Bariatric surgery at Mercy is a critical component of your weight-loss journey, providing the initial step to motivate and educate you for a healthier way of life.
Mercy Bariatrics offers a variety of minimally invasive procedures surgeries. Selecting the appropriate procedure is a highly individualized process, which is why each plan is customized to your unique profile and needs.
Mercy Bariatrics offers four types of surgery:
The gastric bypass procedure is often performed laparoscopically. This procedure restricts food intake and shortens the digestive track by creating a small gastric pouch from the upper portion of the stomach. Food is swallowed into the pouch instead of the stomach, and this limits the amount that can be eaten. The food then bypasses the first part of the small intestine and is diverted slowly into the small bowel for digestion.
Once this procedure is performed, patients often lose 50 to 75 percent of excess body weight over the next 12 to 14 months.
After the procedure, patients may experience malabsorption of food. This means the digestive tract has some difficulty digesting and absorbing nutrients. Because of this, after surgery patients regularly need to take a multivitamin and mineral supplement, as well as calcium and vitamin B12.
The adjustable gastric band procedure assists in weight loss by limiting food intake. Using open or laparoscopic surgery, the surgeon places an adjustable band around a portion of the upper stomach, creating a small chamber also known as a gastric pouch. This allows for food to be directed into the pouch instead of the stomach, causing a feeling of fullness.
In general, patients experience a 40 to 60 percent loss of excess body weight within three years after this procedure.
The gastric bypass procedure is often performed laparoscopically, which means that surgical instruments are inserted through small incisions. This can reduce scarring and lessen the risk of complications, and often results in faster patient recovery times. There is no stomach stapling or gastrointestinal bypass with the adjustable gastric band procedure.
The patient's weight and health are monitored during several routine follow-up exams in the first year after surgery. Periodically, the band will need adjustment to continue the weight loss process by injecting or removing fluid through the abdominal port, according to the patient's dietary needs.
Vertical sleeve gastrectomy is a new bariatric procedure that offers an alternative to both gastric bypass and adjustable gastric banding. It is particularly effective for patients with mild to moderate Body Mass Index (BMI of 35 – 45) as a primary procedure and for very high BMI (greater than 70) as a staged procedure. Vertical sleeve gastrectomy works mainly by reducing stomach volume – the stomach is divided vertically and 80 to 85 percent of the stomach is removed; a vertical “sleeve” shaped tube is created from the remains of the stomach.
A sleeve gastrectomy also works because it removes the part of the stomach that produces Ghrelin, a hormone that stimulates appetite. This reduces, but does not eliminate, a person’s appetite.
The nerves to the stomach and the outlet valve (pylorus) remain intact to preserve the functions of the stomach while reducing the volume it is able to hold. Food passes through the new stomach tube directly into the intestines. Nutrients and calories are absorbed from food normally, but patients feel full sooner and longer.
Sleeve gastrectomy is performed laparoscopically; there is no intestinal bypass with this procedure, only stomach capacity reduction. A second operation may be required, however, if significant weight loss is required to improve the patient's health.
Patients can expect to lose 50 to 70 percent of excess weight over a one- to two-year period after sleeve gastrectomy. Patients who may benefit from a sleeve gastrectomy over other procedures include those who have previously had small bowel surgery, very high BMI patients (>70) as part of a two-stage procedure, or low BMI (35 – 45) patients who prefer not to or cannot have an implanted device (band) or a malabsorptive (bypass or duodenal switch) procedure.
Bariatric surgery is usually very successful; however, some patients may not succeed in losing the expected amount of excess weight. In these situations, a follow-up bariatric procedure, known as a bariatric surgery revision, may be necessary to alter or repair the initial bariatric surgery.