Emory Bariatric Center at Johns Creek

Roux-en-Y Gastric Bypass is both a restrictive and malabsorptive procedure. The surgeon divides the stomach in two parts; the large portion of the stomach is closed off with staples to create a smaller pouch. The smaller stomach, your new pouch, restricts the amount of food you can eat at one time. The small intestine is cut below the duodenum and reattached to the new stomach pouch, leaving a shortened path for food to travel through so less food is absorbed.

The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat. Because of the malabsorptive component, your body will not be able to process certain foods. Eating certain foods, like sweets, may result in dumping syndrome. This may be identified by nausea, vomiting, diarrhea and abdominal pain or cramping.

Surgery risks include but are not limited to: staple line bleed or leak, fistula, small bowel obstruction, and ulcers.

Laparoscopic gastric banding, or the "lap band" procedure, involves the placement of an adjustable gastric band around the top part of the stomach, which divides it into two parts: a small upper pouch and a lower stomach. The size of the gastric lap band is adjusted using a port placed under your skin. Adjusting the lap band changes how much you can eat and how quickly food leaves the new pouch so patients feel full sooner and longer than usual.

Gastric banding surgery risks include, but are not limited to: gastric perforation, port leakage or twisting, lack of satiety, reflux, nausea and vomiting, infection, outlet obstruction, pouch or esophageal dilation and band slippage.

The ideal candidate for the lap band procedure will have a Body Mass Index (BMI) above 40, or approximately 100 pounds overweight for men, and 80 pounds for women. Lap band surgery may also be an option for people with a BMI between 35 and 40 who suffer from chronic or life threatening complications associated with obesity.

The gastric lap band procedure is fully reversible when medically indicated and does not involve the use of cutting or staples. A few of the additional benefits of laparoscopic gastric banding (as compared to other weight loss surgery options) include:

• Short hospital stay
• Quick recovery
• Adjustable without additional surgery
• No nutrition issues (because no intestines are bypassed)

The sleeve limits food intake by reducing the size of the stomach. A stapling device is used to divide the stomach vertically, leaving behind a thin vertical sleeve of stomach. The excised portion of the stomach is removed.

• One of the newest procedures
• Ghrelin (hunger promoting hormone) is primarily removed with excised stomach, thus decreasing appetite
• Only procedure where a portion of the stomach is removed

Surgery risks include but are not limited to: staple line bleed, gastric leakage, nausea and vomiting.

As the body adapts to changes made during surgery, many factors could lead to low surgery success rates. In some cases, patients may require revisional surgery to correct this. Whether you experienced less-than-expected weight loss or weight re-gain after surgery, bariatric surgeons at Emory Johns Creek Hospital in Metro Atlanta offer a number of procedures that can help you get back on track. Your surgeon can explain each procedure in more detail during the consultation, and will tell you how the procedure will restore the feeling of being full after a meal. Atlanta Bariatric Center performs the following revision/conversion procedures:

• Band over bypass
• Revise the Gastrojejunostomy
• Convert the band or sleeve gastrectomy to a roux-en-Y gastric bypass
• Convert a proximal to distal bypass offering more malabsorption
• Convert the vertical band gastroplasty to the roux-en-Y gastric bypass
• Revise the Jejunoileo bypass