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Bariatric surgery is an effective means of weight reduction. Weight reduction can aid in preventing other medical conditions, such as heart disease and orthopedic problems, by helping you create a healthy lifestyle.

Figure 1

Laparoscopic ROUX-en-Y Gastric Bypass
This procedure involves two basic steps that lead to eventual weight loss; dividing the stomach to form a new, thumb-sized gastric pouch that limits the amount of food that can be eaten. The duodenum is bypassed, so food travels directly from the new stomach pouch to the lower part of the jejunum, thereby reducing the absorption of calories and nutrients.

Roux-en-Y gastric bypass provides restriction combined with some malabsorption.

The stapling is done vertically, creating a small pouch.

The stomach, however, is completely stapled shut, and the outlet of the pouch opens into the small intestine. This divides the small bowel just beyond the duodenum and brings it up to the pouch, constructing a connection.

The other open end of the bowel is attached to the Roux limb of intestine, completing a "Y."

Average Hospital stay
ROUX-en-Y laparoscopic surgery usually requires a one to two night hospital stay.

  • Roux-en-Y laparoscopic gastric bypass surgery video.

Figure 1Laparoscopic Gastric Sleeve Surgery

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a stomach that is roughly the size and shape of a banana. This small banana-shaped tube or sleeve becomes the new stomach pouch and extends from the natural stomach opening to the natural stomach outlet (pyloric valve). Gastric sleeve surgery helps limit eating by reducing the overall size of the stomach and helps control hunger by removing the part of the stomach that produces the hunger-stimulating hormone Ghrelin.

Stomach Intestinal Pylorus-Sparing Surgery (SIPS)
Stomach Intestinal Pylorus-Sparing Surgery is a new procedure that involves the creation of a sleeve gastrectomy with a slightly larger diameter than usual, combined with a malabsorption procedure. The duodenum just beyond the pylorus of the gastric sleeve is divided then attached directly to the side of the small bowel 3 meters (about 10 feet) from the large intestine. The small bowel, which is upstream from the connection, is not in contact with food, so there is less calorie absorption. In addition, the delivery of nutrients directly to the end of the small bowel changes intestinal hormones to improve or resolve diabetes in most patients.

SIPS is a modification of the duodenal-switch surgery, but with one bowel connection instead of two, making the surgery less complicated. While weight loss may be less than with the classic duodenal-switch, there are also fewer problems with malabsorption because less of the small bowel is bypassed.

Results thus far in the relatively small number of patients to undergo the procedure report weight loss with better improvement or resolution of diabetes compared to gastric bypass patients. Since SIPS is still a new procedure, it is important for people interested in it as a weight-loss option to discuss the procedure in detail with their surgeon.

The Day of Surgery
The day or your surgery, you will be admitted to a private room that is specially designed for bariatric patients. The nursing staff are all dedicated to bariatric patients and will be a great source of information and support throughout your hospital stay.

The Surgery
Operations for obesity are designed to change the energy balance. Energy balance is related to the amount of food absorbed and the amount of energy used. Surgery may control obesity by changing energy balance in two ways:

  1. Decreasing the intake of food (restriction)
  2. Causing some foods, such as sugars and fats, to be poorly digested and incompletely absorbed (malabsorption) and, therefore, eliminated in the stool.

Going Home
As with anyone who's had surgery, you'll need a little extra help once home. Cooking, cleaning, going to the store and bathing will all be accomplished more safely with the assistance of a family member or friend. Your strength will return, and you'll soon be able to accomplish all normal tasks with confidence.

Weight loss following surgery varies. On average, 95 percent of patients of laparoscopic ROUX-en-Y gastric bypass patients lose about 30 percent or more of their excess weight in three months, and 85 percent of patients have lost at least 75 percent of their excess weight by one year. The long term weight loss is from 55 to 66% of excess weight depending on the surgical procedure.

You're now ready for the third phase of our care—the rest of your life! You'll be part of a family that has worked to create a better, healthier life. Not only will you still receive support from our team, you'll begin moving to a leadership role in support groups, offering advice and encouragement.