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Fairview Park Hospital
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Weight Loss Surgeries

Surgical Options

If you’re thinking about weight-loss surgery, you probably have lots of questions about the different types of procedures. Let us be your guide. Fairview Park Hospital’s weight-loss team of bariatric surgeons, nurses and registered dietitians can help you choose the best path for weight-loss success and can answer your questions along the way.

Restrictive Surgery

Restrictive surgeries work by shrinking the size of the stomach and slowing down digestion. A normal stomach can hold about three pints of food. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2-3 ounces. The smaller the stomach, the less you can eat. The less you eat, the more weight you lose.

Lap-Band® (Adjustable Gastric Banding)

Single-incision, minimally invasive

In this type of surgery, the surgeon uses an inflatable band to squeeze the stomach into two sections: a smaller upper pouch and a larger lower section. The two sections are still connected by a very small channel, which slows down the emptying of the upper pouch. Most people can only eat a 1/2 to 1 cup of food before feeling too full. You can also get the band adjusted in a doctor's office.

Gastric Sleeve

Single-incision, minimally invasive

During gastric sleeve surgery, the surgeon removes about 75% of the stomach though a minimally invasive, laproscopic procedure. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines. For people who are very obese or sick, gastric sleeve is a simpler operation that gives them a lower-risk way to lose weight. If needed, once they've lost weight and their health has improved -- usually after 12 to 18 months -- they can have a second surgery, such as gastric bypass. Because the intestines aren't affected, gastric sleeve doesn't affect how your body absorbs food, so you're not likely to fall short on nutrients.

Intragastric Balloon

Minimally invasive, often same-day

During this surgery, a soft balloon is inserted into your stomach through your mouth, using an endoscope (a thin, flexible telescope). The balloon is then filled with saline solution to partially fill your stomach, leaving less room for large amounts of food or drink. A gastric balloon is designed to be a temporary weight loss solution, and will usually be removed after six months. It is sometimes used to help you lose enough weight to undergo gastric banding or gastric bypass surgery.

Gastric balloons are inserted under sedation in a procedure that takes 20 to 30 minutes. It is a relatively minor procedure, but it may take your stomach a little while to get used to the balloon. You will usually be able to go home the same day, or the day after the balloon has been inserted.

Overstitch

Minimally invasive

This procedure is for patients who have had previous gastric bypass surgery – but have stretched out their smaller stomach pouch over time. An endoscope and the Overstitch® device is passed through your mouth and into the stomach pouch. Using the device, the stomach outlet is sewn smaller, and the pouch size is significantly reduced. This allows you to feel satisfied after only a few bites of food, and to regain the feeling of stomach restriction you may have lost, which can help restart weight loss.

Malabsorptive Surgery

Malabsorptive surgeries change how you take in food by giving you a smaller stomach and bypassing part of your digestive tract, which makes it harder for your body to absorb calories. Most malabsorptive surgeries use restrictive procedures in combination.

Gastric Bypass

Gastric bypass is the most common type of weight loss surgery. It combines both restrictive and malabsorptive approaches. During the operation, the surgeon divides the stomach into two parts, sealing off the upper section from the lower -- then connects the upper stomach directly to the lower section of the small intestine. Essentially, the surgeon is creating a shortcut for the food, bypassing part of the stomach and the small intestine. Skipping these parts of the digestive tract means that the body absorbs fewer calories.

Weight loss tends to be swift and dramatic. About 50% of it happens in the first six months, and may continue for up to two years after the operation. Because of the rapid weight loss, conditions affected by obesity -- such as diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, and heartburn -- often get better quickly. Gastric bypass also has good long-term results. Studies have found that many people keep most of the weight off for 10 years or longer.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

This surgery combines restrictive and a malabsorptive techniques. The restrictive portion of the surgery involves removing approximately 70% of the stomach. The malabsorptive portion reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel.

The common channel is the portion of small intestine, usually 75-150 centimeters long, in which the contents of the digestive path mix with the bile from the biliopancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat. As a result, following surgery, these patients only absorb approximately 20% of the fat they intake.

The primary advantage of BPD/DS surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a higher percentage of excess weight loss versus a purely restrictive gastric bypass for all individuals. And since the stomach pouch is larger than with other bariatric operations, you can eat larger portions than with the gastric bypass or LAP-BAND.

Implantation Surgery

Implanting an electrical device prompts weight loss by interrupting nerve signals between the stomach and the brain.

vBloc

Minimally invasive, often same-day

vBloc® Therapy is delivered through an implantable device called the Maestro® System. By blocking the signals between your stomach and your brain, the therapy helps controls hunger—meaning you have an active tool to help you make healthier choices.

With vBloc surgery, a device is implanted just under the skin, typically during an outpatient procedure that can be performed as a same-day surgery. Unlike other treatments, vBloc does not prevent nutrient absorption or alter your anatomy. And because the device directly targets your source of hunger, losing weight does not require you change the foods you eat or adopt a low-calorie diet.