At Lee's Summit Medical Center, our team of bariatric surgery experts will create a treatment plan to meet your specific needs in order for you to be most successful. We are with you during your entire weight loss journey providing support and expertise throughout every step.
Laparoscopic Adjustable Gastric Banding
Laparoscopic Adjustable Gastric Banding (LAP-BAND®) is a surgical procedure where a small band is placed around the upper part of the stomach. This creates a small pouch to hold food, limiting the amount of food that can be consumed and making you feel full.
Revision Weight Loss Surgery
If you have already had a bariatric surgery and either experienced complications or results have not been successful, you may be a candidate for revision weight loss surgery. Revision procedures can differ based several factors, including:
- Previous bariatric procedures
- How long it’s been since previous procedure
- The amount of weight loss you have achieved
- Current health factors
Revision procedures are not one-size-fits-all, and there are multiple factors that determine whether or not you are a candidate. The information below will give you an idea of what options are available based on your bariatric surgical history.
Gastric Sleeve Revisions
Gastric sleeve procedures may result in the need for a revision surgery due to mechanical failure, such as:
- Causing severe acid reflux
- Persistent nausea and vomiting
- A sleeve that is too large
Sometimes after a sleeve procedure, you may not experience as much weight loss as anticipated. It’s important to make sure you are appropriately educated on how to use the sleeve as a successful weight loss tool. Can you answer “yes” to each of the following statements?
- My daily calorie intake is 800 calories or less while incorporating 60-80 grams of lean protein.
- I drink 80-100 ounces of zero calorie liquids daily and avoid all liquid calories (i.e., milk, juice, smoothies, sweet tea, soda, coffee creamer/drinks).
- I do not drink with my meals and wait a minimum of 30 minutes after eating to resume drinking.
- I exercise a minimum of 3-5 times per week for at least 45 minutes.
If you answered “no” to any of the above questions, give our weight loss team a call so we can work together on a plan that’s best for you. If you answered “yes” to all of the questions above and have been unsuccessful at losing weight or have regained weight, you may be a candidate for conversion to gastric bypass or duodenal switch procedure.
Gastric Bypass Revisions
It is uncommon for patients to need a gastric bypass revision. The most common complaint from patients who have regained their weight after gastric bypass surgery is that the pouch has stretched out. While that is possible for some, most patients tend to revert back to previous eating habits. It is important that you continue to track and remain aware of the type/quantity of food you are eating.
Weight loss surgery provides you with a tool to help deal with issues such as a slow metabolism or poor eating habits, however the main function is to help control appetite and portion sizes.
Another possible cause of weight gain after gastric bypass surgery is stretching of the opening between the pouch and small bowel connection (termed “anastomosis”) over time. This can lead to faster emptying of the pouch which allows you to eat more or be less full with a meal. Revision surgery is not usually effective in maintaining that small opening over time.
Roux-en-Y Gastric Bypass
Roux-en-Y gastric bypass procedure, uses a small part of the stomach to create a new stomach pouch (roughly the size of an egg), which bypasses part of the small intestine. This will cause you to feel fuller more quickly and avoid eating a large amount of food at a single time. You may be a candidate for this procedure if:
- You are at least 100 lbs over your ideal weight and you have been unable to lose weight through diet and exercise.
- Your Body Mass Index (BMI) is 40 or above.
- Your BMI is 35 or above and you have a condition related to being overweight such as high blood pressure, heart disease, diabetes or sleep apnea.
How it Works
Once you and your weight loss team have determined that this procedure is the best option for you, your Roux-en-Y gastric bypass will be scheduled. Here’s how you will prepare for the surgery:
- Your doctor will order tests to check for nutritional deficiencies, and prescribe any supplements you may need prior to your surgery.
- Other pre-operative tests may be necessary to ensure you are healthy enough for surgery. In addition to meeting with other providers like a dietitian, before your surgery.
- If you smoke, your doctor will provide resources and support to help you quit smoking prior to surgery. Smoking slows recovery and increases surgery-related risks, so it’s important that you quit before undergoing surgery.
- You should give your doctor a complete list of all prescription medicines, supplements and over-the-counter medicines that you take. In the week prior to your surgery, your doctor may ask you to discontinue certain medications such as aspirin, ibuprofen or warfarin.
The Roux-en-Y gastric bypass procedure is a laparoscopic procedure done through small incisions using a tiny camera. The procedure is done in three steps:
- The stomach is divided into two separate parts, creating a small pouch approximately the size of a man’s thumb, separated from the rest of your stomach
- The surgeon will then bypass part of the small intestine
- The bypassed intestine (Roux Limb) is then attached to your stomach pouch
The laparoscopic Roux-en-Y gastric bypass typically takes up to a couple of hours. A two to three day hospital stay is necessary after surgery to help you recover. You can expect to return to normal activity within a couple weeks after surgery.
Advantages of Roux-en-Y gastric bypass:
- The procedure is predominantly effective for people with a high BMI because it has more predictable outcomes than some other types of weight loss surgery.
