Weight loss Surgery Options

My weight loss Obesity is one of the leading preventable causes of death in America. The medical treatment of obesity, including sur- gery, is very effective, safe and is advancing quickly, with new procedures regularly being de- veloped and approved. surgery options ''''" LLL. 25 "I"""T" Roux-en-Y gastric bypass Adjustable gastric band A laparoscopic gastric band, commonly referred to as a lap-band, is an inflatable silicone device, placed around the top portion of the stomach to treat obesity by reducing the amount of food consumed. The gastric bypass surgery involves two main steps. First, the upper part of the stomach is stapled to create a small pouch, roughly the size of a golf ball. After this, a portion of the small intestine is attached to the pouch, "bypassing" a large portion of the stomach and the upper segment of the small intestine. In the U.S. market, two typs of adjustable gastric bands have been approved by the FDA: Realize ® and LAP-BAND® Average Excess Weight Loss at 12-18 Months with gastric bypass: 70.4% Average Excess Weight Loss at 12-18 Months with Lap-Band: 44.4%3 Number of patients who experienced resolution of their health condition Number of patients who experienced resolution of their health condition b. 94.6% 100 100 83.7% 80.4% 73% 74% 80 80 67.5% 60 60 40 40 20 20 Type II Diabetes High Blood Pressure Sleep Apnea Type II Diabetes High Blood Pressure Sleep Apnea New! Sleeve Gastrectomy New! Gastric Plication During this surgery, about three-quarters of the stomach is removed. The resulting pouch is the shape of a banana, or a tube, hence the name "sleeve gastrectomy." The gastric plication, also known as the gastric imbrication, is a new weight loss surgery technique and is already showing very encouraging results. In this procedure, the stomach is folded over and stitched to itself, shrinking it to a small fraction of its original size. This means that it holds less food, which in turn means fewer calories This restricts the patient's food intake and results in effective long term weight loss. The sleeve gastrectomy is perceived by surgeons as a lower-risk alternative to gastric bypass, espe- cially in high-BMI individuals, because it involves less radical surgical changes to the internal organs. Unlike the gastric bypass and sleeve gastrectomy procedures, there is no cutting or stapling of the stomach in the gastric plication. Unlike the lap-band, there are no adjustments or needles required as part of the post-op follow up and support regime. For these reasons, the gastric plication may provide a viable alternative to patients looking for an effective weight loss procedure. Sources Nicolas Christou, MD, PhD, Evangelos Efthimiou, MD, MSc Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada. Canadian Journal of Surgery, Vol. 52, No. 6, December 2009, pp. E249-E258 Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA. 2004;292:1724-1737. M. S. Parikh, G. A. Fielding and C. J. Ren. U.S. experience with 749 laparoscopic adjustable gastric bands: intermediate outcomes. Surgical Endoscopy. Volume 19, Number 12, 1631-1635, DOI: 10.1007/s00464-005-0302-7 John B. Dixon, Paul E. O'Brien, Julie Playfair, Leon Chapman, Linda M. Schachter, Stewart Skinner, Joseph Proietto, Michael Bailey, Margaret Anderson. Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial. JAMA. 2008;299(3):316-323 Jaime Ponce, MD; Beverly Haynes, RN; Steven Paynter, MD; Richard Fromm, MD; Brooke Lindsey, RN; Amanda Shafer, PA-C; Eric Manahan, MD; Christopher Sutterfield, MD. Effect of Lap-Band®-Induced Weight Loss on Type 2Diabetes Mellitus and Hypertension. Obesity Surgery, Volume 14, Number 10, 1335-1342 Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA. 2004;292:1724-1737. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469-475 22