Surgilite

This relatively new technique is becoming very popular with patients because it eliminates the large abdominal incision (diagram 1B) thereby resulting in less scarring and less pain. Through five or six small incisions (diagram 1) thin instruments and a camera are introduced into the abdominal cavity. The entire procedure is performed and viewed on a video monitor (diagram 2). Other benefits of laparoscopic technique include quicker recovery, shorter hospital stay, lesser chance of reoperation for hernias, and activities can be resumed sooner.

Diagram 1

Diagram 2

With all the types of surgery, except for the LapBand and Vertical Gastroplasty, women especially, should be aware of the potential for heightened bone calcium loss. Iron and calcium should be replaced through diet and supplements. Chronic anemia due to vitamin B-12 deficiency can also occur. This can usually be managed with B-12 pills or injections.

One disadvantage of the surgery is Dumping Syndrome. By bypassing the pylorus at the base of the stomach, a condition know as “Dumping Syndrome” can occur as the result of rapid emptying of stomach contents from the pouch into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. Dumping Syndrome is not considered to be a serious risk to your health, however the results can be unpleasant and can include nausea, weakness, sweating, faintness, and occasionally diarrhea. Another disadvantage of the operation is that the bypassed portion of the stomach, duodenum and segment of small bowel cannot be easily visualized by X-rays or endoscopy if a problem, such as ulcers, bleeding or malignancy occurs. These two disadvantages do not occur in LapBand or Vertical Gastroplasty patients.

In this procedure, a band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. This technique leaves the digestive tract in normal sequence for digestion and absorption. The surgical effect is a reduction in capacity for a meal. The success of this operation is the small pouch volume and correct outlet diameter. In this procedure the band can be adjusted to increase or decrease restriction, surgery can be reversed, and digestion and absorption remain normal.

This procedure is purely restrictive. The upper stomach near the esophagus is stapled vertically for about 2 ½ inches (6cm) to create a small stomach pouch. The outlet from the pouch is restricted by a band or ring that slows the emptying of the food, helping to create the feeling of fullness. Food digestion occurs through the normal digestion process.

This type of operation maintains the principles of a small pouch and a narrow outlet to produce restriction of food intake, the main cause of weight loss. In addition, most of the stomach and duodenum are bypassed, and malabsorption occurs. By adding malabsorption food is delayed in mixing with stomach secretions, bile and pancreatic juice which are needed for the digestion and absorption of nutrients. The result can be a sense of fullness, combined with a sense of satisfaction, which reduces the desire to eat.

This procedure is considered to be the current gold standard procedure for weight loss surgery. It is the most frequently performed weight loss procedure in the United States. In this procedure, stapling creates a small (15 to 20 cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the lower stomach. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption and the duodenum. This is done by dividing the small intestine just beyond the duodenum and bringing it up to the pouch constructing a connection with the new smaller stomach pouch. The other open end of the bowel is sewn back into the side of the Roux limb of intestine, completing a Y-shaped arrangement that gives the technique its name. The length of either segment of the bowel can be increased to produce more malabsorption, but increase in length also increased the risks and side-effects. The average weight loss is higher in the compliant patient, than with pure restrictive procedures. Poor absorption of iron and calcium may result because the duodenum is bypassed.