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Understanding Obesity

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Mid Louisiana Surgical Specialists
3311 Prescott Rd Ste 201
Alexandria, LA 71301

Phone : 318-442-6767
Email : Click Here To Email Us

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Bariatric Procedures

At MLSS we offer three bariatric procedures: Gastric Bypass, Gastric Banding (Lap Band and Realize Band) and Gastric Sleeve. Below you will find an overview of how each procedure works to help you lose weight, what results our average patients expect and the risks and benefits of each procedure.

Gastric Bypass

(Roux-en-Y Gastric Bypass)

The gastric bypass procedure is the most commonly performed bariatric surgical procedure in the United States. It is widely considered the gold standard in bariatric surgery because it offers patients the greatest potential weight loss of any bariatric procedure currently available. Gastric bypass is incredibly effective because it combines restriction - by creating a smaller stomach pouch - with malabsorption of calories - by rerouting and bypassing part of the small intestine.

How it Works

Gastric Bypass is generally performed as a minimally invasive surgical procedure, and only if there are complications or health considerations during surgery will it be converted to an open procedure. Much like other laparoscopic procedures, the surgeon will create five small incisions in the abdomen, each a quarter to half-an-inch long. The surgeon will insert trocars, which service as passageways for the medical devices that will be used to manipulate parts of the stomach and small intestine.

First, the surgeon will cut away a portion of the existing stomach leaving only a small stomach pouch to accept food. This small pouch is about the size of a golf ball or 1-2 tablespoons in capacity. The surgeon will then bypass part of the small intestine, creating a Y-shaped attachment with the remaining intestine, and attaching it to the newly created smaller stomach pouch. With the now smaller stomach pouch, the patient will not be able to consume as much food as before, and by rerouting the intestine, there will be less surface area to absorb calories through the small intestine. As such, the procedure offers exceptional weight loss results.

Expected Outcomes

  • Gastric bypass patients may lose up to 60% of their excess body weight
  • 80% of patients saw the elimination of type II diabetes
  • 75% of patients saw the elimination of high blood pressure
  • 90% of patients saw the reduction or elimination of high cholesterol

Benefits of Gastric Bypass

  • Gastric bypass offers the most weight loss potential of any bariatric surgery procedure.
  • Since gastric bypass is now performed laparoscopically, hospital stays and recovery times have been reduced significantly.
  • Risks of surgery have also been minimized through advancements in technology and training.

Risks and Considerations

  • A condition known as dumping syndrome may occur if the patient eats high-sugar or high-fat foods. Dumping syndrome is not life-threatening, however it is very unpleasant.
  • Gastric bypass is major surgery and has all the risks associated with any other surgical procedure. Please understand the risks fully.
  • Because the small intestine is bypassed, patients may experience decreased nutritional intake. Nutrients and vitamins will not be entering the bloodstream in the quantity they once were, so generally, gastric bypass patients will have to take daily vitamins including calcium, B-12 and iron for the rest of their lives.
  • The exceptional weight loss that gastric bypass provides can leave behind excess skin which may irritate the patient, and in some cases, requires cosmetic surgery to remove.


Gastric bypass will require between a one and three day stay in the hospital after surgery. Once discharged, the patient will be given diet instructions that will include clear liquids for the first two weeks after surgery, followed by soft foods for another two weeks. About a month after surgery, patients will begin to eat normal food in moderation. Returning to work will depend on the patient’s healing progress after surgery.

Gastric Banding

(Lap Band and Realize Band)

Gastric banding, also known by its trade names Lap Band and Realize Band, is the least invasive form of bariatric surgery. The gastric band is essentially an inflatable tube that is fully adjustable and reversible. Its safety as a bariatric procedure is unparalleled because it does not require the alteration of the stomach pouch or the rerouting of the small intestine in order to function. The gastric band was first approved by the FDA in 2001, however it had been used in Europe and elsewhere in the world for many years prior. As such, gastric banding is the most commonly performed bariatric surgery outside of the United States.

How it Works

The gastric band procedure is generally performed laparoscopically - instead of the traditional large incision in the abdomen, the surgeon will create five tiny incisions (each about a quarter to half an inch) in the upper and lower abdomen area. Trocars are inserted into these incisions, serving as passageways to give the surgeon access to the abdomen. By using specially made medical devices and high definition cameras, the surgeon can place the band around the stomach with ease. The gastric band is placed around the top of the stomach, fastened, and then tightened to mold the stomach into two interconnected chambers. The smaller top chamber acts as a reservoir for the food that enters the stomach. Because of the chamber’s small size, it restricts the amount of food that can be consumed and the patient feels fuller sooner.

