Skip to Content

What Is Bariatric Surgery?

Bariatric surgery refers to two categories of weight loss surgeries: restrictive procedures that decrease food consumption like the LAP-BAND or Realize Band, and malabsorptive procedures that alter digestion, like gastric bypass.

Both types of procedures can be performed using minimally-invasive laparoscopic surgery, but some gastric bypass patients may require traditional open surgery.

Gastric band surgery

During this minimally invasive procedure, an adjustable band – commonly called a LAP-BAND or Realize Band - is placed around the upper stomach to create a smaller stomach pouch.

Like a wristwatch, the band is fastened around the upper stomach to help limit and control the amount of food a patient can eat. The gastric band slows digestion and allows the patient to feel full sooner and longer.

Weight loss with the gastric band procedure is more gradual than other approaches and usually continues over the next few years.

Advantages

Disadvantages

Potential Complications

  • Less invasive surgical procedure.
  • Less initial risk than gastric bypass
  • No stomach cutting, stapling or intestinal rerouting
  • Adjustable – customized for each patient
  • Potentially reversible
  • Less dietary deficiencies
  • Usually a 1-2 day hospital stay
  • Less weight loss compared to gastric bypass
  • Slower weight loss compared to gastric bypass
  • More long term complications
  • Less effective with sweet eaters
  • Requires significant dietary compliance
  • Regular follow-up critical for optimal results
  • Complications of the band:
  • Slippage
  • Erosion
  • Band Prolapse
  • Complications of the port:
  • Infection
  • Twisting
  • Tube defect

* Source: The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical 2002.

If you choose gastric band surgery, you can expect to lose 35 to 40 percent of your excess body weight, the majority of it in the first three to five years after surgery. After ten years, you can expect to keep off up to 50 percent of the excess weight.

Learn more about gastric band surgery

Sleeve gastrectomy

In a sleeve gastrectomy, the surgeon removes approximately 80 percent of the stomach. This limits the amount and rate at which a person may eat or drink.

This procedure also sensitizes the pancreas to create more effective insulin, thereby helping to improve or resolve diabetes. It also results in an 80 percent reduction of the “hunger hormone” ghrelin, which means you are 80 percent less hungry!

Type 2 Diabetes may gradually resolve, and other conditions such as high blood pressure, high cholesterol and sleep apnea, may show rapid improvement.

Advantages

Disadvantages

Potential Complications

  • Provides restriction without implanted device
  • Minimally invasive surgical procedure
  • No intestinal rerouting
  • Fewer dietary deficiencies
  • Usually a one- to two-day hospital stay
  • Less weight loss compared to gastric bypass
  • Slower weight loss compared to gastric bypass
  • Less effective with sweet eaters
  • Requires significant dietary compliance for optimal results
  • Not reversible
  • Leakage
  • Stenosis of the gastric tube
  • Infection, bleeding or leaking at suture/staple lines
  • Blockage of the intestines or pouch
  • Vitamin and mineral deficiency
  • Protein malnutrition
  • Complications may lead to short or long term hospitalization and/or re-operation

* Source: The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical 2002.

If you choose a sleeve gastrectomy, you can expect to lose 50 to 70 percent of your excess body weight, the majority of it in the first two to four years.

Learn more about sleeve gastrectomy

Gastric bypass surgery

In gastric bypass, the surgeon creates a small pouch using the upper part of the stomach. The pouch (approximately the size of an egg) limits the amount and rate at which a person may eat or drink.

In addition, the intestines are reorganized to separate the digestive enzymes from the food that is eaten, thereby limiting the amount of calories that are absorbed by the body.

This can be performed as a minimally invasive procedure with a laparoscope through short incisions in the abdomen, or as a traditional open surgery.

Advantages

Disadvantages

Potential Complications

  • Quicker and greater weight loss compared to gastric band
  • Significant improvement in diabetes in the immediate post-operative period (GBP now considered metabolic surgery for the treatment of diabetes)
  • Significant improvement in associated comorbid conditions
  • Long term sustained weight loss
  • Built in “police officer”
  • Add disadvantages here
  • Infection, bleeding or leaking at suture/staple lines
  • Blockage of the intestines or pouch
  • Vitamin and mineral deficiency
  • Protein malnutrition
  • Complications may lead to short or long term hospitalization and/or re-operation

* Source: The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical 2002.

If you choose gastric bypass surgery, you can expect to lose 70 to 90 percent of your excess body weight, the majority of it in the first 18 to 24 months after surgery. After 10 years, you can expect to keep off 70 percent of the excess weight.

Type 2 Diabetes may resolve immediately post-op, and other conditions such as high blood pressure, high cholesterol and sleep apnea, may show rapid improvement.

Learn more about gastric bypass surgery

Laparoscopic vs. open surgery

laparoscopic bariatric surgery

Laparoscopic surgery is a less invasive approach using a small camera to view internal organs through small (1/4-1 inch) incisions. The benefits of laparoscopy include:

  • Less pain after surgery
  • More rapid recovery
  • Smaller scars
  • Fewer wound problems and less risk of infection
  • Reduced risk of hernia

Traditional open surgery for a gastric bypass involves making a 10- to 12-inch incision to access the stomach and intestines. However, not every patient is a candidate for the laparoscopic approach. The final decision will determined by your surgeon.

Learn more about laparascopic surgery with Adjustable Gastric Banding and Sleeve Gastrectomy Overview.

Gastric Bypass or Sleeve Gastrectomy with Robotic Surgery

If you are a candidate for bariatric surgery, you may want to consider gastric bypass surgery or sleeve gastrectomy with robotic surgery. Crozer-Chester Medical Center is one of the first hospitals offering bariatric surgery through the use of the daVinci® robotic surgical system. The advantages of robotic surgery in general are well-documented: less invasive surgery means less pain, more rapid recovery, smaller scars and reduced risk of complications. Although there are no documented studies that convey the advantages of bariatric surgery through the use of the daVinci system, robotic surgery does offer these features:

  • Surgeons are able to see internal organs in three-dimensional high definition, impossible with regular laparoscopic surgery.
  • Surgeons are able to control four instruments at the same time, increasing surgical precision.

Regardless of which type of surgery you choose, our team of specialists can help guide you to make the best choice for your particular health needs.

For more information about the program and to register for a free surgical weight loss information session, visit http://bariatricsurgery.crozerkeystone.org or call 610-619-8450.

Choosing the right procedure for you

When it comes to bariatric surgery, one size definitely does not fit all. Some of the considerations for each type of procedure include:

  • Your age
  • Health risk, such as heart or lung problems
  • The amount of weight you need to lose
  • Whether or not you have diabetes
  • Your lifestyle and the ability to commit to the required lifestyle changes

The type of bariatric surgery you’ll undergo will be a mutual decision between you and your surgeon.  Remember – it’s great to take advice from family and friends, but do what’s right for YOU.

Ready to get started on the road to healthy weight loss?

If you’re interested in Crozer’s Comprehensive Bariatric Surgery Program, take the next step and attend a free educational seminar – in person at a location near you, or online from your home or office via a convenient webinar.

For physician referrals or other medical inquiries, call 610-619-8450.