Making the decision to have weight loss surgery is huge. But even when you are certain that this is what you need to do, it can be overwhelming to move forward. Our surgeon and staff will be with you every step along the way, but we know that many patients like to be as informed as possible about their options. 

In this post, we will take a closer look at three of our most common procedures to discuss differences, advantages, disadvantages, and more. 

Differences between our three most popular weight loss surgery options

One thing we hear often is that patients want to have the least invasive surgery possible. As our name suggests — Birmingham Minimally Invasive Surgery — all of our options are indeed minimally invasive. Our three most common procedures are gastric sleeve, gastric bypass, and LAP-BAND. We perform each of these laparoscopically, which requires only four to six tiny incisions and less than two hours in the operating room.

Gastric Sleeve

During gastric sleeve surgery, we basically cut away the top and largest part of the stomach, which is called the fundus. About ⅔ of the stomach is removed. The removed section is where the hunger hormone, ghrelin, lives. If you’ve heard someone say they are never hungry after gastric sleeve surgery, it is because we have removed the hormone completely. Some people find this benefit more appealing than others. The combination of removing the hunger hormone and a large portion of the stomach typically leads to significant weight loss.

Who’s a good candidate for gastric sleeve? If using insurance to cover the procedure, you must have a minimum BMI of 35 to 40, along with various other health issues, such as diabetes, sleep apnea, or heart disease. If your BMI is higher than 40, these other health issues are not required. Gastric sleeve is a good option for anyone meeting these requirements without insurance coverage as well. Because the procedure has been shown to be acid inducing, anyone with severe acid reflux disease should probably avoid this option.

What are the benefits of gastric sleeve as opposed to other weight loss surgeries? Compared to other options, gastric sleeve is a simpler procedure. We do not reroute the intestines like we do during gastric bypass, and we do not put in a foreign body like we do with the LAP-BAND. It’s a quick procedure that involves cutting 2/3 of the stomach away, leaving a very small, banana-sized stomach.

Gastric Bypass

With gastric bypass (also called Roux-en-Y), we create a very small stomach pouch that restricts food intake. A Y-shaped section of the small intestine is attached to the pouch and allows food to bypass the lower stomach — the duodenum (the first segment of the small intestine) and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of food you can take in because your stomach holds only one to two ounces. This also decreases the absorption of food and nutrients, which aids in weight loss as well.

Who’s a good candidate for gastric bypass? Gastric bypass is often a better option for our heavier patients because most will lose up to 80% of their excess body weight as opposed to about 60% with gastric sleeve. This rapid weight loss can be very beneficial for those who have more severe health issues, such as sleep apnea, high blood pressure, and diabetes. It’s also a good option for anyone with severe acid reflux or poorly controlled diabetes since gastric bypass has proven to cure both. 

What are the advantages and disadvantages of gastric bypass? Some people like knowing that gastric bypass is technically considered reversible. However, this is something we always want to avoid, because reversal will cause you to gain the weight back. After surgery, you do have to take nutritional and vitamin supplements for life because of the malabsorption of food and nutrients.

We hear that people often have the impression that gastric bypass is more invasive than other options, but we take a minimally invasive approach. We typically make six incisions, and it’s done completely laparoscopically. It is a little more labor intensive because we do change your anatomy.  

The LAP-BAND

With this procedure, we place the LAP-BAND, a foreign body made of a special material, near the top of the stomach where it meets the esophagus. This creates a very small pouch that empties into the larger remaining portion of the stomach. The band is connected to a port, which is located underneath the skin of the abdomen. This is how we put fluid in the band, which allows us to make the band opening larger or smaller in size, giving patients more or less restriction.

Who’s a good candidate for the LAP-BAND? Many patients prefer the LAP-BAND because it is not permanent. We are not changing the anatomy of the stomach, and we can take the LAP-BAND out if the patient chooses to do so. It can be a good option for those paying out of pocket, because the cost is less than other options. It’s one of our more cost effective procedures.

What are the advantages and disadvantages of the LAP-BAND? With the LAP-BAND, weight loss may be somewhat slower than with other options. We have to find that “happy place” where the patient is able to get food down but also able to maintain smaller portion sizes. This is where band adjustments come into play.

Weight loss surgery with and without insurance

The role your insurance plays may be a big factor in which weight loss procedure is best for you. Many insurance companies have a BMI requirement for each surgery that you will need to meet in order to be a candidate. If you will be paying out of pocket, the cost of the procedure will likely play a major role in your decision. 

With all three of these weight loss procedures, the goal is for you to lose weight and become healthier, hopefully eliminating or reducing the severity of other health issues. But you must remember that no weight loss surgery option is a magic fix for permanent weight loss. While these procedures will certainly help, diet and exercise will still be important.

Contact Us to Learn More About Gastric Bypass Surgery

Birmingham Minimally Invasive Surgery is a caring group of professionals who specialize in all types of bariatric surgery.  Our surgeon Dr. Jay Long has highly specialized training in bariatric surgery, having completed a fellowship in minimally invasive and bariatric surgery at The Methodist Hospital in Houston, Texas, where he focused on taking care of patients that are morbidly obese.  And we are so proud of our pricing that we publish the costs right on the front page of our website!  Insurance won’t pay?  We have a variety of financing options we can offer you so that you are able to get the healthy body you’ve wanted for years.  Visit us today at http://www.bmisurgery.com/ or give us a call to set up a consultation at 205-833-6907. 

