Weight Loss Operations

The Vertical Sleeve Gastrectomy is commonly referred to as the "Sleeve". The surgeon removes about 80% of your stomach, and the patient is left with a narrow tube-shaped stomach.

This procedure is considered a metabolic operation, where it improves your body's hormonal signaling physiology. This procedure was initially used as the first of two operations for treating patients with very high BMI’s. However, many patients did so well with this operation, that the procedure has since gained popularity as a stand-alone operation. This procedure is the most commonly performed bariatric operation being performed in the US.

Patients need to be on lifetime multivitamin supplements. Your doctor will monitor these vitamin and mineral levels on a regular basis to ensure your maximum health. Weight loss for this procedure is approximately 60% excess weight loss the first year, with most patients maintaining this level for the years to come.

Complications are uncommon. Some patients may develop acid reflux after this procedure.

The Roux-en-Y Gastric Bypass is categorized as a metabolic procedure. It produces changes in the gut physiology which improves carbohydrate metabolism, as evidenced with dramatic improvement in a person’s diabetes after the operation. The stomach is cut and divided, thereby making a smaller stomach that limits the amount of food you eat before you feel full. The first part of the small intestine and stomach remnant are bypassed, so the food you eat does not see this part of the intestine.

The Bypass has been performed safely for more than five decades, and has proven itself to be a great procedure for maximizing health. Possible complications, which are less than 10%, include the chance of an intestinal leak, bleeding, obstruction, ulcer, and malabsorption.

Patients need to be on lifetime multivitamin supplements. We will monitor these vitamin and mineral levels on a regular basis to ensure your maximum health. Weight loss for this procedure is approximately 70% excess weight loss the first year, with most patients maintaining this level for the years to come.

The Single Anastomosis Duodenal Switch has several names. It can be mentioned as the “SADI” or “SADI-S” or “Loop Duodenal Switch”. It is a modification of the standard Duodenal Switch operation. The main difference with this procedure is that a ‘loop’ of intestine is attached to the duodenum instead of a separate limb of intestine. This avoids the need of creating two bowel connections, hence the name “Single Anastomosis”. The SADI was first performed in Europe, then adopted in the US around 2016. We have been performing the operation since January 2019. In October 2019, the ASMBS classified this operation as an Approved Operation.

The SADI has many possible advantages over the traditional Duodenal Switch. Bowel habits tend to be minimally affected. Vitamin and protein deficiency seem to be less of a risk. Risk of internal hernia is less. At the same time, weight loss and metabolic improvement appears to be close to the Duodenal Switch.

The SADI is advantageous over the Gastric Bypass in terms of: (1) greater weight loss and metabolic improvement, (2) less chance of internal hernia, ulcers, and strictures, and (3) less symptoms of dumping syndrome.

We are the first, and only program in the state to offer this operation. It is an excellent option for patients with Type II Diabetes uncontrolled with medication.

Some people who have undergone weight loss surgery in the past have either developed complications which require intervention, or have gained back a significant amount of weight, where consideration is made to perform another weight loss procedure.
Revisional surgery encompasses these two situations.

A decision to go forward with a revisional surgery should not be made lightly, and input from the surgeon, psychologist, and dietician are essential to plan the best possible chance of success. When considering revisional surgery, make sure to get a second opinion, and align yourself with a program that has experience with these types of cases.

Knowledge and experience with a dedicated team will be critical in maximizing your safety. We have over 20 years and 3,000 cases of bariatric procedures. We have experience with revising sleeves to SADI, duodenal switch, and gastric bypass. We revise gastric bypasses with pouch reconstruction and roux limb distalization. We perform LapBand and VBG conversions. Call our office to understand what options may be available to you.