Laparoscopy is the technical term for minimally invasive surgical procedures, requiring only the tiniest of incisions. Michigan Bariatric Institute specializes in providing our patients with three different bariatric surgery options. They are:
Laparoscopic Gastric Bypass
Considered the "gold standard" of weight loss surgery, laparoscopic gastric bypass is the most often-prescribed weight-loss surgical procedure in the U.S. It involves surgically creating, from the existing stomach, an approximately 1 ounce stomach pouch located at the uppermost portion of the stomach and then connecting this newly fashioned stomach pouch to a shorter length of small intestine. This is the only procedure that bypasses both the remaining portion of stomach and a significant length of small intestine, effectively decreasing caloric intake and decreasing hormone creation, which stimulates appetite. With a laparoscopic gastric bypass, patients don't eat as much, don't retain as many calories, and don't get as hungry as they did before.
The gastric bypass results in the most weight loss and the highest resolution of comorbidities (medical ailments which often accompany morbid obesity, such as fatigue, depression, high blood pressure, and diabetes.) The gastric bypass cures diabetes in 84% of patients, even those who are on insulin injections. Those who are not fully cured of diabetes at the very least experience improvements in their conditions. Sleep apnea is eliminated in nearly 87% of patients. High blood pressure and reflux disease is eliminated in 75% of patients. Joint disease is eliminated in 40% of patients, and the list of health improvements continues on and on. Gastric bypass patients, on average, lose 70% of their excess body weight.
Laparoscopic Sleeve Gastrectomy
The sleeve gastrectomy is a more recently introduced surgery for weight loss. It is rapidly gaining popularity among those seeking permanent weight loss.
It involves the removal of approximately 75% of the stomach, leaving about a 2-3 ounce stomach, now structured as a narrowed tube. The normal continuity between the esophagus, stomach, and small intestine is not changed, as it is in gastric bypass. Therefore, food is normally absorbed and there is no risk of vitamin or mineral malabsorption. The small size of the new stomach limits caloric intake and decreases some of the hormones that stimulate appetite. Therefore, patients feel less hungry, which greatly helps with weight loss.
Sleeve Gastrectomy is a safe and effective option for patients with 100 pounds or more to lose. On average, sleeve gastrectomy patients lose about 60-65% of their excess body weight within 18 months.
Laparoscopic Adjustable Gastric Banding
The laparoscopic adjustable gastric banding or "lap band" has gained popularity in the U.S. more recently. Much experience has been provided from Europe, where it has been well known for a longer period of time. The procedure involves placing a synthetic band around the uppermost portion of the stomach. The band is then tightened and adjusted to limit intake and curtail hunger.
The benefits of the band are that there are no anatomical changes associated with its placement, and no risk of nutrient malabsorption. The band has several other advantages. First, is its adjustability. The band allows for an individualized degree of food restriction, pregnancy is supported by allowing for increased nutritional needs and adjustments are easily performed in the surgeon's office. A second advantage is its reversibility. The band is removable at any time and anatomy is restored to its original form. The band has fewer side effects and fewer risks. Nationally, there is lower mortality risk and nutritional deficiencies with the lap band than with more involved bariatric surgeries.
It is mainly for these reasons that patients opt for the band. However, in comparing the results to gastric bypass results, patients using the band enjoy less weight loss and less resolution of co-morbidities than patients who have undergone the gastric bypass.
Non-surgical band adjustments at regular intervals and close follow up are needed to optimize weight loss, and for the motivated patient laparoscopic adjustable gastric banding can be associated with effective weight loss. Adjustable gastric banding patients, on average, lose 50% of their excess body weight.
Generally speaking, the Laparoscopic Gastric Bypass is the most effective solution to achieve permanent weight loss, the Laparoscopic Sleeve Gastrectomy is the second most effective treatment, and the Laparoscopic Adjustable Gastric Banding is the third most effective treatment to achieve permanent weight loss.