Bariatric Surgery Bariatrics is the field of medicine that addresses the issue of obesity. Thus, bariatric surgery is the treatment of obesity by surgical means. Bariatric surgery has been around since about the 1950's and has gone through many advances. Today's procedures are much safer and have better results than the older procedures. You can read about the history of bariatric surgery at the ASBS website. There are several procedures available today, each of which has its own particular benefits and risks. When you come into our office, we will discuss with you which procedure may be best for you in regards to BMI, diet history, amount of excess weight, past surgeries and overall general health. We offer 3 types of surgeries; Vertical Banded Gastroplasty(VBG), Roux-en-Y Gastric Bypass(RNY), and Biliopancreatic Diversion with Duodenal Switch(BPD/DS, commonly referred to as just DS). We can perform these procedures laparoscopically or "open", depending on your situation and needs. Laparoscopic refers to the technique of making 4-6 small 1 inch incisions in the abdomen, by which a small camera and instruments are passed into the abdominal cavity. These instruments are then used to perform the operation. This technique offers smaller scars and a quicker recovery time. The "open" technique refers to the traditional approach to surgery. The incision is usually from the bottom of the breast bone to just above the naval. While this approach results in a longer recovery time, it offers the surgeon a better field of view and usually results in fewer complications. To view a comparison of of the laparoscopic and open techniques, click here. Vertical Banded Gastroplasty - VBG This, along with the RNY, is one of the two major types of operations recognized by the NIH for the treatment of clinically severe obesity. It is a purely restrictive procedure with no malabsorptive effect. The goal of this procedure is to severely restrict the patient's capacity to eat certain foods. This procedure is the least effective and thus would not be suitable for higher BMI's. ADVANTAGES completely reversible body anatomy is left intact no dumping syndrome no nutritional deficiencies DISADVANTAGES needs strict patient compliance to diet no malabsorption vomiting if food is not properly chewed or if food is eaten too quickly Click here for additional information about the vertical banded gastroplasty procedure. Roux-en-y - RNY This operation is the most common gastric bypass procedure. With this procedure a portion of the stomach is sectioned off creating a small pouch for reduced food intake. The pouch will usually hold about one ounce of food or less, which causes the feeling of fullness after just a few bites. The size of the pouch varies with different doctors. Weight loss is usually 60-75% of your excess weight. ADVANTAGES greatly controls food intake dumping syndrome -  dumping conditions to control intake of sweets reversible in an emergency - though this procedure should be thought of as a permanent DISADVANTAGES staple line failure ulcers narrowing/blockage of the stoma vomiting if food is not properly chewed or if food is eaten too quickly Click here for additional information about the Roux-en-Y gastric bypass procedure. Biliopancreatic Diversion with Duodenal Switch  - BPD/DS It is also referred to as Duodenal Switch or 'DS'). There is a significant malabsorptive component which acts to maintain weight loss long term. The patient must be closely monitored to guard against severe nutritional deficiencies. This procedure, unlike the RNY keeps the pyloric valve intact. This procedure can provide a 70-85% loss of excess weight, however, it carries a higher risk of malnutrition. ADVANTAGES  more "normal"  absorption of many nutrients than with RNY, including calcium, iron and vitamin B12 better eating quality when compared to other WLS procedures essentially eliminates stomal ulcer and dumping syndrome DISADVANTAGES greater chance of chronic diarrhea significant malabsorptive component more foul smelling stools and flatus(gas) Click here for additional information about Biliopancreatic Diversion with Duodenal Switch..