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Less Invasive Weight Loss Surgery

Which Minimal Access Surgery Is Right For Me

Medical Marvels – Minimally Invasive Weight Loss Surgery

While the new fields of minimal access surgery are promising, laparoscopic surgery remains the safest, most effective, and cosmetically best approach to weight-loss surgery for most patients. While Dr, Long participated in the development of novel robotic procedures, this platform does not yet show a clear benefit. Studies have shown that robotic bariatric surgery does not hold any significant advantages over laparoscopic bariatric surgery when the laparoscopic surgeon is highly trained and skilled. This may not always be true when revisional bariatric surgery is needed, but holds true for initial procedures.

Single site surgery can also be performed for the sleeve to decrease the number of incisions to 1. However, most people find that their cosmetic benefit is better with a few very small incisions rather than one that is a little larger, and prefer laparoscopic minimally invasive surgery. Finally, a NOTES bariatric procedure known as the ROSE can be a consideration for some revisional bariatric surgeries.

This page was medically reviewed by Dr. Joshua Long, MD, MBA, FACS, FASMBS. Dr. Long is a double-board-certified bariatric surgeon and bariatric medical director for Parker Adventist Hospital.Page Updated: February 6th, 2021

What Is The Long

Many people lose weight with the gastric band in the first year or two after surgery. The gastric band placement itself rarely causes complications immediately after surgery, but some complications may develop down the road. Complications may require reoperation or removal of the Lap-Band. Some people decide after removal that they desire another bariatric procedure.

A note from Cleveland Clinic

Any bariatric surgery is a major commitment with important pros and cons to consider. Gastric band surgery is no exception. As a reversible and removable option that doesnt require cutting your organs, the Lap-Band may be an easier commitment up front. It also means more follow-up care, however, including frequent adjustments in the first year or two and possible revision surgeries later on. And it will require lifelong changes to your eating habits.

For some people, this is the option they need to take the next big step toward significant weight loss and lifelong change. Depending on how it works for you, it might be the end of your weight loss journey, or a step along the way. Some people use the Lap-Band to effectively retrain themselves to change the ways that they eat and live. Others may fail to lose enough weight or maintain their weight loss over time. If this happens, youll have other treatment options.

Last reviewed by a Cleveland Clinic medical professional on 04/26/2022.

References

How Is The Vertical Sleeve Gastrectomy Performed

With this procedure, restriction of the stomach is accomplished by dividing, stapling and removing more than 85% of the existing stomach. The remaining part of the stomach is long and narrow, much like a shirt sleeve. Since the intestines are not touched, the functioning of the stomach remains the same.

This means the nutritional elements of food can still be absorbed, but the volume of food that can be eaten is drastically reduced.

Do you want to know if you qualify for weight loss surgery? Contact WBI today and let us help you choose the right weight loss program for you.

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Our Team Helps You Achieve Success

Like other weight loss procedures, nonsurgical weight loss options require lifestyle changes for you to achieve success. Our bariatric team evaluates your condition as well as your commitment to making these lifestyle changes. We help you achieve your weight loss goals.

Attend your pre-surgical evaluation, all appointments, and monthly support meetings near where you work or live. Attend a free information session online to learn more about obesity and weight loss surgery.

Weight Loss After Endoscopic Sleeve Gastroplasty Surgery

New Minimally Invasive Weight Loss Surgery

Endoscopic sleeve gastroplasty works by reducing the size of the stomach. As ESG is a new procedure, short term and long term weight loss after ESG are still unknown. However, there are encouraging results from a recent study in which patients lost 50 percent of excess weight at one year after ESG. These results are comparable to excess weight loss after popular bariatric procedures, like gastric sleeve surgery and gastric band surgery.Like other bariatric procedures, ESG is a tool for weight loss and long-term weight loss success depends heavily on the patients commitment to a healthy lifestyle program, including dieting and regular exercise.

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Laparoscopic Adjustable Gastric Band

  • Gastric band surgery uses the restrictive technique to help patients lose weight.
  • An inflatable band is cinched around the top part of the stomach which divides it into two sections.
  • The smaller section becomes the main stomach and the opening between the two sections causes the ingested food to flow very slowly from the top section to the bottom section.
  • The patient feels full quicker and can not eat as much food due to the smaller stomach size. There is a port implanted under the patients skin that will allow the opening between the two sections to be adjusted by inflating or deflating the ring that is positioned around the stomach.
  • While considered the safest form of bariatric surgery for several years, it is not widely used by bariatric surgeons today because it yielded inadequate weight loss results and a high rate of long-term complications. By 2015 gastric lap band usage was down to approximately 5.7% compared to the other bariatric surgery choices.
  • Gastric band surgery is fully reversible.

What Should I Expect After Surgery

After surgery, you will need to rest and recover. Walking and moving around the house may help you recover more quickly. Start slowly and follow your health care professionals advice about the type of physical activity you can do safely. As you feel more comfortable, add more physical activity.

