Surgical Weight Loss
The goal of bariatric surgery is to help you lose weight and keep it off. The three most common procedures are:
- Roux-en-Y Gastric Bypass
- Laparoscopic Adjustable Gastric Band
- Sleeve Gastrectomy
To understand how these operations work, it is helpful to understand how food normally moves through your body.
The Digestive Process
After you chew and swallow, food moves down the esophagus into your stomach. The stomach stores what you've eaten until it can be broken down, or "digested." Those particles of food get pushed into the small intestine, where the food is broken down so you can absorb vitamins, minerals, proteins, carbohydrates, and fats. What is left over is waste, which moves through your large intestine and then out.
Bariatric surgery changes the way your body's normal digestive process works by:
- Restricting the amount of food that can pass through your stomach,
- Limiting the amount of food that can be absorbed by the body ("malabsorption"), or
- A combination of the two.
Bariatric surgery generally results in you feeling fuller sooner, making you less likely to overeat.
Roux-en-Y Gastric Bypass
In the Roux-en-Y Gastric Bypass (RYGB) procedure, the surgeon creates a small pouch by dividing the upper portion of the stomach. This restricts food intake.
Next, a section of the small intestine is attached to the pouch to allow ingested food to bypass a portion of the small intestine, and mix with digestive enzymes farther down.
The procedure employs both restriction from the smaller stomach pouch, and a degree of malabsorption from the bypassed small intestine.
The hospital stay for a gastric bypass done at Cedars-Sinai Medical Center is typically 2 days.
"Laparoscopic" versus "Open" Technique
"Laparoscopic" gastric bypass surgery involves several small incisions. Small cameras and other surgical instruments are inserted through the small incisions so the surgeon can see what he or she is doing, without having to make a large incision.
"Open" gastric bypass surgery typically involves one long incision, from near the breastbone, to close to the navel.
The laparoscopic, or "minimally-invasive" approach, generally results in a shorter hospital stay, a quicker recovery, less post-operative pain, and less risk of complications (such as infections or hernias) than the open gastric bypass.1
The surgeons at the Cedars-Sinai Weight Loss Center perform gastric bypass surgery laparoscopically almost exclusively. We will attempt to do your surgery laparoscopically unless your health prevents it. Your safety is our primary concern.
Laparoscopic Adjustable Gastric Band (LAGB)
During adjustable gastric banding surgery, the surgeon inserts an inflatable silicone band around the esohpagus, tubing, and an access port that sits just under your skin.
The band creates a new, smaller pouch that restricts the amount of food consumed and slows the emptying process into the stomach and intestines, allowing you to feel fuller sooner. The band is adjustable, and can be modified by inflating or deflating the band with saline solution to control the amount of restriction. In the first year after surgery, monthly adjustments are necessary to achieve optimal results. The hospital stay for laparoscopic adjustable gastric banding surgery at Cedars-Sinai is typically 1 day.
In the sleeve gastrectomy procedure, the surgeon removes a large portion of the stomach, creating a vertical “sleeve” stomach about the size of a banana. This new smaller stomach restricts the amount of food you can eat, and makes you feel fuller sooner. The hospital stay for a sleeve gastrectomy done at Cedars-Sinai Medical Center is typically 2 days.
1 Nguyen, N, et. al., "Laparoscopic Versus OPen Gastric bypass: A Randomized Study of Outcomes, Quality of Life, and Costs", Annals of Surgery, Vol. 234, No. 3, 279-291