, including:

• Insufficient weight loss or weight regain.
• Band slippage or erosion.
• Infection or discomfort.
• Patient preference for another bariatric procedure.
• Obstruction.

The main advantage of the adjustable gastric band is that it has a lower risk of complications immediately after surgery. While sleeve gastrectomy and gastric bypass are both considered very safe, the gastric band is estimated to have an even lower risk of complications. There’s no division of your stomach or intestines involved. Additionally, it can be removed if necessary.

There are several disadvantages to gastric band surgery. First, it leads to less weight loss than the other bariatric surgeries. It also may require frequent adjustments, especially during the first year after placement.

Over time, there may be additional issues that arise. For example:

• Risk of complications after a gastric band to be as high as 50%.
• Rate of repeat procedures to fix or remove the gastric band may be as high as 35
• There may be mechanical problems with the band or port.

Many people lose weight with the gastric band in the first year or two after surgery. The gastric band placement itself rarely causes complications immediately after surgery, but some complications may develop down the road. Complications may require reoperation or removal of the Lap-Band. Some people decide after removal that they desire another bariatric procedure.

If you’ve had any type of bariatric surgery but are still gaining weight, your surgeon may recommend revisional bariatric surgery. We also use this surgery if you have any lingering side effects from bariatric surgery. These includes abdominal pain, acid reflux and vomiting.