Procedures

Lap Assisted Gastric Band (LAGB)

Gastric banding is a restrictive surgical procedure. The LAGB reduces the capacity of one’s stomach by placing a silicone band around the very top portion of the stomach. The passage of food from the upper stomach to the lower stomach is delayed. This delay causes the patient to feel full quickly and stop eating after smaller portions are consumed. An injection port is attached to the abdominal wall underneath the skin. This port is connected to the band with soft thin tubing. The LABG can be adjusted according to the patient’s appetite and feeling of satiety with small portions. If the patient starts to feel hungry between meals, is eating larger portions, and not losing weight, an adjustment can be given. Band adjustments are performed by the surgeon, usually in the office, by accessing the implanted port with a needle and injecting a saline solution that will increase the restriction provided by the band. This increased restriction then leads to increased satiety, decreased appetite and fewer calories consumed. If the band were to get too tight, saline can be removed to decrease the amount of restriction. The gastric band does not cause malabsorption, but due to decreased food intake patients should take an adult chewable multi-vitamin daily, or a chewable children’s multi-vitamin twice daily. Learn more. 

Roux-en-Y

Roux-en-Y Gastric Bypass produces weight loss by gastric restriction and malabsorption. A small gastric pouch is created using the upper outer portion of one’s stomach. The surgeon then attaches a section of the small intestine directly to the pouch. The small pouch (1 to 2 oz. size immediately following surgery) reduces the amount of food intake significantly. Then ingested food bypasses the rest of the stomach, the entire duodenum, and a short segment of jejunum (parts of the small intestine). The gastric bypass results in fat and protein malabsorption due to a slight delay of bile and pancreatic enzymes mixing with food. To prevent vitamin and mineral deficiencies as a result of malabsorption, patients are required to take lifelong supplementation of specially formulated bariatric vitamins. The remnant stomach is the large portion of the stomach that is stapled closed after the pouch is created. This remains within the abdominal cavity, it is not removed. This stomach continues to produce gastric acid and enzymes that will eventually aid in the digestive process when the two parts of the small intestine are reconnected. Having the smaller stomach pouch causes patients to feel full sooner and eat less food; bypassing a portion of the small intestine allows the patient’s body to absorb fewer calories. Learn more. 

Sleeve Gastrectomy

Sleeve gastrectomy is a restrictive bariatric surgery. During this procedure a large portion of the stomach is removed and the surgeon creates a small, sleeve-shaped stomach. It is larger than the pouch created during Roux-en-Y gastric bypass. It is approximately 3 to 4 oz. in size, about the size of a small banana. In super-morbidly obese patients, a sleeve gastrectomy is often performed as the first procedure in a two-part treatment. The second part of the treatment can be gastric bypass. Patients should take an adult chewable multi-vitamin daily, along with any additional supplements as ordered by the physician. Learn more.