Roux-en-Y gastric bypass (RGB):
Gastric bypass is the most popular of all weight loss procedures in the US. Gastric bypass is also called Roux-en-Y bypass. Gastric bypass is a combination of two beneficial tools; restriction and malabsorption. With this procedure, the stomach is divided into two parts, the upper portion of the stomach is called the pouch, the lower portion is called the remnant. The pouch can hold one to two ounces of food or liquid at a time. The remnant stomach continues to make enzymes important for digestion.
To bypass, the remnant stomach, the intestines are divided and then reconnected to the pouch. Nothing is removed in the Gastric bypass, the intestines are merely rerouted to help bypass the stomach.
If you choose the gastric bypass surgery, you can lose up to 70% of your extra body weight or more. Although everybody initially loses weight, approximately 20% of people will gain some of the weight back. The key to success is to choose nutritious foods that make you feel full. Meats, fruits and vegetables are healthy, wise choices that make people feel full. Soft foods are easier to eat but do not provide the same full feeling, which often leads to over eating and eventually weight gain. Many patients who have gastric bypass cannot eat sugary foods as they make them feel weak, jittery, nauseated and even sometimes painful. This is also called dumping syndrome.
The benefits of gastric bypass are: good weight loss and weight maintenance, resolution of co-morbidities (diabetes, hypertension), can be performed laparoscopically, and can tolerate most healthy foods, increased quality of life.
As with any surgical procedure complications can occur with gastric bypass. At the time of surgery the is the risk of bleeding, infection, staple line leaks, injury to other organs, pain, blood clots, pneumonia or death. Complications that could occur in the future include: unexplainable pain, malnutrition, weight gain, inability to eat certain foods, nausea, vomiting, gallstones, diarrhea, constipation, bowel obstruction, ulcers or death.
Vertical Sleeve Gastrectomy (VSG):
Sleeve gastrectomy is our newest surgical weight loss alternative. The sleeve gastrectomy may be the only surgery you need to fully achieve your weight loss goals. But it can also be performed as the first stage to a gastric bypass, duodenal switch or gastric banding procedure. We perform the sleeve gastrectomy as a stand-alone procedure.
The sleeve gastrectomy involves permanently removing approximately 85% of the stomach. Research has shown that removing this portion of the stomach reduces a hormone called ghrelin which causes hunger. Therefore, patients not only feel full after a small amount of food, but also do not often crave food. It is not uncommon to hear sleeve patients say that they have to remind themselves to eat. The other benefit of the sleeve gastrectomy is that there is no malabsorption of nutrients and patients have fewer problems with vitamin deficiencies including calcium, iron and vitamin D. You simply have a smaller stomach.
The benefits of the sleeve gastrectomy: it is performed laparoscopically, minimal pain.
The complications or risks of the procedure: pain, nausea, vomiting, bleeding, infection, blood clots, dysphagia, need to convert the sleeve to gastric bypass, duodenal switch or gastric banding for inadequate weight loss.