After surgery, you will probably be started on a liquid diet. Over several weeks, you will move to a soft diet that includes such foods as cottage cheese, yogurt, or soup. Eventually you will begin consuming solid foods again. Your health care professional will tell you which foods and beverages you may have and which ones you should avoid. You will need to eat small meals and chew your food well. You will need to take dietary supplements that your health care professional prescribes to make sure you are getting enough vitamins and minerals.

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What Qualifies You For Bariatric Surgery

Bariatric surgery requirements begin with establishing a diagnosis of class III obesity. That means that you either:

  • Have a BMI of 40 or higher. The Body Mass Index is a way of estimating how much body fat you have based on your height-to-weight ratio. A score of 40 or higher is associated with a high risk of related diseases. It usually equates to about 100 lbs. overweight.
  • Have a BMI of at least 35 and at least one related health problem. A BMI of 35 without a related health problem is considered class II obesity.

The criteria are slightly higher for adolescents. An adolescent may be a candidate if they have:

  • BMI of at least 40 and an obesity-related medical condition.
  • BMI of at least 35 and a severe obesity-related medical condition.

While BMI is easily measured, you may have to take some medical tests to diagnose your obesity-related health conditions.

Exploring The Pros And Cons Of Sleeve Gastrectomy: Is It A Less Invasive Option For Weight

Minimally Invasive Weight Loss Surgery: Expert Q& A

The question of whether sleeve gastrectomy is a less invasive procedure than other forms of weight-loss surgery has been a topic of debate among medical professionals for many years. Sleeve gastrectomy is a form of bariatric surgery that involves reducing the size of the stomach, which then decreases hunger and encourages the patient to eat less. While it is often seen as a less invasive option than other bariatric surgeries such as gastric bypass, there are some risks and benefits associated with this procedure that should be considered when deciding whether or not it is the right choice for a patient. In this article, we will explore the pros and cons of sleeve gastrectomy and discuss whether it is a less invasive procedure than other forms of weight-loss surgery.

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What Is Endoscopic Sleeve Gastroplasty

  • ESG or endoscopic sleeve gastroplasty is a procedure that is performed through an endoscope that is lowered down the patients throat. The procedure is not surgery and does not require the use of any incisions.
  • An endoscope is a very thin flexible tube that is equipped with a camera that also allows room for additional surgical tools to access the procedure site.
  • A special suturing device is lowered through the endoscope and used to strategically place about 7-12 sutures in the stomach to reduce its size and reshape it into a sleeve-like pouch resembling a banana.
  • The procedure takes about 30 to 45 minutes and does not require a hospital stay.
Endoscopic Sleeve Gastroplasty or Accordion Procedure: Everything You Need to Know

Dr. Chris explains what Endoscopic Sleeve Gastroplasty procedure is, how it is done, and what its benefits are.

Who Should Have It

In the past, guidelines recommended gastric band placement only if a personâs body mass index was 35 or above. Some people with a BMI of 30â34.9 had surgery if there were other obesity-related problems, such as diabetes, hypertension, or sleep apnea. This was because of the high risk of complications.

Advances in surgical techniques, however, have improved the safety record of the procedure, and this recommendation is no longer in place.

A doctor may now recommend bariatric surgery for some individuals with a BMI of 30â35 if:

  • they have obesity-related complications and
  • non-surgical approaches have not proven effective

Nonsurgical options include:

The advantages of laparoscopic gastric banding include:

  • the possibility of long-term weight loss for those with obesity
  • relatively rapid recovery
  • smaller chance of wound infections and hernias after surgery
  • reduced risk of diabetes, high blood pressure, urinary incontinence, and other conditions related to excess weight
  • no loss of nutrient absorption
  • improved quality of life after surgery in many cases

There is also the option to remove or adjust the band. Adjustability means it can be tightened or loosened, for example, if not enough weight is being lost, or there is vomiting after eating.

On average, between 40 and 60 percent of excess weight may be lost, but this depends on the individual.

There are some risks associated with having a gastric band.

These include the following:

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How Is Endoscopic Sleeve Gastroplasty Done

Endoscopic sleeve gastroplasty is done using a flexible endoscope, allowing your surgeon to see inside your stomach. An endoscopic stitching system allows the surgeon to place stitches in the intestines. The new stomach will be tube shaped and about the size of a banana, similar to the stomach left intact after gastric sleeve surgery.

The procedures takes around one to three hours . Although ESG does not use surgical incisions, patients undergo general anesthesia during the procedure. ESG is done as an outpatient procedure. Most patients return home the same day. Patients can return to work and resume daily activity one to three days after the procedure. After four weeks patients can expect a full recovery.

Is Gastric Sleeve Safe

Which Surgery Helps You Lose Weight the Fastest?

Laparoscopic gastric sleeve surgery has been around for more than two decades and many studies have been done, and historical data collected regarding the safety and efficacy of the procedure.

A study conducted in Spain followed patients for five years after having a laparoscopic sleeve gastrectomy procedure. Eight patients experienced side effects that were controlled and some patients experienced acid reflux or gallstones. Despite the few side effects, 75% of the patients in the study experienced remission from type 2 diabetes and 72% remission from high blood pressure.

