My Journey

Let's start with the Adjustable Gastric Band. An inflatable band is placed around the upper part of the stomach to create a smaller stomach pouch. This slows and limits the amount of food that can be consumed at one time. This pouch holds approximately ½ cup of food, whereas the typical stomach holds about 6 cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps the person to be hungry less often, feel full more quickly and for a longer period of time, eat smaller portions, and lose weight over time. Typically, patients who undergo adjustable gastric banding procedures lose less weight over the first 3.5 years than those who have other bariatric weight loss surgeries.

Click on the left to see the Lap Band Procedure Video.

The Roux-en Y procedure was first performed in 1993 and is regarded as one of the most difficult procedures to perform by limited access techniques. However, use of this method has greatly popularized the operation due to associated benefits such as a shortened hospital stay, reduced discomfort, shorter recovery time, less scarring, and minimal risk of incisional hernia. With the Roux-en Y surgery, the small intestine is divided approximately 18" below the lower stomach outlet and is re-arranged into a Y-configuration, enabling outflow of food from the small upper stomach pouch via a "Roux limb". The Y-intersection is formed near the upper (proximal) end of the small intestine. The Roux limb is constructed using 31–59" of the small intestine, preserving the rest (and the majority) of it for absorbing nutrients. The patient will experience very rapid onset of the stomach feeling full, followed by a growing satiety (or "indifference" to food) shortly after the start of a meal. The gastric bypass reduces the size of the stomach by well over 90%. A normal stomach can stretch, sometimes to over 34oz, while the pouch of the gastric bypass may be 0.5oz in size. The gastric bypass pouch is usually formed from the part of the stomach which is least susceptible to stretching. That, and its small original size, prevents any significant long-term change in pouch volume. What does change, over time, is the size of the connection between the stomach and intestine and the ability of the small intestine to hold a greater volume of food. Over time, the functional capacity of the pouch increases; by that time, 45-75% total body weight loss has occurred, and the increased capacity should serve to allow maintenance of a lower body weight. With just a small amount of food, the first response is a stretching of the wall of the stomach pouch, stimulating nerves which tell the brain that the stomach is full. You then feel a sensation of fullness, as if you had just eaten a large meal—but with just a thumb-full of food. Most people do not stop eating simply in response to a feeling of fullness, but the you rapidly learn that subsequent bites must be eaten very slowly and carefully, to avoid increasing discomfort or vomiting.

Click on the right to see the Roux-en Y Procedure Video

Vertical Sleeve Gastrectomy (VSG) is a newer, innovative weight loss surgery. The Vertical Sleeve (or "Sleeve" as it is commonly known) involves removing 85%-90% of the stomach, without changing the intestinal tract. The new 1-2 ounce pouch that is created significantly reduces the volume of food that can be consumed, while still allowing the stomach to function normally. The part of the stomach that is removed contains cells that produce the hunger hormone, Ghrelin. By drastically reducing the production of Ghrelin, the appetite and sensation of hunger is markedly reduced or eliminated. Our patients have a success rate of >80% excess weight loss which occurs within 1 year.

• Estimated weight loss >80%
• Resolution of diabetes >90%
• Resolution of obstructive sleep apnea >95%
• Resolution of hyperlipidemia (high cholesterol and triglycerides) >80%
• Resolution of hypertension >80%
• The portion of the stomach that produces the hormone that stimulates hunger (Ghrelin) is removed.
• The stomach is dramatically reduced in volume yet also functions normally.
• No dumping syndrome because the pylorus is preserved.
• Minimizes the potential for ulcer, so the use anti-inflammatory drugs such as aspirin, Motrin, Aleve and ibuprofen are not problematic (great procedure for those with arthritis, joint pain or migraine headaches).
• No intestinal bypass and therefore little or no chance of nutritional and vitamin deficiencies
• Most patients with BMI between 30-50kg/M2 achieve their goal weight within 12 months following surgery.
• Safer alternative for high body weight (>400 pounds) or medically high-risk patients than the gastric bypass or duodenal switch.
• No foreign body or implanted devices.
• Can be performed laparoscopically in virtually all patients.

Click on the right to see the Vertical Sleeve Gastrectomy Procedure Video.