Procedures we use

Our Procedures

Bariatric Weight Loss Procedures

Vertical Banded Gastroplasty (VBG), Adjustable Laparoscopic Band (Adj Lap Band) Roux en Y Gastric Bypass,

Vertical Banded Gastroplasty (VBG)

The vertical banded gastroplasty (VBG) is a restrictive procedure that limits food intake and causes early fullness. The procedure was developed by Ed Mason and evolved into the laparoscopic technique used by our practice.  A linear stapler is used to form a 20cc gastric pouch, which is bound by a synthetic band to prevent stretching. The average excess weight loss achieved by the VBG is 50 – 60%.  This procedure is less invasive than the LRYGB and maintains access to the distal stomach and billiary tract. The average hospital stay is 24 hours. Patients who constantly ingest high caloric liquids and soft foods will not be restricted and may have sub-optimal weight loss.

Adjust Laparoscopic Banding (Adj. Lap Band, Lap Band, Banding or LAGB)  

The laparoscopic adjustable gastric bypass (Lap Band) is a restrictive procedure approved by the FDA in 2001.  A silastic band with a balloon on the inner surface of the band is placed around the upper stomach.  The front wall of the stomach is then sutured over the band to prevent band migration.  The band is attached to a silastic tube, which connects the band to an injectable port, which is placed under the skin of the stomach wall.  Saline is injected into the port, which causes tightening of the band around the upper stomach.

The advantages of the Lap Band include adjustability, less invasive than the VBG or Gastric Bypass because there is no rearrangement of the stomach or intestines. Endoscopic access to the distal stomach and billiary tract is maintained as opposed to the gastric bypass.  The Lap Band has the lowest reported mortality rates of the accepted bariatric procedures. 

Disadvantages of the Lap Band include slower excess weight loss when compared to the gastric bypass or other malabsorptive procedures; a foreign body is implanted which may need to be removed if it becomes infected. The band can erode into the stomach, which requires removal of the band. The stomach may prolapse through the band and cause an acute obstruction, which requires an operation to treat the obstruction.  The port may leak or become infected which may require an operation to repair or replace the port.

Patients with the Lap Band loose their excess weight slower than patients with the Lap Band but 44 – 68% excess weight loss has been reported at 4 years after Lap Band. Patients who constantly ingest high calorie liquids and soft foods may also have limited weight loss.

Roux en Y Gastric Bypass (RNY, LRNY, LRYGB, Lap Gastric Bypass)

The laparoscopic Roux-en-Y Gastric Bypass is a combined restrictive and malabsorptive procedure, which creates a small pouch with a linear endoscopic stapler.  The small pouch is then connected to the second portion of small intestines using a “Y” configuration. The distal stomach and first portion of small intestines is bypassed by ingested foods.  90% of patients with the Gastric Bypass will develop an assemblage of symptoms known as dumping syndrome after ingesting processed sugars. This syndrome serves as a deterrent for patients that are tempted to eat sweets or drink high calorie liquids. The Gastric Bypass has an average excess weight loss of 75-80% at one year.  Most patients will experience a resolution of their obesity related illnesses. The average hospital stay in my practice is two days. This procedure has a 90% success rate and success is determined by loosing 50% of excess weight. The Gastric Bypass  is the most common weight loss procedure performed by bariatric surgeons in the United States.