Sarasota Memorial performs the three most common bariatric surgeries, as well as revisional surgeries to reverse or repair a previous bariatric procedure.
Roux-en-Y Gastric Bypass
The current gold standard procedure for weight-loss surgery, gastric bypass is one of the most frequently performed weight-loss procedures in the United States. In a Roux-en-Y gastric bypass, stapling creates a small stomach pouch. The remainder of the stomach is stapled shut and divided from the stomach pouch. The outlet from this pouch empties directly into the lower portion of the small intestine, thus bypassing calorie absorption.
- Higher average weight loss than other procedures or pure dietary restriction methods. One year after surgery, weight loss can average 77 percent of excess body weight.
- Studies show that after 10 to 14 years, most patients maintain 50 percent to 60 percent of excess body weight loss.
- Reduced or resolved associated health conditions, including back pain, sleep apnea, high blood pressure, diabetes and depression.
All of the following deficiencies can be managed through proper diet and vitamin supplements.
- Iron deficiency anemia and osteoporosis.
- Heightened bone calcium loss in women at risk for osteoporosis after menopause.
- Metabolic bone disease, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones.
- Chronic anemia due to Vitamin B12 deficiency.
- A condition known as “dumping syndrome” can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating.
- Some patients are unable to eat any form of sweets after surgery.
Adjustable Gastric Band
At Sarasota Memorial, the gastric band procedure is available to patients using either the LAP-BAND® by Apollo Endosurgery, or the REALIZE® Gastric Band from Ethicon Endo-Surgery. Both gastric bands reduce stomach capacity and restrict the amount of food that can be consumed at one time. In both cases, this minimally invasive procedure does not require stomach cutting and stapling, or gastrointestinal re-routing to bypass normal digestion. An implanted silicone ring is placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food.
- A laparoscopic procedure with no gastrointestinal rerouting, band surgery is considered the safest, least invasive and least painful of all weight-loss surgeries.
- Shorter hospital stays and quicker recovery.
- The band’s diameter can be modified to meet the patient’s needs. Pregnant patients can expand their band to accommodate a growing fetus, while patients who aren’t experiencing significant weight loss can have their bands tightened. If the band is removed, the stomach generally returns to its original form.
- Complications may include gastric leakage or bleeding, band erosion and band slippage.
- Common side effects include diarrhea, nausea and vomiting, heartburn and abdominal discomfort.
- Infection, spleen bleeding or injury, gastric perforation (a tear in the stomach wall), and access port leakage.
When a gastric sleeve is used, the surgeon creates a small, banana-sized stomach, which is known as the “sleeve” and typically holds between 50 ml and 150 ml. The unused portion of the stomach (approximately 85 percent) is removed. This surgery may be used as a first step prior to other weight-loss surgery procedures such as gastric bypass or as a single procedure.
- Food intake is reduced.
- In clinical studies, patients lost an average of 60 percent to 70 percent of their excess weight.
- Can resolve co-morbidities such as hypertension by 49 percent, sleep apnea by 60 percent, and Type 2 diabetes by up to 45 percent.
- Vitamins and nutrients are fully absorbed into the body, as there is no gastrointestinal rerouting.
- Gastric leakage or bleeding, ulcers and dyspepsia.
- Common side effects include abdominal discomfort and nausea.
On occasion, patients are unable to achieve significant weight-loss results from their initial bariatric procedure or are otherwise dissatisfied. Revisional surgery reverses the initial procedure. In some cases, this is done so that a different bariatric procedure can be performed. For example, with a gastric band removed, the surgeon and patient may decide that gastric bypass is actually a better fit for that patient’s lifestyle and wellness goals. Revisional surgery may also be needed to repair failed or failing gastric lap bands, and the Sarasota Memorial Bariatric and Metabolic Health Center's medical director specializes in these complex revisions and repairs.