Types of Procedures
There are several types of bariatric procedures offered at the Weight Reduction Surgery Program at Montefiore. Some procedures involve surgery to bypass a portion of the small intestine that absorbs nutrients and calories, which is why they are referred to as "malabsorptive" procedures (Duodenal Switch). Other procedures involve stapling, wrapping a band around, or surgically removing part of the stomach, which reduces the amount of food consumed (Lap Band, Lap Sleeve Gastrectomy). These procedures work by simply decreasing the amount of food consumed and are called "restrictive" procedures. The last type of procedure combines these two elements (Lap Gastric Bypass). In these cases, the procedure is both "malabsorptive" and "restrictive" (because the size of the stomach also has been reduced).
Laparoscopic Roux-en-Y Gastric Bypass
The most commonly performed bariatric surgery is called Roux-en-Y Gastric Bypass (RGB). Roux-en-Y gastric bypass is both a malabsorptive and restrictive procedure. The procedure begins by using surgical staples to reduce the size of the stomach and the amount of food that can be consumed. Next, a portion of the small intestine is reshaped so that when food is being digested it travels directly into the lower part of the small intestine, bypassing the upper portions and thereby significantly reducing the amount of calories and nutrients that are absorbed by the body.
In virtually all cases at Montefiore, the Roux-en-Y gastric bypass is performed laparoscopically rather than through an open incision. Laparoscopic surgery is a minimally invasive procedure in which several extremely small incisions are made so that tiny surgical instruments and laparoscopes — small thin tubes with video cameras attached — can be used. The cameras, which visualize the inside of the abdomen during the operation, are projected onto TV monitors so that the surgeon can easily view and control the entire process.
The benefits to our patients of laparoscopic surgery are many, including significantly less pain and scarring, faster recovery and reduced post-operative complications associated with traditional surgery.
Laparoscopic Gastric Banding Surgery
Gastric banding surgery, also referred to as adjustable gastric banding and vertical banded gastroplasty, is a type of bariatric weight reduction surgery performed to limit (restrict) the amount of food a person can eat. In gastric banding surgery, no part of the stomach is removed and the digestive process remains intact. Instead, staples or a silicone band are used to separate the stomach into two parts, one of which can hold about one ounce of food at a time. The food from this "new stomach" empties into the closed-off portion of the stomach and then resumes the normal digestive process. Over time, the "new stomach" can expand to hold two to three ounces of food, but intake remains significantly restricted.
As with gastric bypass surgery, gastric banding at Montefiore is almost always performed laparoscopically, which results in less pain and scarring, faster recovery and reduced post-operative complications as compared with traditional, open surgery. In fact, gastric banding often is performed on an out-patient basis, eliminating the need for an overnight hospital stay.
If you have had bariatric surgery in the past and failed to lose enough weight or have regained the weight, we can help you. Our team of highly trained professionals will evaluate your failed surgery on a case by case basis and will help develop a plan to get you back on track. Through a combination of counseling, nutritional, exercise support and possibly surgery, we will help you achieve your weightloss goals.