Bariatric procedures at Long Term VSG Tijuana

Laparoscopic Sleeve Gastrectomy

Sleeve gastrectomy is a restrictive bariatric surgery. During this procedure, the surgeon creates a small, sleeve-shaped stomach. It is larger than the stomach pouch created during Roux-en-Y bypass-and is about the size of a banana.

Sleeve gastrectomy is typically considered as a treatment option for bariatric surgery patients with a BMI of 30 or higher. It is often performed as the first procedure in a two-part treatment. The second part of the treatment can be gastric bypass

Choosing weight-loss surgery is an important decision. You should be informed on what to expect. Although our staff will review guidelines during each phase, we provide this overview to get you started.

Sleeve Gastrectomy/Vertical Gastrectomy

  • Newer surgical option for carefully selected patients
  • Long term outcome data beyond five years has not been reported
  • Perioperative risk appears low, even in high risk patients
  • 70% to 80% of the stomach is removed
  • Requires long term vitamin and mineral supplementation
  • Does not require the implantation of a foreign device
  • Documented weight loss as high as 85% of excess body weight
  • Not reversible, but can be converted to a Gastric Bypass

Laparoscopic Gastric Bypass

In gastric bypass surgery a large section of the stomach is stapled leaving a small pouch. Next, a section of the small intestine is attached to the pouch to allow food to bypass the lower stomach and much of the small intestine. The small pouch can accommodate only a few ounces of food at a time, and fewer calories and nutrients are absorbed due to bypassing the stomach and intestine. Thus patients eat less, absorb fewer calories and lose weight. Gastric bypass is typically reserved for patients who are more than 100 pounds overweight.

The most common gastric bypass surgery is a Roux-en-Y gastric bypass.

In a Roux-en-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).

Roux-en-y Gastric Bypass

  • Extensively studied and most frequently performed weight loss surgery in the U.S
  • Restrictive and malabsorptive components to the procedure
  • Complex procedure affecting multiple areas of the abdomen
  • Lower stomach remains healthy and intact
  • Less tolerance for foods high in sugar and fat
  • Requires long term vitamin and mineral supplementation
  • Does not require the implantation of a foreign device
  • Initial and sustained weight loss ranging from 60% to 75% of excess body weight
  • Not reversible

Laparoscopic Adjustable Gastric Banding

The LAP-BAND® Adjustable Gastric Banding System is a simple yet advanced gastric banding system that helps you gradually lose and control your weight by reducing the amount of food that your stomach can hold at one time.

The LAP-BAND® System is the safest, simplest and least traumatic of all weight-loss surgeries. An inflatable silicone band is inserted through small incisions in the abdomen and positioned to create a much smaller stomach pouch, allowing you to feel full and satisfied while eating less. Hundreds of thousands of people around the world are losing weight permanently and changing their lives with the LAP-BAND.

The name "LAP-BAND" comes from the minimally invasive surgical technique used (laparoscopy) and the silicone gastric band placed around the top of the upper part of your stomach. The LAP-BAND® System works by helping you control your food intake and supporting long term, sustainable weight loss.

Adjustable Gastric Banding

  • Relatively new technology in the U.S. with FDA approval in 2000
  • Restrictive procedure limiting food consumption during meals
  • A band is placed around the uppermost part of the stomach
  • Less invasive procedure with lower surgical risks
  • Food is processed through normal digestion and absorption
  • Requires long term vitamin and mineral supplementation
  • Documented weight loss of 40% to 60% of excess body weight
  • Frequent adjustments required to control band restriction
  • Implantation of a foreign device
  • Reversible

Due to the increasing popularity of weight loss surgery, more and more patients are undergoing operations to lose weight. Weight loss surgery, however, is not a miracle cure, and while most patients are successful after weight loss surgery, some patients may experience problems with the surgery or not succeed in losing the expected amount of excess weight.

In these situations, a follow-up bariatric procedure, known as a bariatric surgery revision, may be necessary to alter or repair the initial surgery. Revision weight loss surgery is a procedure that repairs or revises a prior weight loss surgery. Even the most successful operations may require a revision from time to time. Common revision cases include:

Complications from prior vertical banded gastroplasty (VBG) or “stomach stapling”

  • Complications from a previous open gastric bypass surgery
  • Failure to lose adequate weight after a LAP-BAND surgery
  • Inadequate weight loss or tendency to regain weight after gastric bypass
  • Unresolved co-morbidities after surgery.

Although it can be an emotional setback when weight loss surgery does not lead to the expected amount of weight loss, the only failure is in giving up. Obesity is a chronic disease and not easily treated. As with any serious health condition, if the first treatment is not effective, then the doctor will recommend additional treatment options. With weight loss surgery, a revision surgery may be necessary as an additional treatment for obesity.

Most revision surgeries can be done laparoscopically. You will be discharged from the hospital within one to two days. It is important to understand that while revision surgery is slightly higher-risk than a first-time operation, it is still lower-risk than remaining morbidly obese.


Revisions after LAP-BAND®

The revision rate for the LAP-BAND System is approximately 10% during the first two years. Revisions are due to either device-related problems, slippage or unsatisfactory weight loss. A complication specific to this type of procedure is slippage of the gastric band, which requires a follow-up procedure to fix the problem. While some patients will have the band replaced, others choose to revise to another procedure.

Revisions after Gastric Bypass

A gastric bypass revision is necessary in approximately 5 to 10% of patients over 5 years due to complications, unsatisfactory weight loss, or weight regain. Complications that may occur after gastric bypass surgery, such as ulcers, chronic vomiting, hernia, staple line failure, can often be improved through revisional surgery.

Results with a Bariatric Revision

Although the results can vary widely depending on the original procedure and the reason for the revision, these surgeries are usually successful in resolving the associated problems and promoting further weight loss. Weight loss following a revision is usually not as dramatic as the initial bariatric procedure, but it can be substantial over time. As revision surgery can be more complex and involve more risks than general weight loss surgery, it is important to choose a bariatric surgeon that is experienced and skilled in performing revision surgery. As with all bariatric procedures, the best weight loss results are achieved by patients who are able to comply with the diet and exercise recommendations of their surgeon. The post operative process can be a struggle and you will benefit in your weight loss efforts by attending support groups, talking to a nutritionist for dietary advice, working out with a exercise program, and, if needed, talking to a psychologist to help deal with emotional aspect of obesity and weight loss surgery.