- One year after surgery, weight loss averages 77% of excess body weight.
- Studies show that after 10 to 14 years, some patients have maintained 50-60% of weight loss.
- This procedure will help to control or eliminate various weight related conditions such as diabetes, high blood pressure and cholesterol and heart disease.
- Ongoing adjustments aren’t necessary as would be with other weight loss procedures. However, regular follow up care is needed to ensure weight loss is on track.
Considerations for Roux-en-Y gastric bypass:
Patients who have undergone a Roux-en-Y gastric bypass must limit their intake of sugary and starchy foods to avoid “dumping syndrome.” This syndrome happens when too much of sugary or starchy foods are consumed causing one or more of the following symptoms:
- Abdominal pain
- Flushing skin
- Rapid heart rate
- Low blood pressure
These symptoms typically lasts 30-45 minutes. For many people who have had a gastric bypass, dumping or the fear of dumping serves as a motivation to make better food choices and stay away from foods that have tempted them in the past.
Risks of Roux-en-Y gastric bypass:
- Your body will no longer properly absorb nutrients such as iron and calcium because the duodenum (small intestine) is bypassed, which can lead to iron deficiency anemia. This is a particular concern for those who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis after menopause, should be aware of the potential for increased loss of bone calcium.
- Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of these deficiencies can be managed through proper diet and vitamin supplements.
- A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
- The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily seen using X-ray or endoscopy (a small, flexible tube with a camera and light attached to the end) if problems such as ulcers, bleeding or malignancy should occur.
Vertical Sleeve Gastrectomy
Vertical sleeve gastrectomy involves removing a large portion of the stomach. The new, smaller stomach is about the size of a banana, limiting the amount of food you can eat at once and helps you feel fuller after smaller meals.
You may be a candidate for vertical sleeve gastrectomy if:
- You are more than 100 lbs. over your ideal weight and you have been unable to lose weight through diet and exercise.
- You have a Body Mass Index (BMI) of 40 or higher.
- You have a BMI of 35 or higher and have a condition such as heart disease, sleep apnea, high blood pressure or diabetes that is related to being overweight.
Vertical sleeve gastrectomy is often performed on patients who are too overweight to safely undergo other types of weight loss surgery.
How it Works
If you and your weight loss team has determined that vertical sleeve gastrectomy is the best weight loss surgery option for you and your needs, your procedure will be scheduled.
Prior to the surgery, you should expect the following:
- A complete physical exam and related testing to ensure you are healthy enough for surgery
- Blood tests and an ultrasound of your gallbladder
- Nutritional counseling
- Psychological counseling to make sure you are emotionally prepared for surgery and the required follow-up care
The vertical sleeve gastrectomy is a laparoscopic procedure done through small incisions using a tiny camera.
Here’s how vertical sleeve gastrectomy works:
- Your surgeon will make two to five small incisions in your abdomen. The scope and instruments needed to perform the surgery are inserted through those incisions.
- The camera (now inside your abdomen) is connected to a video monitor, so the surgeon can have a clear view during the procedure.
- Your surgeon removes approximately three-fourths of your stomach, and joins the remaining portions of your stomach with surgical staples. This process creates a long vertical tube-shaped stomach.
- Your surgeon removes the scope and other instruments, and the incisions are stitched closed.
The laparoscopic vertical sleeve gastrectomy takes about 60-90 minutes. A two to three day hospital stay is necessary after surgery to help you recover. You’ll be able to drink clear liquids the day after your procedure, and begin a pureed diet by the time you go home. Your surgeon, nurse or dietitian will work with you to develop a proper diet following surgery. Following your dietary instructions is important for your safety and to achieve maximum weigh loss results.
ORBERA Non-Surgical Weight Loss Procedure
ORBERA™ is a non-surgical weight loss procedure for those who haven’t had luck losing weight with other diet and exercise programs. The ORBERA procedure was designed by weight loss specialists to be a temporary tool to assist in weight loss. ORBERA is a two-part weight loss system that places a soft gastric balloon in the stomach to limit how much you can comfortably eat at one time. In addition, this program includes a one-year coaching program to help you maintain your new, healthier lifestyle.
How it Works
ORBERA™ is ideal for people who don’t want to undergo surgery and the risks of complications while still getting the positive effects of weight loss surgery. The placement of the soft gastric balloon only takes about 20-30 minutes for your doctor to perform.
ORBERA is a simple outpatient procedure. Here’s how it works:
- You will be given a mild sedative to help you relax.
- The deflated gastric balloon will be inserted through your mouth and into your stomach.
- Your doctor will then fill the balloon with a safe saline solution until it is about the size of a grapefruit.
Most people are able to go home the same day. The gastric balloon will stay in place for six months, during which time you’ll see the most dramatic weight loss. Your doctor will work closely with you along with other specialists such as a dietitian to help develop a healthier diet plan and lifestyle habits for you to follow. After six months, the balloon will be removed and for the next several months, you will continue to work through your weight loss coaching program to make sure you have developed and are maintaining healthy habits to achieve maximum weight loss.