What Are My Options?

The most common bariatric surgical procedures performed today work primarily by restricting the capacity of the stomach. These operations are nearly always performed with a minimally invasive laparoscopic technique, so a large incision is rarely necessary.

The Hickory Surgical Clinic currently offers three options for weight loss. To learn more about each procedure, click on the links below:

Laparoscopic  Roux-en-Y Gastric Bypass	Laparoscopic  Sleeve Gastrectomy	Laparoscopic Adjustable Gastric Band (Lap-Band or Realize Band)\
Anatomy
Small (1-2 oz) stomach pouch Connection between stomach pouch & intestine Roux-en-Y bypass of the stomach	Longer stomach pouch (2-3 oz) Vertical shaped stomach pouch No intestinal bypass	Small (1-2 oz) stomach pouch Soft plastic band placed around stomach Port used for adjustment access
Mechanism
Small pouch restricts size of meals, creates sensation of fullness Minimal malabsorption Can have dumping syndrome with sweets	Small pouch restricts size of meals , creates sensation of fullness No malabsorption NO dumping syndrome	Small pouch restricts size of meals , creates sensation of fullness Must be adjusted No malabsorption NO dumping syndrome
Surgical Technique
Laparoscopic approach Surgical staplers	Laparoscopic approach Single incision (SILS) possible Surgical staplers	Laparoscopic approach Single incision (SILS) possible No staplers
Operating Room Time
60-90 minutes	60 minutes	45 minutes
Hospital Stay
Go home in 1-2 days	Go home in 1-2 days	Go home same day
Time Off Work
1-2 weeks Varies by job duties	1-2 weeks Varies by job duties	1 week Varies by job duties
Weight Loss Results
70% excess weight loss (EWL) in 1-2 years More rapid initial weight loss 50% EWL in first 6 months	50-70% excess weight loss in 1-2 years Limited long-term data available at this time	50-60% excess weight loss May take several years to reach goal weight  Will require several adjustments Requires the most effort of all procedures to be successful
Supplements Required
Multivitamins with iron Calcium Vitamin B12	Multivitamins with iron Calcium	Multivitamins with iron Calcium
Potential Problems
Leak Ulcer Stricture Internal hernia Dumping syndrome Vitamin/mineral deficiency Inadequate weight loss Weight regain	Leak Stricture Nausea/vomiting Heartburn Inadequate weight loss Weight regain May need a second operation	Band slippage Band erosion Port leak Port infection Heartburn Slow weight loss Inadequate weight loss Weight regain May need another operation
Potential Advantages
Rapid weight loss Dumping syndrome is actually seen as an advantage by most patients Rapid control of blood sugar (type II diabetes) No need for adjustments Proven track record	Initial weight loss results similar to gastric bypass No need for adjustments May be a safer option in some patients with very high BMI or previous abdominal surgery	Adjustable No irreversible changes to the anatomy
More Information
Laparoscopic Gastric Bypass	Laparoscopic Sleeve Gastrectomy	Laparoscopic Adjustable Gastric Band

If you feel that you or someone you love might benefit from weight loss surgery, or if you would like any additional information, please contact us at 828-327-9178. Or click here to see how to get started in our program.