As you research your options about surgical weight loss procedures available today, we know there is a lot of information out there and it can be confusing. As experts in bariatric medicine, we want to emphasize that your safety and comfort is of utmost importance to us.

Our surgical practice – and the hospitals where we perform surgeries – are all designated as bariatric centers of excellence. As such, this designation reiterates that everything we do is designed to make sure that your comfort, well-being and safety are always put first.

Most surgery is performed laparoscopically, with tiny incisions used rather than the old technique of using a large incision, which significantly scarred the abdomen from the breastbone to the belly button. With the newer laparoscopic approach, only a few tiny scars are left on the belly and, with time, most fade and may not even be visible. We’ll discuss the laparoscopic approach in more detail below.

SURGICAL OPTIONS TO TREAT MORBID OBESITY: WHICH PROCEDURE IS RIGHT FOR YOU?

Adjustable Gastric Banding: How it Works
The adjustable gastric banding procedure is the only adjustable and fully reversible weight loss surgery available in the United States today and is performed by making several tiny incisions in the upper abdomen. Small instruments – including a laparoscopic camera – are inserted through these tiny incisions into the abdomen. A silastic band is securely placed around the upper portion of the stomach, creating a small pouch and a narrow passage into the larger stomach. Once the band is in place and secure, the surgical instruments are removed and all incisions are closed.

The gastric banding procedure is designed to restrict food intake without interfering with the body’s normal digestive processes. Unlike gastric bypass, there is no cutting or rerouting of the small intestines. It is a restrictive procedure only, meaning there is no malabsorption of calories and/or nutrients. Because the new stomach pouch is restricted by the band and can hold only about an ounce or two of food at a time, the quantity of food eaten is greatly reduced and a feeling of satiety is easily obtained (satiety is the feeling of fullness). The narrow passage between the new, small pouch and the lower stomach allows food to empty slowly into the stomach where normal digestion then occurs.

Because the band is adjustable, it can be inflated or deflated by adding or removing saline via a port that rests beneath the skin, usually just below the breast. By adjusting the diameter of the band – either tighter or looser – food empties into the stomach either faster or slower. With a gastric banding procedure, one should expect an average of four to six band adjustments within the first year after surgery. Additional adjustments may be made if necessary. Follow-up with your surgeon is vitally important to achieve desired weight loss and to maintain appropriate levels of micro-nutrients. Having the ability to make band adjustments all along your weight loss journey allows for continued weight loss and maintenance long-term.

Advantages of adjustable gastric banding include:

• typical weight loss of 1-2 pounds per week;
• adjustability;
• reversibility;
• minimal impact on the anatomy;
• low risk of complications;
• procedure is done laparoscopically;
• if deemed appropriate by your surgeon, the procedure may be done as outpatient surgery;
• proven success;
• long-term control;
• excellent at-home support resources via lapband.com and realizemysuccess.com;
• typical recovery period of 7 to 10 days; and
• normal digestion and absorption of food energy and nutrition.

Click here to watch the REALIZE Band animated video.

Click here to watch the LAP-BAND® System animated video.

Sleeve Gastrectomy: How it Works
The sleeve gastrectomy procedure is performed by making several tiny incisions in the upper abdomen. Small instruments – including a laparoscopic camera – are inserted through these tiny incisions into the abdomen. Your surgeon will use a special stapling device to create a long, vertical sleeve stomach (similar to the shape of a banana) and the remainder of the “unused” stomach will be removed through your belly button. Once surgery is completed, the surgical instruments are removed and all incisions are closed.

The sleeve gastrectomy is designed to restrict food intake without interfering with the body’s normal digestive processes. Unlike gastric bypass, there is no cutting or rerouting of the small intestines. It is a restrictive procedure only, meaning there is no malabsorption of calories and/or nutrients. Because your new “sleeve” stomach will be much smaller than your original stomach, the quantity of food eaten is greatly reduced and a feeling of satiety is more readily obtained (satiety is the feeling of fullness). Food begins digestion in the new “sleeve” stomach and passes on into the small intestines, where normal digestion then occurs.

The sleeve gastrectomy is considered a “low maintenance” type procedure in that no adjustments – as with a gastric band—are required. Consequently, follow-up appointments with your surgeon are fewer than that of a band; however, due to the decreased capacity for eating food in the same volume as before surgery, follow-up with your surgeon is vitally important to achieve desired weight loss and to maintain appropriate levels of micro- nutrients.

Advantages of sleeve gastrectomy include:

• typical weight loss of 2-4 pounds per week;
• reduced capacity to eat large volumes of food;
• no “dumping syndrome” as in the gastric bypass;
• no band adjustments as with the gastric band;
• fewer follow-up appointments than with the gastric band;
• minimal impact on the anatomy (intestines are not affected);
• low risk of complications;
• procedure is done laparoscopically;
• proven success;
• excellent at-home support resource via realizemysuccess.com;
• typical recovery period of 7 to 14 days; and
• normal digestion and absorption of food energy and nutrition.

