What surgery is right for me?
There are several effective operations for obesity. Our goal is to help you find the surgery that is best for you. We educate patients about the pros/cons and risks/benefits of each surgery and, in most cases, let the patients choose. However, for a few patients, particularly those who are at a higher risk for surgical complications, one surgery may be recommended over another.
At Oregon Weight Loss Surgery, LLC (OWLS) we usually perform “restrictive” procedures. These procedures reduce the amount of food your stomach can hold. Patients eat smaller meals, which allow them to lose weight. There are three primary restrictive procedures: laparoscopic Roux-en-Y Gastric Bypass, laparoscopic Sleeve Gastrectomy and laparoscopic adjustable Gastric Banding.
Even though all three are restrictive procedures and performed with laparoscopic techniques, there are significant differences. Each has its own distinct advantages and disadvantages.
Gastric Bypass involves rearranging the gastrointestinal anatomy using surgical staplers. (A small stomach pouch is created). The surgery lasts around two hours and usually requires two nights in the hospital. The weight loss after surgery occurs over one to two years. Because most of the stomach and part of the small intestine is bypassed, patients are at risk for anemia and osteoporosis and must take vitamins and supplements for the rest of their lives. The vitamins recommended for a bypass patient are: multi-vitamin, calcium, vitamin D, vitamin B and iron. Because the stomach and small intestine is stapled and divided, there is a risk for leaking and bleeding at the staple lines.
Sleeve Gastrectomy does not involve rearranging the gastrointestinal anatomy, but does use surgical staplers similar to a bypass. A portion of the stomach is removed to create a very narrow tube in lieu of an entire stomach. It is not reversible. The surgery lasts around 60-90 minutes and requires one night in the hospital. The weight loss occurs after one to two years. Patients do not have the same risk of nutritional deficiency that is found after Gastric Bypass. Similar to the bypass, there is a risk of leaking and bleeding at the staple lines. Since this is a newer procedure, it is less likely that your insurance company will cover it. Because a portion of the stomach—which aids in the absorption of certain vitamins and supplements—is removed, it is recommended that the following vitamins be taken after the Sleeve Gastrectomy: multi-vitamin, calcium, vitamin D, and vitamin B.
Gastric Banding involves placing a silicone device around the top of the stomach. The device is connected via tubing to a port that is placed under the skin. There is no rearrangement of the anatomy. The surgery lasts around one hour and usually requires one night in the hospital, although some patients can go home the same day as surgery. The weight loss after Banding occurs over two to three years. By using a special needle to access the port, the band can be adjusted by adding or removing saline solution. The adjustment changes the opening in the stomach at the level of the band and, therefore, controls how much food can be eaten. Banding requires more frequent follow-up visits, where adjustments may be performed. Vitamin recommendations are the same as any non-bariatric patient: multi-vitamin, calcium and vitamin D.
In summary, all three procedures, Bypass, Sleeve and Banding can provide good, sustained weight loss; however, you must adhere to a proper diet and exercise program in order to get the best results. Bypass and Sleeve result in faster weight loss, but there are more risks with the surgery itself. Banding is a less-invasive surgery, but it does require several adjustments to be performed after surgery.
There are many factors that will influence your choice of procedure, including your medical history and insurance coverage. We strongly believe in allowing you to choose your operation after learning about all of the benefits and risks of each procedure.