Weight Loss Surgery
If non-surgical methods have not helped you lose weight and keep it off, you still have another option:
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- Studies show that weight loss surgery (as compared to other options) offers the best results - sustained long-term weight loss in patients who have failed with other treatments.
- Among the most crucial success factors, however, are a positive attitude, self-discipline, and the ability to set and work towards goals.
- Surgery can be the best option as long as you are ready to make this commitment to losing your excess weight and keeping it off.
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Weight Loss (Bariatric) Surgery Options
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- Restrictive (for example, the LAP-BAND® System)
- Reduces the amount of food that your stomach can hold, but doesn’t interfere with normal digestion of food and nutrients.
- Malabsorptive (for example, biliopancreatic diversion)
- Shortens the digestive tract to limit the number of calories and nutrients that can be absorbed by your body.
- Combination (for example, GASTRIC BYPASS)
- Restricts the amount of food the stomach can hold and reduces the number of calories absorbed by altering the digestive tract.
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The two most commonly performed weight loss surgeries in the United States are the gastric bypass (combination procedure) and adjustable gastric banding with the LAP-BAND® System (restrictive procedure).
Here’s a quick and informative overview of the advantages and differences between the LAP-BAND® System and Gastric Bypass weight loss surgeries.
LAP-BAND® System
A restrictive procedure during which an adjustable gastric band is placed around the upper part of the stomach. This creates a smaller stomach pouch, which restricts the amount of food that can be consumed at one time and increases the time it takes for the stomach to empty. As a result, patients achieve sustained weight loss by limiting food intake, reducing appetite, and slowing digestion.
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Gastric Bypass
Gastric bypass (also known as the Roux-en-Y) is a combination procedure using both restrictive and malabsorptive elements. With this surgery, first the stomach is stapled to make a smaller pouch. Then most of the stomach and part of the intestines are bypassed by attaching (usually stapling) a part of the intestine to the small stomach pouch. The result is that you cannot eat as much, and you absorb fewer nutrients and calories.
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LAP-BAND® System
ADVANTAGES
- Lower short-term mortality rate than gastric bypass
- Minimally invasive surgical approach
- No stomach stapling or cutting, or intestinal rerouting
- Adjustable
- Reversible
- Lower operative complication rate than with gastric bypass
- Low malnutrition risk
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Gastric Bypass
ADVANTAGES
- Rapid initial weight loss
- Minimally invasive approach is possible
- Longer experience in the U.S.
- Higher total average weight loss reported than with the LAP-BAND® System
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LAP-BAND® System
DISADVANTAGES
- Slower weight loss
- Regular follow-up critical for optimal results
- Requires an implanted medical device
- In some cases, effectiveness may be reduced due to slippage of the LAPBAND® Adjustable Gastric Banding
System
- In some cases, the access port may leak and require minor revisional surgery
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Gastric Bypass
DISADVANTAGES
- Cutting and stapling of stomach and bowel are required
- More operative complications than with the LAP-BAND® System
- Portion of digestive tract is bypassed, reducing absorption of some nutrients
- “Dumping syndrome”
can occur
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| RESULTS : A review of published studies showed many laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB) patients achieve comparable weight loss at 3 years and beyond (55% for LAGB and 58% for standard RYGB). |
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Mortality rate: 0.05%:
Risks include:
- Standard risks associated with major surgery
- Nausea and vomiting
- LAP-BAND® System slippage
- Stoma obstruction
- Band erosion
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Mortality rate: 0.5%
Risks include:
- Standard risks associated with major surgery
- Nausea and vomiting
- Leaks from staple lines
- Nutritional deficiencies
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| COSTS AND INSURANCE : Generally speaking, both procedures will be covered by insurance, but check with your employer or your surgeon’s office for specific information about your policy. Costs of LAP-BAND® Adjustable Gastric Banding System surgery and gastric bypass surgery will vary depending on the site where the surgery occurs (in-patient or out-patient), the type of bypass procedure (laparoscopic or open), and how long you are required to stay in the hospital. |
LAP-BAND® System
RECOVERY TIMELINE
- Hospital stay is often same day or less than 24 hours
- Most patients return to normal activity in about 1 week
- Full surgical recovery usually occurs in about 2 weeks
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Gastric Bypass
RECOVERY TIMELINE
- Stay is usually 24 to 48 hours
- Many patients return to normal activity within 1 to 2 weeks
- Full surgical recovery usually occurs within about 3 weeks
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Considerations for Bariatric Surgery
As with any surgery, individuals considering bariatric surgery must discuss the risks and benefits with the surgeon. Bariatric surgery has associated risks and long-term consequences and should be carefully considered prior to beginning this journey. The operation works best when patients promote lifelong behavioral and dietary changes.
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Bariatric Specialists of
North Carolina
300 Ashville Avenue, Suite 200
Cary, North Carolina 27518
  
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Seminars in Cary
Seminar and Support Group
300 Ashville Avenue, Suite 200
Cary, NC 27518
Click Here For
Schedule and Times
Seminars in Raleigh
Seminar and Support Group
Rex Hospital
4420 Lake Boone Trail
Raleigh, NC 27607
Click Here For A
Schedule and Times
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Dr. Paul Enochs is a Member of:
ASMBS
(American Society of
Metabolic and
Bariatric Surgery)
ACS
(American College of Surgeons)
SLS
(Society of
Laparoendoscopic Surgeons)
SAGES
(Society of American Gastrointestinal
Endoscopic Surgeons)
North Carolina Medical Society
American Medical Association
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