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Your Bariatric Options in San Antonio, TX

While bariatric surgery can produce remarkable outcomes in many patients, doctors at The Weight Loss Solutions Center do not recommend surgery as a primary therapy for obesity. In fact, the majority of obese patients do not need surgery at all. Rather, a medically supervised diet, exercise routine, and physician-prescribed drugs may be just as effective – without the complications of surgery.

Of course, those who do need surgery need the right kind of surgery. Generally speaking, bariatric surgery can be divided into three classifications: malabsorptive, restrictive, and combined.

Your surgeon will be happy to discuss your personal weight loss goals in order to determine if one of these types of surgery may be right for you. Click on a procedure to learn more about it.

Malabsorptive Bariatric Surgery

This surgery refers to a procedure that alters the digestive system. Typically, the size of the stomach is reduced and/or part of the intestine is bypassed, which allows food to pass more quickly and reduces caloric absorption.

Restrictive Bariatric Surgery

In these procedures, the size of the stomach is reduced, which results in limited food intake and a greater sense of fullness.

  • Biliopancreatic Diversion
  • Duodenal Switch
  • Sleeve Gastrectomy
  • StomaphyX

Combined Bariatric Surgery

Some patients will require a combined bariatric surgery, which draws on both malabsorptive and restrictive surgery techniques.

  • Gastric Bypass

To learn more about specific weight loss surgeries available at the Weight Loss Solutions Center, view a list of routine procedures:

Adjustable Gastric Band Procedures (LAP-BAND®, Realize® Band, etc.)

Adjustable gastric band procedures are becoming increasingly common with patients at the Weight Loss Solutions Center and elsewhere throughout the United States. These adjustable band procedures are non-surgical, reversible, and more affordable than traditional gastric bypass surgery. Learn about two of the most common adjustable gastric band procedures we offer:

LAP-BAND®

The LAP-BAND® procedure is still relatively new to the United States. However, it’s been achieving great results for patients around the world (Australia, Europe, and Mexico) and now in the United States, as well. LAP-BAND® surgery, though typically covered by insurance, costs 25-50% less than gastric bypass (if paid out of pocket).

In this procedure, the surgeon places an adjustable band on the stomach, just below the area where the esophagus and stomach connect. The band’s restriction can be adjusted with a port that lies just beneath the skin. The effect is that the patient feels fuller by eating less food. Also, food is digested completely normally through this procedure.

Realize® Band

Most patients are familiar with the LAP-BAND®, which can tout itself as the “original” lap band. However, your surgeon may recommend the Realize® Band for your surgical weight loss. The Realize® Band received FDA approval in 2007, six years after the Allergan LAP-BAND® received FDA approval. For this reason, the Realize® Band is sometimes considered “second best,” a common misunderstanding that the Weight Loss Solutions Center would like to change.

The Realize® Band offers some advantage in that it comes with more advanced online patient support and weight loss tools, but ultimately long-term success isn’t the result of choosing one surgical product over another. Successful patients enjoy sustained weight loss because of their commitment to living a healthy post-op lifestyle.

Gastric Bypass

Gastric bypass surgery is the one surgical weight loss procedure that everyoneknows. The most common form of gastric bypass surgery is Roux en-Y bypass surgery. In performing gastric bypass surgery, the surgeon creates a smaller stomach pouch in the stomach, which limits food and caloric intake.

With a reduced stomachs size, patients eat less food and feel full sooner. With a Roux en-Y procedure, your surgeon will divide your small intestine, creating a Y-shape. This new Y-shape will allow the excess food that you eat to leave the body as waste.  Patients with gastric bypass surgery have just enough small intestine length for the right amount of nutrients to be absorbed into their system.

The Weight Loss Solutions Center team is proud to offer this surgerylaparoscopically to nearly 100% of patients treated. Laparoscopic gastric bypass surgery results in less pain and faster recovery. Success rates for laparoscopic Roux en-Y gastric bypass:

Outcomes Texas Bariatric Specialists National Average
Death <0.5%  <0.5% to 2%
Leak  <0.5% 2% to 5%
Strictures 5% to 7% 7% to 25%
Excess Weight Loss 65% to 80% 65% to 80%

Sleeve Gastrectomy

The gastric sleeve gastrectomy procedure (also known as “lap sleeve” and “laparoscopic vertical sleeve gastrectomy”) was originally designed to treat patients who were believed to be too obese for traditional bypass surgery. Over the years, surgeons noticed that the results these patients experienced were phenomenal. This restrictive weight loss surgery became more popular with patients for a number of reasons.

Patients who undergo a sleeve gastrectomy:

  • Eat more natural portions of food
  • Enjoy weight loss and diabetes improvement
  • Have no adjustments
  • No foreign bodies
  • No long-term risks

It’s easy to see why many patients choose to have a vertical sleeve gastrectomy over LAP-BAND® surgery or gastric bypass. In this procedure, your surgeon uses a surgical stapler and sizing tube to reduce the stomach to 20% of its original size. The patient’s stomach will then resemble the shape of a slender banana, connecting the esophagus with the pylorus. After this surgery, patients feel less hungry between meals and begin to naturally eat smaller portions.

