Descriptions of Each Bariatric Surgical Procedure

The Single Anastomosis Duodenal Switch (SADI-S/SIPS) is a welcomed modification of the older and more traditional Duodenal Switch Procedure. This procedure starts by creating a Sleeve Gastrectomy, reducing the size of the stomach by 80% and removing that portion from the body.

The second step divides the intestine just after the stomach followed by reconnecting the ileum as a loop. The ileum is the portion of small intestine furthest away from the stomach.

This procedure helps patients lose weight in two ways:

1.  Restricting the amount that you can eat
2. Changing the way your body absorbs food.

This procedure is an excellent option for patients with very high BMI and/or severe uncontrolled Diabetes Mellitus 2. This procedure is not a good option for patients with severe acid reflux or Barrett's Esophagus as these patients would be better served with a Roux-en-Y Gastric Bypass.

Dr. Brown is a nationally renowned surgeon and proctor for the SADI-S/SIPS procedure.

A Vertical Sleeve Gastrectomy is a common procedure that restricts the amount of food you can eat by making the stomach smaller. Your surgeon removes a portion of your stomach, leaving a portion about equal in size and shape to that of a banana. The remainder of the stomach is removed from the abdomen.

The removed portion produces a hormone called Ghrelin that is responsible for hunger. Therefore, in addition to decreased caloric intake, you will also have less desire to eat.

For the right patient, a Sleeve Gastrectomy may be a good alternative to Gastric Bypassor Duodenal Switch, depending on your BMI and underlying medical conditions.

While it is one of the most commonly performed weight loss procedures, it is not for everyone. For those who suffer from severe acid reflux, a Sleeve Gastrectomy could exacerbate these symptoms creating a significant reduction in quality of life and/or a need for revisional surgery in the future.  As you may expect, revisional surgery carries higher risks, including an increased risk of leak and damage to other structures during surgery.  This is why it's important to consult a Fellowship Trained Bariatric Surgeon about what surgical option best suits you and your needs.

The Roux-en-Y Gastric Bypass is a procedure where your surgeon creates a small pouch of stomach the size of a walnut to act as your new stomach (pouch) followed by re-routing of your intestines into a Y formation. The disconnected portion of the stomach (remnant) remains in place and is still connected to the small intestine (biliopancreatic limb) draining the Liver, gallbladder and pancreas. A portion of intestine from further along in the intestinal tract (alimentary limb) is then connected to the new pouch. These two pieces of intestine meet to form a common channel where absorption of food and nutrients begin.

Because Acid is produced in the lower portion of the stomach and the surgery disconnects them from the esophagus curing Acid Reflux, this procedure is the Gold Standard for Barrett's Esophagus and Severe Acid Reflux. It is also the gold standard for Hiatal Hernias with BMI >33.

This procedure helps patients lose weight in two ways:

1. Restricting the amount that you can eat
2. Changing the way your body absorbs food.

The bypass surgery is performed as a minimally invasive procedure, either laparoscopic or robotically.

The Duodenal Switch is a complex weight loss surgery that combines two main components:

1. Vertical Sleeve Gastrectomy: A large portion of the stomach is removed, leaving a smaller, sleeve-shaped stomach.
2. Intestinal bypass: The small intestine is rerouted, significantly shortening the path food takes through the digestive system.

In this procedure, the duodenum (the first part of the small intestine) is divided just past the stomach outlet. The last portion of the small intestine is then connected to this short duodenal segment, creating the "switch." This limits calorie absorption and alters hormone production related to hunger and satiety.

The duodenal switch leads to significant weight loss but requires lifelong nutritional supplementation due to reduced nutrient absorption. It's typically reserved for patients with severe obesity or those who haven't succeeded with other weight loss methods.

This procedure helps patients lose weight in two ways:

1.  Restricting the amount that you can eat
2. Changing the way your body absorbs food.

This procedure is an excellent option for patients with very high BMI and/or severe uncontrolled Diabetes Mellitus 2. This procedure is not a good option for patients with severe acid reflux or Barrett's Esophagus as these patients would be better served with a Roux-en-Y Gastric Bypass.

If you have had an adjustable gastric band placed in the past and you have weight regain or abnormal symptoms you may be a candidate for removal. Symptoms include nausea, vomiting, acid reflux, pain, difficulty tolerating foods, or redness or infection of the port site.

The removal of the Band and port site is performed by making an incision of the existing port followed by laparoscopic removal of the intra-abdominal band and tubing.

If you still suffer from Morbid obesity, BMI > 35, you may be a candidate for a Sleeve Gastrectomy, Roux-en-Y Gastric Bypass, or Duodenal Switch procedure. This is typically performed as a separate surgery in a delayed fashion and usage of our weight loss program as dictated by your insurance requirements.

Sometimes patients have undergone prior bariatric surgery that has resulted in nausea, vomiting, acid reflux, weight gain or other atypical symptoms. These patients may be candidates for surgical revision and are always assessed on an individual basis during your one on one consultation.

Examples of revision include: Lap Band Removal and conversion to other procedure, Sleeve to Bypass, Sleeve to Single Anastomosis Duodenal Switch, and rarely Reversal of Gastric Bypass to normal anatomy.

Revisional surgery does carry higher risk of leak at the staple lines as well as increased risk of injury to other structures due to scar tissue. Risks. benefits, and alternatives are always discussed at the time of consultation.