Our Procedures

Numerous surgical procedures have been devised for the treatment of morbid obesity. The once-popular intestinal bypass is no longer a recommended procedure, since 50% of these patients experience severe side effects.

The term "gastric stapling" should not be confused with any specific surgical procedure, since most obesity operations involve various amounts of stapling.

The treatment of morbid obesity is a world-wide endeavor. At this time, there are four basic surgical procedures being performed around the world. These include gastroplasty, gastric bypass, gastric binding and the Duodenal-Switch.

The Gastric Bypass Duodenal-Switch

An anesthesiologist will begin the surgery process with general anesthetic. Following appropriate preparation, an incision is made from the area below the sternum (breastbone) to the umbilicus. All abdominal organs and structures are examined for unsusoected disease. The appendix and gallbladder are routinely removed in order to obviate future surgery. The stomach is then reduced in size to hold aan approximate capacity of 3-6 ounces, which explains the first part of the procedure's name, Gastric (pertaining to stomach) Bypass. The bigger section is removed. This is the area of the stomach that normally could store a large quantity of food. The smaller stomach still has the blood supply, nerves and pyloric valve (the opening between the stomach and small intestines) that it had prior to surgery.

The small intestines are then measured so that the procedure can be tailor-made for each patient. Everyone does not have the same length of small bowel, which makes this measurement important. This length will allow the surgeon the ability to calculate how much should be considered the "common channel" or the area where the majority of absorption will take place. Also teaken into consideration are such things as age of onset of obesity, family history, severity of co-morbidites, and severity of obesity. usually the length of this channel will vary between two and four feet. The remainder of the small bowel, although not absorbing foods as before, is still functioning. This posrtion remains connected to the liver (bile) duct and the pancreatic duct; therefor it is called the "biliopancreatic" channel. It is important to remember that no intestines are removed during surgery. This part of the procedure is what makes up the last part of the name, "Duodenal-Switch". The intestine is divided at the area just below the stomach which is the duodenum; it has been "switched" from its typical connection. This specific area that is bypassed is the section of the small intestines that prior to surgery is absorbing the mojority of nutrients such as fats, proteins, calcium, iron and other nutrients. the main priciple behind the weight loss is that fat is not absorbed into the system as it was prior to surgery. It is also important to note that nutritional deficiencies can be created with a  malabsorption procedure. Due to this fact, anyone considering bariatric surgery must understand the commitment to a lifelong regimen of vitamin/mineral supplements, daily exercise and the necessity of a well-balanced diet. Remember, any surgery for weight loss is just providing you with a "tool" that can help create weight loss. That "tool" will only be as good as how it is used by the "owner".

Negatives of the Duodenal-Switch

The negative aspects of the Gastric Bypass operation are: the mid-upper abdominal scar, the necessity of life-long vitamin/mineral supplements, and the fact that a high fat diet causes more frequent stools and flatulence (gas). There is also possibility of having excess skin folds after weight loss. Will these factors be unacceptable to you?