Rancho Specialty Hospital :: Contact Us at (909) 581-7270

The below diagram shows the different programs and plans that you can choose based on your Body Mass Index (BMI).  For instance, if you are Class I Obese (BMI 30-34%), the arrows will show you which are the common non-invasive treatment options.  As your BMI reaches Level 3, surgical intervention becomes more prevalent.  And at 40%, the recommended treatment option is surgery.  

Surgery to Treat Obesity

Surgery is an option when other weight-loss therapies have failed.  Doing nothing is not an option.


Types of weight-loss surgeries

• Malabsoptive procedures shorten the digestive tract
  


• Restrictive procedures reduce how much the stomach can hold
  


• Combined procedures shorten the digestive tract and reduce how much the stomach can hold

Malabsorption

Operations that work primarily by malabsorption, such as the duodenal switch procedure and the biliopancreatic diversion, limit the quantity of food that the body can digest and absorb. This is accomplished by making food bypass a large portion of the small intestine, where digestion occurs. More normal portions of food can be consumed, but it can't be completely digested and absorbed.

Restrictive

Restriction Operations that work primarily by restriction, such as the Roux-en-Y gastric bypass and the LAP-BAND procedure, limit food intake to very small portions. The operations accomplish this by constructing a very small stomach pouch. Because of this, fewer calories can be consumed, and weight is lost. An important aspect of restrictive operations is the feeling of fullness that accompanies the consumption of small amounts of food.

Both Malabsorption and Restriction

The long limb Roux-en-Y gastric bypass (or distal gastric bypass) is an operation that works by both restriction (due to a small stomach pouch) and malabsorption (due to bypassing a large amount of the small intestine).

The National Institute of Health published a consensus statement on bariatric surgery in 1991 (ref. 1). They endorsed two procedures for the surgical treatment of obesity: the gastric bypass and the gastroplasty. Gastroplasty, otherwise known as stomach stapling has subsequently been replaced by the more effacious adjustable gastric band (LAGB), a restrictive but adjustable procedure. Today, the gastric bypass operation remains the operation of choice with LAGB fast-gaining in popularity. Currently more than 90% of all weight loss surgeries in the United States are Roux-en-Y gastric bypasses (ref. 2).

Outside the United States, adjustable gastric banding is the operation of choice for severe obesity. The FDA approved the laparoscopic adjustable gastric band or LAP-BAND® in June 2001 for use in the United States. This appears to be a promising option because of its less invasive nature, its reversibility, and its adjustability. Long term studies in the United States have not been done.

Operations performed at Weight Options 4 Life

Weight Options 4 Life offers laparoscopic and open Roux-en-Y gastric bypass, LAP-BAND® and sleeve gastroplasty procedure.



Gastric Bypass

Gastric Bypass is the most common surgical procedure for weight loss. The Gastric Bypass creates a small upper stomach pouch from which the rest of the stomach is permanently divided. A segment of the small intestine is then attached to the pouch allowing food to bypass most of the stomach and the first part of the small intestine. No stomach or intestine is removed during surgery. The new connection between stomach pouch and intestine restricts intake and changes the way food is digested. The new small stomach pouch allows the patient to feel full with much smaller meals.

Sleeve Gastroplasty

This procedure works by restricting food intake without any bypass of the intestines or malabsorption. The stomach is restricted by dividing it vertically, creating a small vertical stomach pouch shaped like a banana. The new stomach pouch measures 2-5 ounces. The remaining part of the stomach is removed. The portion of the stomach that is removed is thought to be responsible for secreting Ghrelin, the hormone that is responsible for appetite and hunger. By removing this portion of the stomach, the appetite hormone is reduced to almost nothing, usually causing a loss of appetite.

LAP-BAND®

The LAP-BAND® is a device that is surgically placed around the stomach to cause weight loss. It consists of a small adjustable ring and an attached access port. The ring is placed around the top part of the stomach, partitioning the stomach into a small pouch , proximal to the ring and the remainder of the stomach distal tot the ring. The access port is implanted under the skin of the abdomen. By adding or removing saline from the access port, the tightness of the ring can be adjusted. As food is consumed, it quickly fills the small pouch, which causes a feeling of fullness.