Click here to watch the sleeve gastrectomy animated video.

Gastric Bypass (Roux-en-Y): How it Works
The gastric bypass procedure (also known as Roux-en-Y) is performed by making several tiny incisions in the abdomen. Small instruments – including a laparoscopic camera – are inserted through these tiny incisions into the abdomen. The gastric bypass is designed to restrict the amount of food one can eat and to bypass a portion of the small bowel, thus allowing less food to be absorbed. Your surgeon will use special staples to create a small upper-stomach pouch that restricts food intake to about one ounce. This “new” stomach is known as the “pouch.” The small intestine is then transected past the duodenum, and brought up to the pouch so that food bypasses the lower stomach and a portion of the small bowel. Once surgery is completed, the surgical instruments are removed and all incisions are closed.

The gastric bypass procedure is designed to restrict food intake and to change the body’s normal digestion and absorption processes. It is a restrictive and malabsorptive procedure, meaning that the small pouch restricts the amount of food you can eat, while the change that occurs in the small intestines also limits how calories and nutrients are absorbed. Because the new stomach pouch restricts how much you can eat, the feeling of satiety is easily obtained (satiety is the feeling of fullness). Food passes from the esophagus into the new, small pouch and then moves into the portion of the small intestine that was brought up and connected to the pouch, thus bypassing most of the “old” (or distal) stomach and the duodenum.

Because the gastric bypass is a malabsorptive procedure, follow-up with your surgeon is vitally important to achieve desired weight loss and to maintain appropriate levels of micro-nutrients.

Advantages of gastric bypass include:

• rapid weight loss (typical weight loss of 5 pounds per week);
• reduction or resolution of serious co-morbidities such as type 2 diabetes;
• reduced desire to eat;
• “dumping syndrome” (negative response to sugar intake);
• easy follow-up schedule with your surgeon;
• procedure is done laparoscopically;
• proven, long-term success;
• excellent at-home support resource via www.realizemysuccess.com; and
• typical recovery period of 10 to 14 days.

Click here to watch our animated video on gastric bypass.

Duodenal Switch: How it Works
The duodenal switch (DS) combines malabsorptive elements to achieve weight loss. The DS procedure includes a partial gastrectomy, which reduces the stomach along the greater curvature, effectively restricting its capacity while maintaining its normal functionality. This means that part of the stomach is permanently removed. Unlike the unmodified BPD and gastric bypass Roux-en-Y (RNY), which use a gastric “pouch” and bypass the pyloric valve, the DS procedure keeps the pyloric valve intact. This eliminates the possibility of dumping syndrome, marginal ulcers, stoma closures and blockages, all of which can occur after other gastric bypass procedures.

At The Davis Clinic, we understand your concerns about how surgery will be performed. To reduce risks of infection, scarring, and other complications associated with the older, “open” surgical technique, nearly every procedure we do is performed laparoscopically. Dr. Robert Davis and Dr. Garth Davis specialize in the laparoscopic surgical approach, making surgery less invasive, and making the recovery period much easier for you.

In the laparoscopic approach, several tiny incisions are made in the abdomen rather than making a larger, long incision along the midline of the belly. A tiny camera and small surgical instruments are inserted through these incisions, allowing Dr. Davis to operate while viewing the procedure on a video monitor. Once surgery is completed, the camera and instruments are removed and incisions are closed. With a laparoscopic surgery, most people return to work within one to two weeks of their procedure.

Preparing for Your Surgery

The surgeons and staff at The Davis Clinic understand that obtaining better health and a better quality of life through weight loss surgery are extremely important to you. That’s why you have our commitment to provide excellent clinical care, nutrition and behavior modification education, exercise classes, an online community that’s available to you 365/24/7, and ongoing support throughout your weight loss journey.

To get started in our surgical weight loss program, just register to attend a free pre-operative educational seminar. At our seminar, you will learn the facts about why weight loss surgery is considered an appropriate and effective treatment for morbid obesity, how surgery is performed, associated risks and benefits, potential complications, what kind of weight loss to expect with each procedure, and real life after surgery.

Click here to register to attend our free pre-operative educational seminar today. 

Once you’ve attended our seminar, you’ll receive next steps for moving down your personal path to freedom from obesity.

At The Davis Clinic, we understand the importance of surrounding yourself with success, so we encourage you to check the schedule of our support groups and nutrition classes and begin attending right away. Studies show that people who attend live support group meetings before and after their weight loss surgery reach and maintain their goal weight more often than individuals that do not. At our support groups you’ll meet others who have traveled the path before you and can offer encouragement, friendly advice, and real-life practical tips for success. You will also meet others going through the journey right alongside you. You’ll be surrounded by individuals that truly understand your struggles and who simply just “get it.” In addition, our “Food as Friend or Fuel?” coursework will allow you to finally make the mental and emotional connections that are critical to your long-term success.