At Ocala Health Surgical Group, our Bariatric board certified physicians, Dr. Angel Caban and Dr. George Rossidis, provide a wide–variety of weight-loss surgery options for the treatment of obesity. They are part of the nationally recognized bariatric surgery program at Ocala Regional Medical Center, a recognized Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP(R)) as designated by the American College of Surgeons American Society for Metabolic and Bariatric Surgery.

Minimally Invasive Weight Loss Surgery Procedures Include

  • Sleeve Gastrectomy
  • Roux en Y Gastric Bypass
  • Laparoscopic Adjustable Gastric Band
  • Band placement
  • Band removal
  • Single Anastomosis Duodenal Switch
  • Revisions

If you struggle with obesity, you aren’t alone. Obesity is a chronic disease that impacts 42% of American adults, or approximately 107 million people. It can trigger a host of related health concerns including heart disease, cancer, hypertension, type 2 diabetes, joint pain, difficulty breathing, depression and limited mobility.

For many, it’s not enough to “eat right and exercise”—because symptoms of obesity can make these tasks an overwhelming challenge. However, bariatric surgery presents another treatment option that can protect your long-term health.

Bariatric surgery—also called “weight loss” surgery—is the most effective treatment for obesity. It can also be effective in improving type 2 diabetes. All surgeries reduce calorie intake through one (or several) of the following methods:

  • Restrictive procedures constrict the stomach, causing the patient to feel full after eating only a small amount of food.
  • Malabsorptive procedures make it harder for the body to absorb calories from the food consumed.
  • Rerouting procedures may “reset” your digestive hormones that regulate appetite, satiety and blood sugar.

Many bariatric procedures use a combination of these strategies to promote long-term weight loss.

Depending on the procedure, patients can expect to lose 40-60% of excess weight, with the majority of weight loss occurring in the first year. However, bariatric surgery is not a substitute for healthy eating and exercise, and many procedures require strict adherence to a nutritious diet and daily supplements after the operation.

What it looks like

An inflatable band is placed around the upper area of the stomach. This effectively creates two stomachs—a small upper stomach pouch and a large lower stomach, with a narrow channel in between.

As the name of the procedure implies, the band is adjustable. When sterile saline is pumped into the band, it inflates, and the channel between the upper and lower stomach becomes narrower. This changes how much food the patient can eat before feeling full. After the initial operation, the size of the channel will be gradually reduced on follow-up visits.

How it works

Although food eventually passes through the opening, the patient will feel satiated as soon as the small upper stomach is full.

Advantages

Gastric band surgery is reversible and adjustable. Unlike other surgeries, which may involve cutting part of the stomach, rerouting intestines or reducing the body’s ability to absorb nutrients, this surgery allows your stomach to function “normally.”

Disadvantages

Because the surgery relies on a foreign device inserted in the body (the band), there may be mechanical problems that require postoperative care. If the band slips or erodes the stomach—which can occur with a small percentage of patients—the procedure may need to be reversed. Gastric banding has the slowest rate of weight loss after the operation.

What it looks like

A laparoscopic sleeve gastrectomy, or “sleeve,” is performed by removing approximately 80% of the stomach. The remainder of the stomach is much smaller and tube-shaped. The small intestine is reattached to the base of the stomach.

How it works

Because the stomach is much smaller, the patient feels full after eating a small amount of food. The surgery also “resets” gut hormones that regulate hunger, satiety and blood sugar control, causing the patient to feel less hungry.

Advantages

The sleeve can be described as a “compromise” between gastric banding and gastric bypass. Most patients lose more than half of excess weight over the long term, and initial weight loss occurs rapidly. There is a lower risk of complications compared to the gastric bypass.

Disadvantages

A sleeve gastrectomy is not reversible, and the reduced stomach capacity may lead to vitamin deficiencies over the long term. It has a high re-operation rate and has a higher risk of early complications than a gastric band.

What it looks like

There are three components to the procedure. First, a small stomach pouch is formed by separating the upper part of the stomach. The pouch is approximately one ounce in volume. Next, the first portion of the small intestine is separated from the lower stomach and connected to the stomach pouch, allowing food to pass into the intestine. Finally, the remainder of the small intestine from the lower stomach is reattached further down the small intestine, allowing stomach acid and digestive enzymes to mix with the food.

How it works

A gastric bypass has several functions. First, the smaller stomach causes the patient to consume less food. Second, the smaller stomach and reduced intestine causes the body to absorb fewer calories and nutrients. Lastly, the rerouted intestines “reset” gut hormones to increase satiety, reduce hunger, and regulate blood sugar.

Advantages

The gastric bypass creates the fastest, most immediate weight loss and the best tendency to maintain that weight loss over the long term. In that sense, it is the “most effective” treatment for obesity.

Disadvantages

A gastric bypass is a complex operation that can increase the risk of complications during surgery. It also requires a longer hospital stay. Because it reduces the body’s ability to absorb nutrients (as well as calories), it can lead to long-term deficiencies in vitamins and minerals, especially vitamin B12, iron, calcium and folate. After the operation, patients will need to follow a lifelong regimen of nutritional supplements and follow a physician-supervised diet.

Currently, The U.S. National Institute of Health recommends bariatric surgery for adults with a body mass index (BMI) of 40 or higher. Bariatric surgery is also recommended for adults with a BMI over 35 who have another serious medical condition, like diabetes.

You may be considered a candidate for bariatric surgery if you have been diagnosed with obesity and have a related chronic medical condition. Your physician will also consider whether you have tried a fitness and exercise plan, with or without assistive medication.

Any kind of surgery comes with complications and risks, and you should discuss the advantages and disadvantages of the procedure with a doctor. If you have another condition that puts you at higher risk for surgical complications, you may not be a candidate.

To learn more, call (352) 291-0239 and schedule a consultation with one of our bariatric specialists.

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