Biliopancreatic Diversion

Biliopancreatic diversion surgery is a form of restrictive surgery that changes the size of your stomach and/or the length of your small intestine. By reducing the size of your stomach, you can attain a feeling of fullness while eating less food.

Your surgeon performs this surgery by creating a smaller pouch within the stomach. The new stomach pouch, which can’t hold as much food, will help you restrict your food intake. Additionally, part of the small intestine is bypassed in a biliopancreatic diversion, which results in less food/caloric absorption.

This routine surgery is highly effective and commonly performed at the Weight Loss Solutions Center at Southwest General. It has remarkably high success rates. No rehab process is necessary following a biliopancreatic diversion. In fact, most patients will experience a smooth recovery simply by taking it easy and avoiding any kind of heavy lifting or strenuous exercise. Most patients experience a full recovery after 4-6 weeks, and are able to enjoy a new life in a healthy weight range!

Note: Before you consider a biliopancreatic diversion, it’s important to know the complications that could potentially ensue. The dramatic weight loss that follows biliopancreatic diversion surgery can result in deposits in the gallbladder (gallstones). In order to avoid this complication, your surgeon may recommend that your gallbladder be removed during your surgery (or shortly after surgery).

StomaphyX

Some patients will experience an enlargement of their stomach pouch after undergoing a Roux-en Y gastric bypass procedure. When the stomach pouch stretches (or the outlet of the stomach pouch into the bypass stretches), a StomaphyX procedure can correct the enlargement.

The StomaphyX procedure is performed endoscopically, which means there are no internal or abdominal incisions. While the StomaphyX procedure might sound like a great option, the surgeons at Southwest General Hospital do not perform StomaphyX. Here’s why:

The StomaphyX procedure is not as safe and well researched as other surgical weight loss procedures. Also, many StomaphyX procedures address what is actually a nutritional issue. Here are a few reasons why The Weight Loss Solutions Center advises against the StomaphyX procedure:

  • The procedure is still relatively new. It received FDA approval in 2007.
  • Lack of restriction after surgery is typically related to the patient’s poor food choices, grazing habits, or other dietary issues, which are best addressed and corrected through a nutritionist.
  • This procedure is not insurance-approved. A $9,500-$10,500 procedure offers “benefits” that last as little as three months.

While the Center advises against the StomaphyX procedure, physicians are more than happy to evaluate the size and shape of patients’ stomach pouches after they’ve undergone a restrictive surgical weight loss procedure. By using an endoscope and a dual contrast x-ray, your physician and his team can get a clear, three-dimensional vision of the stomach pouch. With this information, the physician can provide guidance for the patient’s next steps.

Revision Surgery

Sometimes surgical weight loss procedures fail. This could be the result of an inept surgeon’s work, or it could be because the patient lacked the proper education and/or self-control to follow through with a new post-op diet.

Choosing a weight loss surgeon may be one of the biggest decisions you have made up to this point in time. Now, if you’re thinking about revision weight loss surgery, you have an even bigger decision: What surgeon will you trust for revision work?

Your surgeon and the team at the Weight Loss Solutions Center bring a holistic approach to revision surgery (as they do to all aspects of weight loss). Because there are no “standard” revision surgery procedures, your surgeon will meet with you to discuss your problems and your goals.

Some patients may find that revision surgery actually isn’t necessary. Others will find that a re-banding or re-sizing of the stomach pouch is the solution that they need. In order to learn more about how your surgeon can help you through this emotional and physical challenge, come visit us at the Weight Loss Solutions Center. We use an evidence-based approach to help you make the right decision!

Duodenal Switch

A duodenal switch (often performed in conjunction with a biliopancreatic diversion) is one of the more high-risk surgical weight loss procedures available. At the same time, it can be one of the most effective surgeries for patients with a Body Mass Index over 60 kg/m2.

In a duodenal switch procedure, surgeons use staples to reduce the size of the patient’s stomach. This reduced size means patients can eat less while feelingfull. If the procedure ended there, it would simply be a biliopancreatic diversion.

For patients with an extremely high BMI, your surgeon may advise performing a biliopancreatic diversion with a duodenal switch. Instead of dramatically reducing the size of the stomach, patients undergoing this procedure will have their stomach moderately reduced and the small intestine partially bypassed.

This configuration allows patients to live without significantly altering their eating habits. Any excess food that doesn’t comfortably fit in the stomach is directed through the duodenum (upper portion of the small intestine) to the end of the smaller intestine so that it is not absorbed.

Patients that undergo this procedure can lose 70-80% of excess body weight in the two years following this procedure.

For more information about surgical weight loss procedures at Southwest General Hospital, call 1-877-215-WELL.

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