Weight loss surgery options

The Redefine affiliated bariatric surgeons perform the full range of weight loss procedures at our bariatric centers of excellence, all of which are fully accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). This designation is reserved for weight loss surgery programs that have demonstrated a history of successful bariatric surgery patient outcomes focused on long term success.

Because you and your reason are unique, only you, your surgeon and your weight loss team can determine which procedure is right for you.

• Adjustable gastric banding
• Gastric bypass
• Gastric balloon
• Sleeve gastrectomy
• Duodenal switch
• Bariatric revision surgery
• Robotic bariatric surgery

This surgical procedure restricts and reduces food intake by implanting a silicone band around the upper part of the stomach. This band slows down the passage of food, which makes you feel “full” with smaller amounts of food. The band can easily be adjusted to increase or decrease food restriction. Gastric banding does not affect the digestive process, which means your body will absorb the vitamins, minerals and other nutrients it needs. It is perhaps the least invasive of the weight loss surgical procedures and is a viable option for those with a lower BMI (greater than 35 with comorbidities or obesity-related medical conditions).

• Patients may lose about 40 percent of excess body weight within two years after surgery
• The band can be easily adjusted, or removed entirely, under the care of the highly-skilled affiliated Redefine bariatric surgeons
• Does not require the removal of any part of the stomach as with sleeve gastrectomy or complex rearrangement of the intestines as with gastric bypass
• No need for a lifetime of nutritional supplements

Gastric bypass has been performed for nearly half of a century and is the most widely researched. It is considered by many as the ‘gold standard’ for weight loss surgery. Also known as Roux-en-Y, it promotes weight loss by permanently reducing the size of your upper stomach to a small pouch and then rerouting your small intestine to decrease the amount of fat and calories your body absorbs. Rerouting the small intestine can also lead to patients feeling full much sooner, due to an earlier release of gut hormones that reduce appetite.

• Patients may lose about 70 percent of excess body fat within the first year and a half after surgery
• Patients may develop an intolerance to sugary and starchy foods called "dumping syndrome," which causes sweating, vomiting and rapid heart rate. For many patients, the fear of experiencing these symptoms is motivation to make healthier food choices, which can result in even greater weight loss
• Nutritional deficiencies may develop, but can be managed through proper diet and vitamin supplements

This is a non-surgical procedure that involves a Redefine physician placing and inflating a balloon in the stomach in order to reduce stomach capacity. After six months, the gastric balloon is removed and patients continue their weight loss journey through diet and exercise. The gastric balloon helps patients adjust their portion size, and over time this new healthier portion size, in combination with a healthy diet, results in weight loss.

• Patients may lose about 15 percent of excess body weight during the six months of implantation
• Gastric balloon is temporary and reversible
• Gastric balloon does not require the removal of any part of the stomach as with sleeve gastrectomy or complex rearrangement of the intestine as with gastric bypass
• No need for nutritional supplements

Sleeve gastrectomy involves the permanent removal of about 80 percent of the stomach. The stomach is stapled into a sleeve or tube shape to limit the amount of food you can eat. Combined with healthy dietary choices, this can be a very effective, dramatic weight loss method.

• May improve obesity-related diseases, including high blood pressure, obstructive sleep apnea and high cholesterol
• Favorable changes to gut hormones typically prevent overeating
• No foreign object is implanted in the body, which eliminates rejection
• Sleeve gastrectomy is not reversible, but it can be converted into other procedures such as duodenal switch

Duodenal switch is the most complex of the surgical weight loss procedures. It essentially combines sleeve gastrectomy with gastric bypass to achieve the highest expected weight loss in people affected by severe obesity (BMI of 60 or greater). With duodenal switch, the risk of developing nutritional deficiencies is high but can be managed with proper diet and a lifelong strict adherence of vitamin and mineral supplements.

• Patients may lose up to 80 percent of their excess body weight within the first year after surgery
• Studies report duodenal switch is more effective in reducing, and even curing, type 2 diabetes when compared to other weight loss surgical procedures
• Unlike gastric bypass, duodenal switch preserves the pylorus valve which may reduce the likelihood of “dumping syndrome”
• The remaining stomach is larger, which may allow for a more diverse diet with larger portions

It is not uncommon for patients who have undergone weight loss surgery in the past to require surgical revision, most often due to advancements in surgical techniques or inadequate weight loss results.

If you’ve undergone bariatric weight loss surgery that resulted in unexpected complications or procedures have stopped working over time, it may be necessary to undergo additional procedures to correct the anomaly. Our physicians have a wide array of experience in diagnosing and correcting complicated bariatric surgical issues.

If you believe you are a candidate for revision surgery, your bariatric surgeon will discuss options with you. Some bariatric revision options we offer include:

• Conversion of adjustable band to sleeve gastrectomy
• Conversion of adjustable band to gastric bypass
• Conversion of sleeve gastrectomy to duodenal switch
• Revision of previous sleeve gastrectomy

No matter which surgical option is your best fit, almost all are performed using minimally invasive techniques — either through laparoscopic surgery or robotic-assisted surgery. With both techniques, surgeons use only a few small incisions to promote faster healing, shorter hospital stay and fewer complications.

With robotic-assisted surgery, advanced technology is used for a highly-effective procedure. Rather than standing over your body, your surgeon will sit at a console in the operating room and control the arms of the robot to perform the surgery. These arms bend and move with impressive dexterity, which allows for a broader range of motion when compared to the human hand alone. The robotic system also allows for a 3D, high-definition view inside the stomach for enhanced vision, precision and control.

• Requires smaller incisions, which may reduce the likelihood of complications such as gastrointestinal leaks
• Potentially less pain and scarring for faster and easier healing
• Provides 3D visualization, which provides a clear view for the surgeon
• Improved ergonomics, which may minimize surgeon fatigue, and offers more precise positioning during the procedure