Did you know that sleeve gastrectomy, also known as gastric sleeve surgery, is the most frequently performed bariatric procedure in the U.S.? It’s an option many of our patients at Birmingham Minimally Invasive Surgery choose as well. 

To qualify for weight loss surgery, your body mass index (BMI) must be greater than or equal to 40 or between 30 and 40 with other medical problems, such as diabetes, sleep apnea, heart disease, or high blood pressure. In addition to these requirements, gastric sleeve and alternatives are options for those who have not been successful losing weight through diet and exercise alone. These procedures, along with lifestyle modifications, such as the right proportion of healthy food and exercise, can help improve your overall health and quality of life.

So gastric sleeve surgery is a great solution for many, but there are other choices. Why should you choose one over the other? We will explore three common procedures in this blog post to help you learn more, and as always, our surgeon and staff will be happy to discuss with you more.

Gastric sleeve surgery explained 

Gastric sleeve surgery works by changing the structure and reducing the size of your stomach. About two-thirds of your stomach is surgically removed during this procedure. You benefit from a smaller stomach which fills up more quickly. This limits the quantity of food you eat and the amount of calories absorbed by your body. The surgery results in a stomach that functions normally and enables you to eat most foods, just in smaller amounts.

Gastric sleeve surgery is a simpler procedure and helps avoid the associated risks of an intestinal bypass. It typically takes only about 30 to 45 minutes and  is performed laparoscopically. This means we avoid the need for large abdominal incisions, which typically results in less pain, shorter hospital stays, and faster recovery.

Considerations for gastric sleeve surgery: 

• Stomach tube may stretch over time, leading to late weight regain
• If weight is regained, a second stage operation known as duodenal switch or Roux-en-Y gastric bypass can be performed
• The procedure is not reversible
• There is no malabsorption of nutrients
• Not an option for patients with severe reflux disease

Gastric sleeve surgery alternative #1: LAP-BAND

In the LAP-BAND procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution. The entire procedure is done laparoscopically as well and induces weight loss by reducing the capacity of the stomach. This restricts the amount of food that can be consumed.

LAP-BAND is usually performed in the outpatient surgery center, and you are usually discharged the same day of the procedure.

Considerations for LAP-BAND:

• Least invasive surgical option
• No intestinal re-routing
• No cutting or stapling of the stomach wall or bowel
• Reduced pain, hospital length-of-stay, and recovery period
• Lower mortality risk than other obesity surgery procedures
• Low risk of nutritional deficiencies associated with gastric bypass
• Reduced risk of hair loss
• No “dumping syndrome” related to dietary intake restrictions

The lap band procedure is also adjustable and reversible. It allows for an individualized degree of restriction for ideal, long-term weight loss, and adjustments can be made without additional surgery. The band can also be removed, allowing the stomach and other anatomy to be restored to their original forms and functions.

While there are many benefits to LAP-BAND, it isn’t an overnight fix. We often have to work with patients to find their “happy place.” This involves finding the right fit so that you can eat freely but also maintain smaller portion sizes. This is where band adjustments come into play, which could be a process that takes a little time to perfect.

Gastric sleeve surgery alternative #2: Gastric bypass

Gastric bypass has the longest track record in the U.S., having been performed since 1967. It combines “restriction” and “malabsorption.” With restriction, we are creating a stomach pouch that holds 1 to 2 ounces. It is very effective in obtaining and maintaining long-term weight loss.

During the laparoscopic procedure, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces calorie intake.

Gastric bypass is an inpatient procedure requiring a hospital stay of 1 to 2 nights. The surgery takes about 60 to 120 minutes.

Considerations for gastric bypass:

• Rapid weight loss in the first six months
• Best operation to cure diabetes, high blood pressure, and sleep apnea
• Tend to lose more weight than patients after gastric band or gastric sleeve
• Longer recovery time
• Not considered reversible, but could be reversed if medically necessary
• Staple line can leak after surgery
• Minor late weight regain (10-20%) after 2 to 5 yrs
• Nutritional/mineral supplements required for life

As you can see, there are advantages and disadvantages to each option, and which one is best for you will depend greatly on your individual situation. The good news is that you don’t have to figure it out alone! Our surgeon, Dr. Jay Long, is extremely experienced in working with each patient to consider their needs and issues to find the right option.

Contact us to learn more about gastric sleeve and other weight loss surgery options.

Birmingham Minimally Invasive Surgery is a caring group of professionals who specialize in all types of bariatric surgery.  Our surgeon Dr. Jay Long has highly specialized training in bariatric surgery, having completed a fellowship in minimally invasive and bariatric surgery at The Methodist Hospital in Houston, Texas, where he focused on taking care of patients that are morbidly obese.  And we are so proud of our pricing that we publish the costs right on the front page of our website!  Insurance won’t pay?  We have a variety of financing options we can offer you so that you are able to get the healthy body you’ve wanted for years.  Visit us today at http://www.bmisurgery.com/ or give us a call to set up a consultation at 205-833-6907.