Weight Loss Surgery Options

Weighing Your Options

The Detroit Medical Center continues to be a leader in developing and performing innovative weight loss surgery for patients who have a body mass index greater than 35, suffer from related health conditions, and have tried other weight loss methods.

Our surgeons offer minimally invasive laparoscopic surgeries. Unlike open weight loss surgery, minimally invasive laparoscopic techniques require just six small incisions, each about a centimeter or less in length. Minimally invasive bariatric surgery generally results in a shorter hospital stay, fewer complications, decreased pain and a shorter recovery period to return to normal activities.

DMC surgeons perform the following procedures:

Gastric Bypass – In this procedure, the stomach is divided to create a small pouch for restricting food intake. The small intestine is also altered to produce malabsorption of food.

Gastric Sleeve – In this procedure, the left side of the stomach is removed to create a smaller stomach. The intestines are not altered.

Gastric Band – A procedure involving the insertion of a silicone band around the upper portion of the stomach to restrict food intake.

Gastric Bypass Surgery

The second most frequently performed weight loss surgical procedure in America today is Roux-en-Y gastric bypass surgery.

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 it offers patients a high average rate of weight loss and a low average risk of complications.

Another reason for the popularity of this procedure is that it controls food intake and food absorption. Roux-en-Y is both “restrictive” (meaning that it limits food intake) and “malabsorptive” (meaning that it reduces the body’s absorption of food).

About the Roux-en-Y Procedure

This gastric bypass procedure begins with the stomach being divided, and creating a pouch about the size of a medicine cup. This “restrictive” strategy greatly reduces the amount of food that can be taken in at any one time. Overfilling the gastric pouch can give a person an uncomfortable feeling.

Next comes the “malabsorptive” part of the procedure, which is designed to reduce the intestines’ ability to absorb nutrients. Here, the small intestine is divided and is then connected to the gastric pouch.

After these steps have been completed in gastric bypass, food goes into the small gastric pouch and then directly into the small intestine which is connected to the pouch. During this process, food and digestive enzymes mingle so that nutrients can be absorbed.

As a result of this procedure, patients will be able to eat less and absorb less food.

Gastric Sleeve

The gastric sleeve procedure is also known as “vertical sleeve gastrectomy.” The surgeon removes the left side of the stomach, which reduces the overall size of the stomach, and in turn helps you eat less. There is no “rerouting” or “reconnecting” the intestines, which is the process used in gastric bypass surgery.

Is Gastric Sleeve Right for You?

There are several elements to consider when choosing the gastric sleeve:

• The long-term side effects are often reduced since no intestinal bypass is performed.
• No foreign bodies are implanted in the abdomen (this could be important for patients who are also considering a gastric band).
• This procedure is considered to be less complex, therefore the complication rates are expected to be lower.
• For patients with higher BMI’s (greater than 60), the gastric bypass may be more effective.

Gastric Band

Gastric band surgery is a weight-loss procedure which relies on a silicone band to restrict food intake. During this procedure, small incisions are made in the abdomen and the band is positioned around the upper portion of the stomach. This technique 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 to simply restrict the amount of food that can be taken in at one time.

Robotic-assisted Bariatric Surgery

The decision to have surgery is always a big commitment, and it's only natural for those considering weight loss surgery to feel a little apprehensive. However, with robotic-assisted surgery at the Detroit Medical Center, surgery is designed to be safer and more effective than ever before.

Robotic-assisted weight loss surgery is a minimally invasive technique designed to reduce the size and scale of the incisions needed to perform surgery. This creates a safer environment for both the patient and surgical team.

What Is Robotic-assisted Bariatric Surgery?

Robotic-assisted bariatric surgery is a form of bariatric surgery which uses robotic guidance. Surgeons use tools like a 3D camera and high definition screen while performing intricate movements with the benefit of a computer panel that allows control of the robotic arms.

Rather than standing over the patient on the operating table, bariatric surgeons sit at a comfortable and ergonomic workstation, controlling the robotic arms as they perform high-tech surgical procedures. The robotic arms can move with amazing dexterity, allowing for easier movements and control of the surgical instruments.

What Are the Benefits of Robotic-assisted Weight Loss Surgery?

Robotic-assisted bariatric surgery offers many benefits over standard open surgery. The potential advantages of robotic-assisted bariatric surgery include:

• Minimized surgeon fatigue, which reduces errors in the operating room.
• Elimination of physiological tremors, which results in making more precise incisions and adjustments during surgery.
• Small incision sites, generally no larger than one to two centimeters in diameter
• Less pain and scarring for easier healing.
• Reduced risk of infection during and after surgery, reducing post-surgical dangers.

Due to the changes made to the digestive tract, healing after bariatric surgery can take four to six weeks and may involve measures like a liquid diet and reduced physical activity while the body is recovering.

Robotic-assisted Bariatric Surgery at the DMC

Our surgeons are trained on some of the most advanced equipment in the medical community, including the daVinci® Xi HD Surgical System. At the DMC, bariatric surgical procedures are performed using robotic-assisted solutions when preferred, including gastric sleeve and gastric bypass. Our surgeons also perform more complex bariatric surgical procedures, which includes repairing fistulas, conversion from one bariatric surgical procedure to one that is more effective, as well as revisional bariatric surgery. Before starting, all prospective patients will meet with a member of our bariatric surgical team for a consultation. During this time, a surgeon will discuss the surgical options with you.

Weight loss surgery is generally designed for those with a body mass index (BMI) equal to or greater than 40, or equal to or greater than 35 with serious comorbidities. Laparoscopic adjustable gastric banding with the Lap Band® is also FDA-approved for weight loss surgery in people with a BMI of 30 to 35 who have at least one obesity-related condition. Weight loss surgery is considered safe, but like many types of surgery, it does have risks. Consult with your physician about the risks and benefits of weight loss surgery.