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Laparoscopic Sleeve Gastrectomy (LSG) (Banded or Conventional)

The vertical sleeve gastrectomy, or sleeve gastrectomy, is a type of restrictive weight loss surgery. It causes weight loss by restricting the amount of food that a person can consumed before feeling full.

The conventional vertical gastrectomy surgery isolates a small section of the stomach for processing food, limiting the size of meals to approximately 90-100 ml after surgery. The surgery is typically performed on patients who are too heavy to have other types of weight loss surgeries with the expectation that a second surgery will be performed once weight has been lost, or on individuals who do not suffer from severe co morbidities and are young.

The GaBP Ring Autolock™ is a prefabricated, calibrated and sterilized silicone coated implantable device that is designed specifically to control the reservoir capacity in bariatric surgeries. Addition of the band over the upper part of the stomach sleeve adds to the restrictive effect of the sleeve.

Roux-en-Y Gastric Bypass (RNYGB)

This procedure has a restrictive as well as a malabsorptive effect. Physically, it restricts food intake; portions sizes after the RNYGB are much reduced with an early feeling of fullness. Over-eating may then cause abdominal discomfort and vomiting. While the majority of the reduction in a patient’s calorie intake is attributable to the restriction, initially there is also an element of malabsorption of fat.

RNYGB also reduces a patient’s appetite. The mechanism by which this occurs is not fully understood, but is related to a change in the normal gut hormonal patterns. Bypassing the first part of a patient’s small intestine affects the production of hormones that control appetite. After RNYGB most patients feel far less hungry, often forgetting to eat. Bypass surgery also affects the hormones that control blood sugar and consequently many diabetic patients become non-diabetic soon after surgery.

Furthermore, adding the GaBP Ring Autolock™ has been documented to enhance weight loss and weight loss maintenance.

Mini Gastric Bypass (MGB)

The mini gastric bypass is also a restrictive and malabsorptive procedure. In this surgery, a stomach sleeve is created and separated from the rest of the stomach, which is retained in the body (like the RNYGB). The volume of the stomach sleeve is around 70-90 ml. The small intestine is then joined without disconnecting it (unlike the RNYGB) to the newly formed stomach sleeve.

MGB is very successful (50-70% excess weight loss) as a primary weight loss procedure, especially in type II DM. It can be used on patients who have failed previous restrictive procedures, sweet eaters, and patients with heartburn. It has a lower complication rate than RNYGB, and is also completely reversible. In addition, it can also be converted to a RNYGB or a VSG at a later stage if required.

Duodenal Switch Surgery

The Duodenal Switch (DS) procedure, also known as Biliopancreatic Diversion with Duodenal Switch (BPD-DS) or Gastric Reduction Duodenal Switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. This surgery decreases both the quantity of food that can be accommodated by the stomach and the number of calories that can be absorbed and used by the body. The duodenal switch combines the creation of a moderately sized stomach pouch with bypassing part of the small intestine. This allows the patient to lose weight without significantly altering their eating habits. The stomach is able to hold approximately four to six ounces of food, while other common procedures typically leave it able to hold one half to one full ounce.

Revisional Bariatric Surgery

Revisional Bariatric Surgery is performed to alter or repair one of the many types of weight loss surgery for the treatment of morbid obesity. The two currently popular procedures, Roux-en-Y gastric bypass and Mini Gastric Bypass, while successful, also require occasional revision. In fact the revision rate for the Gastric Banding Surgery is more than 10% during the first two years for either device-related problems or unsatisfactory weight loss. Likewise, the revision rate for gastric bypass is roughly 5-10% after 5 years for either troublesome complications, (e.g., ulcer, etc.) or for unsatisfactory weight loss.

If you have had poor weight loss/weight regain or complications of the original procedure, e.g., ulcers for Roux en Y Gastric Bypass or slippage of the band, you may qualify for revisional bariatric surgery.

Endoscopic Intragastric Balloon (EIB)

EIB is an endoscopic procedure in which a gastric balloon (an inflatable prosthetic device) is placed in the stomach via the mouth and oesophagus and then inflated with saline through a valve and port to produce artificial bulk in the stomach. It occupies almost half volume in the stomach, so the person is always half full. This procedure generally takes 20-30 minutes, after which you will be monitored by your doctor before returning home.

The first week you will be on a liquid diet with instructions to drink plenty of fluids. After the first week, you can begin a solid diet with recommendations from your doctor. With the Gastric Balloon you will have a feeling of satiety with smaller meals, lose more weight than with other diet programs and have the benefits of a non-surgical, non-pharmaceutical approach.

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