Bariatric Procedures currently available at Northwest Hospital & Medical Center:

Laparoscopic Roux-en-Y Gastric-Bypass

Gastric bypass is currently the most popular procedure performed in the United States and worldwide. This surgical procedure combines the creation of small stomach pouches to restrict food intake and the construction of bypasses of the duodenum and other segment of the small intestine to cause reduced calorie and nutrient absorption. First, stapling creates a small stomach pouch. This causes restriction in food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum (the first segment of the small intestine) as well as the first portion of the jejunum (the second segment of the small intestine). This causes malabsorption.

Gastric bypass can be performed by both open and laparoscopic techniques. A Laparoscopic Roux-en-Y Gastric bypass uses advanced surgical minimally invasive instrumentation. The laparoscopic technique is minimally invasive and compared to non-laparoscopic (open) technique, has a shorter hospital, a faster return to work and activity, greater postoperative comfort, and a less visible scar from surgery.

Weight loss is usually about 65% to 70% of excess body weight. Weight loss generally plateaus in 1 to 2 years. Potential long-term complications include dumping syndrome, stoma stenosis, marginal ulcers, staple line disruptions, dilation of the bypassed distal stomach in the event of a small bowel obstruction, internal hernias. Additionally, life-long vitamin and mineral supplementation is required to avoid nutrient deficiency conditions.

When performed by skilled surgeons, operative mortality rate is about 0.5%.

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Laparoscopic Adjustable Gastric Banding Laparoscopic adjustable gastric banding surgery is a procedure reducing how much food the stomach can hold. It is considered a restrictive procedure. In this procedure, a silicone band is placed around the upper part of the stomach. As a result, the stomach is able to hold less food and it induces the feeling of satiety. (The band is evaluated on an ongoing basis for gradual tightening if necessary. By adding or removing saline, the band can be made tighter or looser.) The laparascopic adjustable banding procedure is minimally invasive, has the shortest operative time, and there is no need for vitamin and mineral supplementation. However, it requires placing a foreign object in the abdomen and has a slower weight loss and lower overall weight loss compared to other surgical techniques. Weight loss after surgery is about 50% of the excess body weight. Potential long-term complications include gastric prolapse, stomal obstruction, esophageal and gastric pouch dilations, gastric erosion and necrosis, and access port problems. When performed by skilled surgeons, operative mortality rate is about 0.1%. Back to top

Laparoscopic sleeve gastrectomy This surgical procedure generates weight loss by restricting the amount of food that can be eaten. About 2/3 of the stomach is removed; creating a banana-shaped reservoir. The newly created stomach can hold from 1-5 ounces. This is a purely restrictive operation since there is no bypassing of the intestines. It is therefore a simpler operation than the gastric bypass. Unlike laparoscopic adjustable banding procedures, the sleeve gastrectomy does not involve the placement of an artificial, foreign body to create a reduction in stomach volume. This procedure is irreversible. In the past, sleeve gastrectomies were often performed as first stage operations for super obese patients undergoing duodenal switch procedures. Surgical risk is low even with high risk patients. Complication rates range from 0-24%. The overall mortality rate is 0.39%. Percentage EWL range from 33-83%. Although no long term studies are available, small studies have shown resolution at 1-2 years for diabetes, hypertension, sleep apnea and dyslipidemia. Back to top

StomaphyX (Revisional Surgery) This procedure is available for individuals who have failed previous surgery and are regaining weight. StomaphyX enables the surgeon to reduce the size of the stomach or anastamosis without incisions. The procedure involves placing an endoscope through the mouth under direct visualization. Once inside the stomach, a small section of the stomach is suctioned into the device. With tissue suctioned into the device, small folds are created by prolene H-shaped fasteners. Ten to 16 fasteners may be applied depending on the needs of the patient. The procedure is simple lasting 20-40 minutes. It can be done as an outpatient or short stay procedure with minimal pain and quick recovery. No major complications have been reported. StomaphyX procedures have been reported to reduce patient stomach size by 50-90%. When used at the connection of the stomach pouch and small intestine, this procedure can result in slower emptying of the stomach and a quicker sense of satiety. Back to top If you have any questions about weight loss surgery and our support program, please call us at (206) 368-1350, or send us an email.