The LAP-BAND and REALIZE adjustable gastric bands, Sleeve Gastrectomy, Roux-en-Y gastric bypass and StomaphyX are offered through the St. Francis Weight Loss Center. Your surgeon will work with you to determine which surgical method is best for you.

The LAP-BAND and REALIZE adjustable gastric bands can be implanted around a patient’s stomach, creating a small stomach pouch. The band is surgically placed through a small incision and fitted around the upper stomach. It is then inflated using saline and can be tightened or loosened, as necessary. This creates a small pouch, limiting food intake and creating an earlier sense of fullness. As a result, patients will be encouraged to progressively eat less, thus accelerating weight loss.

This procedure is considered to be much less invasive than gastric bypass surgery. It also can be performed laparoscopically.

The sleeve (vertical) gastrectomy is an operation to remove a portion of the stomach and resize it stomach to roughly the size and shape of a banana. A smaller stomach size helps patients become full faster and decrease the sensation of appetite.

You may have heard the sleeve gastrectomy called "partial gastrectomy," "sleeve gastrectomy," "longitudinal gastrectomy" or "vertical gastrectomy."

The sleeve gastrectomy does not involve any "rerouting" or reconnecting of the intestines and is a simpler operation than the gastric bypass or the duodenal switch. Unlike the Lap-Band, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen. It can be done laporascopically, and discharge from the hospital occurs within one day.

Sleeve gastretcomies are recognized as a first and single procedure for weight loss because it can achieve more than 50 percent excess weight loss in as little as 18 months.

For certain patients, in particular those with a body mass index greater than 60, the sleeve gastrectomy may be the first part of a two-stage operation. Patients may safely lose up to 100 to 150 pounds in a six to 12 month period, at which point the weight loss may plateau and other procedures such as Roux-en-Y gastric bypass surgery become less risky.

Both stages of the surgery can be performed laparoscopically and offers the advantages of shorter recovery time, shorter incisions, fewer incision-related problems and less pain.

Within one to two years after a sleeve gastrectomy, patients in medical studies have shown resolution of medical problems including:

• Diabetes
• Hypertension
• High cholesterol
• Sleep apnea

Like any surgical operation, sleeve gastrectomy has possible complications, such as leakage, dilation of the sleeve (which allows for more food intake) and other usual complications associated with bariatric surgery. These risks, however, are known to be much lower than in RNY gastric bypass and duodenal switch.

Roux-en-Y gastric bypass surgery, the most commonly performed bariatric procedure, alters the digestion process by combining restrictive and malabsorptive elements. In other words, the surgery limits, or restricts, the amount of food intake by reducing the size of the stomach, while also limiting the absorption of foods in the intestinal tract, known as malabsorption.

In normal digestion, food passes through the stomach before entering the small intestine, where most calories and nutrients are absorbed. During gastric bypass surgery, a small pouch is created at the top of the stomach using a plastic band or surgical staples. The “new” stomach is then connected directly to the middle of the small intestine, allowing food to bypass the rest of the stomach and upper portion of the small intestine. The stomach empties through the pouch and directly into the small intestine, where digestion now takes place.

By making the stomach smaller and allowing food to bypass part of the small intestine, patients feel full more quickly. As a result, fewer calories are consumed and absorbed, leading to weight loss.

The procedure can be done laparoscopically through a minor incision, using small instruments and a camera to guide the surgery. This procedure is less invasive and usually less painful than the traditional open procedure, which requires a large incision.

StomaphyX is an innovative procedure for people who have had Roux-en-Y gastric bypass surgery but regained weight due to a stretched stomach pouch.

Approved by the Food & Drug Administration in 2007, the StomaphyX procedure reduces the stomach pouch and stomach outlet (stoma) back to the original gastric bypass size without traditional surgery or incisions and with minimal recovery time.

It is not performed as a primary method of weight loss surgery, but as a type of revisional bariatric surgery for gastric bypass patients.