Any surgical procedure involves risks, but gastric sleeve surgery is known as one of the safest bariatric surgical procedures to undergo. It is considered safe or safer than other forms of surgery.

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Weighing The Pros And Cons Of Gastric Sleeve Surgery

Two of the most common weight loss surgeries are gastric bypasses and gastric sleeve transplants. The procedure is generally considered invasive, but gastric bypass is more invasive due to the need to rerouting the small bowel. Gastric sleeve surgery is generally regarded as less invasive than gastric bypass surgery, but it is still a invasive procedure. The amount of pain from a gastric sleeve operation varies from person to person, but it is usually between five and seven out of ten. There is some evidence that long-term results from laparoscopic sleeve gastrectomy are beneficial, but after about two years of the primary surgery, some patients regain weight and may require revision. Despite the fact that gastric sleeve is a popular weight loss treatment, it is a surgical procedure that involves removing large portions of the stomach and is permanent. As a result, before undergoing the procedure, individuals should carefully consider the risks.

Weight Loss And Band Management

Of the 491 patients with an inserted band, 37 were never calibrated because their intake was limited enough to achieve adequate weight loss. The other 454 patients were calibrated within 3 months postoperatively. Of these, 290 needed only one calibration adjustment, 110 had two calibration adjustments, 40 had three adjustments, and 14 patients had four or more calibrations during the 24-month follow-up. On three occasions, band slippage necessitated deflation without reoperation. During the year 2000, there were 342 adjustments of the balloon .

The excessive weight loss was 42.8%, 52%, and 54.8% at 1, 2, and 3 years . The mean BMI decreased from 44.3 to 34.2, 32.8, and 31.9 at, respectively, 1, 2, and 3 years .

Figure 6. Change in BMI from 048 months.

There were 55 superobese patients . These patients lost a great deal of weight but their BMI reduction was less significant . This result was insufficient to protect them from obesity-related vital complications. Among the 343 patients with at least 1 year of follow-up, 16 were considered a failure with an excess weight loss of less than 20%. Among these, 11 were subsequently revealed to be bad candidates because their psychiatric profile showed either compulsive bulimic behavior or sweets-eaters.

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Biliopancreatic Diversion With Duodenal Switch

A surgical procedure called biliopancreatic diversion with duodenal switch, or mixed surgery, involves two separate procedures. The first procedure is similar to gastric sleeve surgery. A second surgical procedure divides the small intestine into two tracts. Food moves through one tract, bypassing most of the small intestine. This reduces the number of calories and amount of nutrients absorbed. Digestive juices flow from the stomach through the other intestinal tract and mix with food as it enters the colon.

This type of surgery allows you to lose more weight compared with the other three operations described above. However, it is also the most likely to cause surgery-related problems and a shortage of vitamins, minerals, and proteins in your body. For these reasons, surgeons do not perform this particular procedure often. However, some surgeons may recommend it for patients who have severe obesity and certain health conditions.

Who Is Not A Candidate For This Procedure

Healthbreak – Minimally Invasive Bariatric Surgery, David Tichansky, MD

People with uncontrolled hypertension, eating disorders, inflammatory bowel disease, and stomach ulcers are not candidates for this procedure.

Fill out our application if you are interested in starting the weight loss surgery process. Once you’ve submitted the application, we will call you to schedule your first appointment.

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Does Insurance Cover Bariatric Surgery

Insurance often covers bariatric surgery. While most of the major insurance carriers offer coverage for bariatric surgery, not all policies include coverage. To find out if your insurance policy provides coverage, we recommend three steps:

  • It doesnt matter which procedure you end up having. Calling your carrier is your first check to see if your policy includes coverage for bariatric surgery procedures.
  • Most bariatric programs are happy to check and often have someone on staff that does this regularly.
  • Use our bariatric program finder to find a bariatric program in your area.
  • Familiarize yourself with your insurance companies requirements for coverage.
  • About Primary Endoscopic Bariatric Therapy

    In the last decade, new endoscopic procedures have been developed for people who are not candidates for weight loss surgery or who prefer a less invasive, non-surgical alternative. This often includes adults who are overweight or obese who have not been successful at losing weight through diet and exercise programs.

    Michigan Medicine is one of only a few centers in the region with doctors trained to perform these two innovative options:

    • Intragastric Balloon
    • Endoscopic Sleeve Gastroplasty

    Each of these procedures is performed on an outpatient basis. Given these are new endoscopic procedures, they may not be covered by your health insurance.

    The Intragastric Balloon is a silicone balloon placed in the stomach and filled with saline, limiting the amount of food the stomach can hold. The balloon and a tiny camera are inserted endoscopically, through a thin tube placed in the mouth and into the stomach. Guided by the camera, the doctor positions the balloon and fills it with saline solution. The outpatient procedure takes about a half-hour.

    The balloon device is FDA-approved for patients with a body mass index of 30 to 40.

    Intragastric balloon therapy is a reversible procedure. Balloons are intended to be left in place for a period of time and then removed endoscopically.

    ESG is intended for patients with a body mass index greater than 30. It is an outpatient procedure, and takes less than two hours to perform.

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