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Weight Management & Surgery

Baylor Scott & White All Saints Medical Center – Fort Worth

 
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Types of Weight Loss Surgery 

All the minimally invasive weight loss procedures offered at Baylor Scott & White – Fort Worth reduce the size of the stomach to limit the amount of food it can hold. As a result, you eat less food and lose weight.

When you meet with a physician on the medical staff at Baylor Scott & White – Fort Worth, you will discuss options and determine the procedure that is most appropriate for you. Learn more at the links below.

Bariatric Surgery: Roux-en-Y Gastric BypassLa cirugía bariátrica: derivación gástrica en Y de Roux

Bariatric Surgery: Roux-en-Y Gastric Bypass

Front view of stomach and duodenum. Stomach has been cut and stapled to form pouch. Cut end of small intestine has been brought up to connect to stomach pouch. Duodenum has been cut and reattached to small intestine. Arrow shows food passing from stomach into shortened small intestine. Another arrow shows path of digestive juices from stomach through duodenum and into small intestine. Digestion begins in small intestine.

Bariatric surgery changes the size of your stomach and the length of your small intestine that comes in contact with the food you eat. The goal is to limit how much food can be eaten and/or absorbed at one time. Bariatric surgery can be done in several ways. You are having a Roux-en-Y Gastric Bypass (RYGB). This is the most common type of bariatric surgery. During this type of procedure, part of the stomach is separated from the rest of the stomach and closed off with staples to create a smaller pouch. The smaller stomach helps restrict the amount of food you can eat at one time. The small intestine is then divided, and part of it is reattached to the stomach pouch. Because some of the small intestine is bypassed, less food is absorbed as well.

The procedure

A large portion of the stomach is closed off. This leaves a small pouch to hold food, restricting the amount that can be eaten at one time. The small intestine is cut below the duodenum and reattached to the new stomach pouch. This leaves a shortened path for food to travel through. As a result, some of the food that is eaten is expelled as waste and not absorbed as energy. The remaining pouch of the stomach and duodenum are also reattached to the small intestine farther down to drain stomach, biliary and pancreatic enzymes, and fluids. 

Special note: the gallbladder

Bariatric surgery is designed to cause a large amount of weight loss. Weight loss can cause deposits in the gallbladder called gallstones. The gallbladder may need to be removed at a later date. If you already have gallstones, the gallbladder may be removed at the time of your RYGB operation.

All types of bariatric surgery have different advantages and disadvantages. Be sure to discuss the risks and complications of this surgery with your healthcare provider. 

Roux-en-Y Gastric Bypass

During gastric bypass procedures, the stomach size is reduced to limit the amount of food it can hold. As a result, you eat less food and lose weight.

Learn More

Bariatric Surgery: Vertical Sleeve GastrectomyLa cirugía bariátrica: Gastrectomía en manga vertical

Bariatric Surgery: Vertical Sleeve Gastrectomy

Bariatric surgery is a procedure that helps you lose weight. During vertical sleeve gastrectomy, approximately 80% of the stomach is removed. The part of the stomach that is removed is thinner than the rest of the stomach and stretches out when you eat to hold all the food. The part of the stomach that is not removed is a narrow "sleeve." This sleeve does not stretch very much and can hold only a few tablespoons of food. Food passes slowly through a narrow opening at the bottom of the stomach called the pyloric valve, and food empties out like it does before surgery.This procedure produces changes in hormones that reduce appetite. In the sleeve gastrectomy, the surgery is only on the stomach and is not on the small bowel. 

Front view of stomach and first part of small intestine. Stomach has been cut to form small pouch at top. Rest of stomach is removed. Staples close off cut edges. Arrow shows path of food from small pouch to small intestine.

The procedure

This surgery can be done using one or two approaches:

  • For laparoscopic surgery, small incisions are made in your upper stomach. During the procedure, a tiny camera sending images to a monitor and thin surgical instruments are inserted through these small incisions. The surgeon operates by looking at the organs on a video monitor. Almost all sleeve gastrectomy procedures are now done laparoscopically. 

  • For open surgery (also called laparotomy), one larger incision is made in the middle of the upper stomach. The surgeon sees and works through this incision. Most cases are not done this way because the laparoscopic approach, if possible, involves smaller cuts, less tissue damage, and fewer problems. 

Using either type of approach, the stomach is cut lengthwise (up and down) with a stapling instrument. The larger part of the stomach is removed. The side of the remaining stomach (the sleeve) is closed off with staples made out of titanium. This creates a narrower, smaller-volume stomach in the shape of a banana, or a sleeve. 

Special note: the gallbladder

Bariatric surgery is designed to cause a large amount of weight loss. Weight loss can cause gallstones. If you already have gallstones, the gallbladder may be removed during your surgery or at a later date to prevent gallbladder problems from developing. 

Gastric Sleeve

By removing part of the stomach, not only is stomach volume decreased, but the part of the stomach that is removed also decreases appetite.

Learn More

Bariatric Surgery: Laparoscopic Adjustable Banding La cirugía bariátrica: banda gástrica ajustable por vía laparoscópica

Bariatric Surgery: Laparoscopic Adjustable Banding

Weight-loss (bariatric) surgery changes the size of your stomach to help you lose weight. The surgery may also keep your body from absorbing nutrients. The goal is to limit how much food can be eaten or absorbed at one time, or both. There are several types of weight-loss surgery. You are having laparoscopic adjustable gastric banding. This surgery closes off part of your stomach to make a very small pouch. This is the most common type of weight-loss surgery that restricts how much food you can eat.

The procedure

The surgeon puts an adjustable band around the top part of your stomach. The band is like a ring. It makes a small pouch in your upper stomach. This pouch holds only a few tablespoons of food. Food passes slowly through a narrow opening at the bottom of the pouch. This lets you feel full longer. The size of the band can be changed by using a port placed under the skin. The port gives your healthcare provider a way to put in a needle. He or she uses the needle to add or remove fluid from the band. This is done to make the size of the opening bigger or smaller. Changing the band changes how quickly food leaves the new pouch.

Front view of stomach and duodenum showing laparoscopic adjustable gastric banding. Band is around top of stomach, creating small pouch. Band is connected by tube to port just under skin. Arrow shows path of food through stomach pouch, stomach, and duodenum.

 

Special note: the gallbladder

Weight-loss surgery is meant to cause a large amount of weight loss. Weight loss can cause gallstones. These are collections of solid material in the gallbladder. These collections could potentially cause blockage, inflammation, and pain. To prevent this, the surgeon may remove the gallbladder during your surgery if you already have gallstones. Or you may need your gallbladder removed at a later date.

All types of weight-loss surgery have different advantages and disadvantages. Be sure to discuss the risks and complications of this surgery with your healthcare provider.

Adjustable Gastric Banding

Also known as Lap-Band®, the stomach is wrapped with an adjustable silicone band, which can be tightened or loosened to control stomach size.

Learn More

Revisional Surgery

Roux-en-Y gastric bypass and adjustable banding procedures may be reversed through revisional surgery if results are unsatisfactory or other issues indicate need for a reversal. Revisional surgeries at Baylor Fort Worth generally are done laparoscopically.