Bariatric Procedures in Fort Worth

Laparoscopic Adjustable Banding

This is a purely restrictive surgical procedure in which a band is placed around the upper part of the stomach. The band divides the stomach into two sections: one small and one larger. Because food intake is regulated, most patients feel full faster. Food digestion occurs through the normal digestive and absorption process.

Advantages

  • It restricts the amount of food that can be consumed at a meal.
  • Food consumed passes through the digestive tract in the usual sequence, allowing it to be fully absorbed into the body.
  • In a U.S. study, the mean weight loss, at three years after surgery was 36.2 percent of excess weight.
  • Band can be adjusted to increase or decrease restriction.
  • Surgery can be reversed.

Risks

In addition to the general risks of surgery, gastric banding may result in perforation or tearing in the stomach wall that requires an additional operation.

  • Access port leakage or twisting may require additional operation.
  • May not provide the feeling that one has had “enough” to eat.
  • Nausea and vomiting
  • Outlet obstruction
  • Pouch dilatation
  • Migration or slippage of the band
  • Talk with your surgeon about the possible surgical risks.

Gastric Bypass

"Roux–en–Y" gastric bypass is one of the most frequently performed types of weight loss surgery. In this procedure, stapling creates a small stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch.

The outlet from the newly formed pouch empties directly into the lower portion of the jejunum (one of the initial segments of the intestine), thus bypassing a region of the digestive tract in which a large portion of the nutrients of food (and their associated calories) are absorbed.

This is done by dividing the small intestine just beyond the duodenum for the purpose of constructing a connection between it and the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine, creating the "Y" shape that gives the technique its name.

The length of either segment of the intestine can be increased to produce higher or lower levels of malabsorption.

Advantages

  • In conscientious patients, the average weight loss after a Roux–en–Y procedure is generally higher than that seen with a purely restrictive procedure.
  • One year after surgery, weight loss can average 77 percent of excess body weight.
  • Studies show that after 10 to 14 years, some patients have maintained a weight loss of 50–60 percent.
  • A 2000 study of 500 patients showed that 96 percent of co–morbidities such as back pain, sleep apnea, high blood pressure, diabetes and depression were improved or resolved.

Risks

  • Because the duodenum is bypassed, poor absorption of iron and calcium can result in a lowering of total body iron and a predisposition to iron–deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone–calcium loss.
  • A chronic anemia due to Vitamin B–12 deficiency may occur. However, this and the deficiencies mentioned above can usually be managed through appropriate dietary supplementation.
  • A condition known as "dumping syndrome" can result from a rapid emptying of the contents of the stomach into the small intestine. This is sometimes triggered when large amounts of food are consumed, or a meal containing too much sugar.
  • In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched.
  • The bypassed portion of the stomach, duodenum and small intestine cannot be easily visualized using X–ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

Duodenal Switch (DSwitch)

The Duodenal Switch is bariatric procedure that works differently than other “mainstream” weight loss surgeries. DSwitch combines a sleeve of the stomach with a bypass of the intestines. This procedure blocks up to 80 percent of fat calorie absorption, leading to lasting weight loss for many patients.

Benefits

  • Laparoscopic, minimally-invasive
  • No implanted medical device
  • Changes the signals the stomach sends to the rest of the body -- including the brain -- that control blood sugar levels, feelings of fullness and hunger.

How it Works

  • The surgeon creates a small stomach pouch shaped like a tube, making the stomach smaller.
  • The small intestine is then divided into two parts. The lower part is attached to the new, smaller stomach.
  • The procedure changes the digestive track by not mixing digestive enzymes until farther along in the digestive track.
  • This reduces the amount of food a person eats and makes better use of the food they do eat.