The food consumed slowly passes through the narrowed opening of the band and into the lower stomach chamber where it is digested normally. The band can be adjusted after surgery through a device known as an injection port, which is fastened to inside of the abdomen wall and connected to the band with soft, thin tubing. The injection port serves as the vehicle through which the surgeon can inject or remove saline from the band. By inserting more saline, the band can be tightened; by removing saline, the band can be loosened, all depending on the patient's weight loss progress.

Expected Results

  • Gastric banding patients typically lost up to 50% of their excess body weight
  • 50% of patients see the elimination of type II diabetes
  • 40% of patients will experience the elimination of high blood pressure
  • 80% of patients will see a significant decrease or elimination of high cholesterol

Benefits of the Gastric Banding System

  • Because the lap band does not require any cutting or rerouting of the stomach or intestine, recovery time, blood loss and the length of hospital stay is minimized.
  • The gastric band is the least expensive of any bariatric surgical procedure.
  • Because it uses only restriction for weight loss, patients can generally eat a wider range of foods than with gastric bypass.
  • The band can be adjusted for faster or slower weight loss and can be removed in cases of need.

Risks and Considerations:

  • While gastric bypass is the least invasive of any bariatric surgery procedure, it also has the lowest weight loss potential of the procedures we offer.
  • Patients will feel full sooner, however the band will not eliminate the feelings of hunger.
  • The band is only a tool for weight loss, and a strict diet and exercise regimen must be followed to ensure maximum weight loss.
  • Because the band can be adjusted, patients will need additional follow-up care with their surgeon to achieve optimal tightness in the band.

Gastric Sleeve

The gastric sleeve is a relatively newer procedure when compared to gastric bypass and gastric banding. In the past, the gastric sleeve was recommended for patients who had an extreme BMI (60 or more) and was often the first part of a two-part procedure - the second part usually being gastric bypass. Because of the exceptional results of the gastric sleeve, it has become widely accepted as a standalone procedure. Many insurance companies now accept gastric sleeve surgery as a viable weight loss option in many of their plans.

How it Works

The gastric sleeve excels because it is a straightforward and simple bariatric surgery. The procedure is performed laparoscopically, and rather than using a large, single incision as in open surgery, the surgeon creates up to five small quarter to half-inch incisions in the patient's abdomen. Trocars are inserted into these incisions and serve as passageways for medical devices to be inserted, including a high definition camera.

The surgeon will cut away approximately 80% of the existing stomach pouch leaving a sleeve shaped stomach about the size of a banana. There is no rerouting of the intestine as with gastric bypass, and no medical devices are implanted into the patient's abdomen as with gastric banding.

Expected Results

  • Gastric sleeve patients typically lose up to 60% of their excess body weight
  • 70% of patients see the elimination of type II diabetes
  • 60% of patients will experience the elimination of high blood pressure
  • 90% of patients will see a significant decrease or elimination of high cholesterol

Benefits of the Gastric Sleeve

  • Because of its simplicity, the gastric sleeve procedure can be performed laparoscopically and in a relatively short period of time. This allows for reduced recovery time and hospital stays, and a possible reduction of pain, blood loss and infection.
  • The gastric sleeve does not reroute the intestine, therefore caloric malabsorption does not occur. Patients will take multivitamins, but should eventually be able to get their entire vitamin and mineral requirements from food consumption.
  • The gastric sleeve procedure removes the part of the stomach that produces grehlin, the hormone that causes hunger. As a consequence, patients tend to feel less hunger.

Risks and Considerations

  • Gastric sleeve surgery is major surgery, and therefore comes with all of the risks of surgery. We would like you to be informed and aware of those risks, and encourage you to speak to our office for more information.
  • The most severe risk of gastric sleeve is the potential for the staple line to leak. This is an emergency situation that will require an additional surgical procedure.
  • The gastric sleeve procedure may cause acid reflux in certain individuals, however it is also shown to eliminate acid reflux in others.


Gastric sleeve patients typically spend 1 to 2 days in the hospital recovering from surgery. Patients are sent home on a liquid diet for two weeks, followed by soft foods for another two weeks. After a month they will be able to eat regular foods. Your surgeon will advise when it is right for you to return to normal activity and work.

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Mid Louisiana Surgical Specialists
3311 Prescott Rd Ste 201, Alexandria, LA 71301
Phone : (318)-442-6767 | Click Here For Email