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Weight Loss Surgery

Michigan LAP-BAND® Surgery

The LAP-BAND® procedure is a weight-loss surgical operation that relies on a silicone band to restrict food intake.  During this procedure the band is positioned around the upper end of the stomach – a technique that establishes a small upper pouch which is linked to the larger bottom portion of the stomach by a narrow passageway.  The purpose of the procedure is simply to create a “full” feeling in the patient, which can help to reduce the intake of food.

The key to the LAP-BAND’s® effectiveness is an adjustable collar that can be expanded or deflated for best results with each individual patient.

After connecting the LAP-BAND® to a reservoir via a tube specifically engineered for this purpose, the reservoir is positioned beneath the upper abdomen.  After that, the stomach-collar can be adjusted by adding or removing needle-delivered saline solution at the doctor’s office.

One of the best things about this approach is that it preserves the natural sequence of steps in digestion and absorption . . . so that the only food restriction involved comes from the mechanical lowering of the stomach’s capacity.  In most cases, the procedure is very low-risk – although success does depend on maintaining both the small-pouch volume and the correct outlet diameter.

The LAP-BAND® procedure usually requires only a 24 hour hospital stay. The procedure itself takes less than an hour and results in very little post-operative pain.  In fact, most patients who undergo the lap-band procedure do not need to take prescription pain medicine - Tylenol or Advil usually is enough.

GASTRIC BYPASS Michigan: Roux-en-Y
It’s a fact: the most frequently conducted weight-loss surgical procedure in America today is known as “Roux-en-Y Gastric Bypass Surgery.”

Why?  It’s simple.  According to both the National Institutes of Health and the American Society for Bariatric and Metabolic Surgery, Roux-en-Y is currently considered to be the “gold standard” for weight-loss surgery – because of the way it offers patients a high average rate of weight-loss success and a low average risk of complications.

Another reason for the popularity of the procedure is its double-barreled approach to controlling the intake and absorption of nutrients.  Roux-en-Y is both “restrictive” (meaning that it restricts food intake) and “malabsorptive” (meaning that it reduces the body’s absorption of nutrients from that food). 

This procedure begins with a step in which the stomach is divided – an outcome that creates a pouch about the size of a medicine cup.  The “restrictive” strategy greatly reduces the amount of food that can be stored at any one time, since feelings of “fullness” begin once the small pouch is filled during eating.

During this first step, the rest of the stomach is left intact, however, so that the risk of infection from invasive trauma remains low.

Next comes the “malabsorptive” part of the procedure, which is designed to reduce the intestines’ ability to absorb nutrients from digesting food.  Here the small bowel is divided at a point about four inches from where it begins.  Next, the divided portion of the bowel is connected to the “pouch” area of the now-restricted stomach.  This section is then sutured back into place, but farther down the bowel.  (In medical parlance, this artificially created digestive zone is now known as the “Roux limb.”)  

After these steps have been completed, newly ingested food can move directly to the “common channel,” where food and digestive enzymes mingle so that nutrients and calories can be absorbed.

The bottom line: once the Roux-en-Y procedure has been completed, patients who receive it will be relying on less than half of their small intestine in order to absorb nutrients from the food they take in.

The good news for those patients, of course, is that most will now experience significantly diminished “food cravings” – even as they begin to rapidly lose weight.

Gastric Sleeve
Also known as “Vertical Sleeve Gastrectomy,” this highly effective bariatric surgical procedure is conducted by only a small number of highly skilled surgeons in the world – several of whom practice at DMC Harper University Hospital.

In this operation, the surgeon removes the left side of the stomach, which reduces the overall size of the body’s food-storage organ and thus helps the patient to lower food-intake.  And the good news here is that the surgery doesn’t rely on “rerouting” or “reconnecting” of intestines.  Simpler and easier to perform than Gastric Bypass, the Gastric Sleeve procedure also doesn’t depend on implanting any artificial devices within the abdomen.
Is Sleeve Gastrectomy right for you?  For some patients with lower BMI, there are several potential advantages to consider:

---the long-term side effects are often reduced, since no intestinal bypass is required;

---no foreign bodies are implanted in the abdomen (this could be important for patients who are also considering a gastric band);

---Sleeve Gastrectomy can help patients with other medical issues, including such conditions as Crohn’s disease, asthma that requires frequent steroids, anemia or extensive prior surgery;

---Sleeve Gastrectomy can be effective for patients who must take anti-inflammatory medications.

Remember, also, that for patients with a BMI above 60, Sleeve Gastrectomy can be the first part of a two-step bariatric procedure that’s custom-tailored to each patient’s individual needs.

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