Choosing a Bariatric Procedure

When we’re asked what procedure is best, the answer is invariably: “it depends.” As frustrating as that answer may be, it’s important to remember that every patient is different, and their particular circumstance may warrant one procedure over another. The only way to truly understand which procedure is best is to research your options and consult with your weight loss surgeon.  Below, you will find some basic information on each of the procedures and general criteria to help you with the research process:

• The gastric sleeve or sleeve gastrectomy is currently the most popular procedure in the United States and removes about 75% of the existing stomach from the abdomen. It is not reversible and is suitable for patients with a BMI of over 35 with obesity related diseases. The sleeve doesn’t reroute the small intestine, meaning it has fewer dietary restrictions than the gastric bypass. Expected weight loss is greater than the gastric band but slightly lower than the bypass. We believe that the gastric sleeve is appropriate for almost every patient, however, patients with poorly controlled type II diabetes or uncontrolled acid reflux may wish to consider the gastric bypass instead. Learn more about the sleeve gastrectomy
• The gastric bypass offers the greatest weight loss potential, but is also the most complex of the three, major bariatric procedures. Ideally suited for those in the upper range of the obesity scale, the bypass combines restriction (cutting away approximately 80% of the stomach) and malabsorption (rerouting the small intestine) to achieve significant excess body weight loss. Dietary restrictions after this procedure are significant. Patients suffering from poorly controlled type II diabetes or acid reflux may benefit the most from this procedure. Learn more about gastric bypass
• The gastric band (also known by its trade name, Lap-Band®, is the only adjustable bariatric procedure and requires no cutting of the stomach or small intestine. The band simply restricts the amount of food that enters the stomach at any given sitting. This procedure is more suited to those who are on the lower end of the obesity scale or those who want an adjustable or reversible procedure. People with a BMI of as low as 30, presenting obesity related diseases, may qualify for the Lap-Band®. We do not perform this procedure as often as we did in the past as we have found that the long-term complication rates are unacceptable for many patients. However, we do want you to be fully informed about the options, so click here to learn more about gastric banding.

As you choose your procedure, you may also wish to speak to Drs. Shawn Tsuda or Heidi Ryan about whether robotically assisted surgery or single incision laparoscopic or SILS surgery may be appropriate for your particular circumstance. These techniques improve upon the effectiveness of laparoscopic surgery, but are not appropriate for every patient.

All in all, choosing a procedure requires thought and discussion with your medical team and bariatric surgeon. Further, a complete understanding of the benefits and risks of each procedure is imperative. You can learn more about your options at one of our free local monthly seminars.