The American Society for Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change: Restrictive procedures that decrease food intake.
Almost all patients who have had laparoscopic adjustable gastric banding procedures are able to go home the same day. It is critically important that you honor your commitment to yourself and the band and keep those monthly appointments. Once the most popular weight loss surgery in San Antonio, lap band surgery is being performed less and less. At BMI of Texas, we feel our surgeons offer the best lap band surgery San Antonio has to offer.
If you would like more information or have more questions about gastric banding in San Antonio, please contact us today or watch a free seminar! Redefining healthcare by creating meaningful relationships and experiences with our patients and the community in order to overcome obesity and metabolic disease fostering improved health and a better quality of life. If you are like most people, you are probably extremely frustrated and tired of dealing with excess weight.
Because every patient is unique, we strive to design a customized program to meet the needs of each individual. BMI of Texas exists to provide innovative and comprehensive medical and surgical care to patients with obesity and metabolic disease.
When it comes to Texas obesity surgery, it is our goal to not only help you achieve your weight loss goals but to improve your overall health and quality of life. Copyright © 2016 Bariatric Medical Institute of Texas provides professional options for bariatric surgery in San Antonio TX.
The Biliary Pancreatic Diversion with Duodenal Switch (Duodenal Switch) is an established weight loss procedure which provides both excellent long term weight loss and long term resolution of comorbid conditions. This operation requires high patient compliance to dietary regimen, vitamin regimen and follow up for the rest of their life. The Gastric Bypass is the most popular of all weight loss procedures in the US with approximately 200,000 cases performed each year.
Patients who choose gastric bypass surgery can lose 70% of their extra body weight or more. The benefits of Gastric Bypass surgery are: Good weight loss and weight maintenance, resolution of medical problems, can be performed laparoscopically, can tolerate most health foods, increased quality of life , covered by most insurances.
At least 5% of patients who have gastric bypass will have to go back to surgery at some time in their lives for removal of gallbladder, bowel obstruction, ulcers, abdominal pain, removal of loose skin, or very rarely reversal. The Roux-en-Y Gastric Bypass has been around since the 1960′s, so we know the most about this procedure and it has the longest follow-up.
Restrictive: The stomach is divided to make a small pouch (15-20 cc) which limits how much one can eat or drink during a given period of time. Traditionally, the Roux-en-Y gastric bypass has been done through a large upper midline incision in the abdomen. Be Aware – some surgeons do not divide (disconnect) the small stomach pouch from the large gastric remnant, thus greatly increasing the chance that the staple line will break down. The Roux-en-Y gastric bypass is the most common bariatric surgery procedure performed in the United States. Use our Body Mass Index Calculator to help determine if weight loss surgery might be for you. Atlanta Bariatric specializes in advance and comprehensive weight loss management for residents in Georgia, especially patients in metro Atlanta.
Register for an in-person or online seminar to learn more about advanced techniques and available information on different types of weight loss surgery. Nutrition, diet, weight loss - spine-health, Nutrition, diet and weight loss are important components of pain management. Bariatricpal before and after weight loss surgery photo, Before and after weight loss surgery pictures and albums by bariatricpal members.
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Duodenal Switch - This is the most effective operation for weight loss and treatment of metabolic syndrome, but also has the highest complication rate and adverse side effects.
Our highly trained and dedicated team is ready to help you on your pathway to a healthier you! Malabsorptive procedures that alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in the stool. This may be a moving target because the stomach can shrink as a person starts to lose weight. After the first year, we are usually able to space these out once you have developed a relationship with your band. Our patients have had wonderful success with adjustable gastric banding procedures in San Antonio.
You have probably tried every diet out there and perhaps had some success but just have not been able to achieve long term success.
We are dedicated to creating an enduring partnership with patients in order to ensure their long-term success. This operation provides patients with a higher degree of satisfaction than a standard Roux-en-Y gastric bypass or purely restrictive operation because they are able to eat larger meals.
Common risks include diarrhea, malodorous stool, malnutrition, vitamin deficiencies, leak, stricture, and ulcers.
Gastric Bypass is also called Roux-en-Y because a Y connection is made with the small intestines during the surgery.
With this procedure, the stomach is divided into two parts – the upper (smaller) portion of the stomach is called the pouch, and the lower (larger) portion of the stomach is called the remnant.
The enzymes from the stomach travel through the duodenum (the first part of the intestines).


Although everybody initially loses weight, approximately 20% of people will gain some of the weight back.
At the time of surgery there could be bleeding, infections, staple line leaks, injury to other organs, pain, blood clots that may travel to the heart or lungs, pneumonia, or death. Grand Health Partners the premiere medical and surgical weight loss clinic in Grand Rapids MI offers medical weight loss, bariatric surgery including lap band surgery and gastric bypass surgery in Grand Rapids Michigan and surrounding areas including Muskegon, Holland, Grand Haven, Kalamazoo, Greenville, Traverse City, Cadillac, Detroit, Ann Arbor, and Lansing MI. Bile from the liver and enzymes from the pancreas don’t mix with the food to aid digestion until after the first 100-150 centimeters in intestine. Dumping syndrome is a constellation of physical symptoms that can occur if a patient with a gastric bypass eats something high in simple sugars (i.e.
However, because of our extensive laparoscopic experience, Atlanta Bariatrics performs the same Roux-en-Y gastric bypass procedure using minimally invasive techniques. That means that food will once again go into the large part of the stomach and the patient will regain weight. Our center focuses on variety of treatment methods for bariatric surgery, including gastric bypass, Lap-Band®, band plication, revisional surgery, single incision surgery and robotic surgery.
This operation is often done in two stages: the Vertical Sleeve Gastrectomy (VSG) followed by the Gastric Bypass months later.
There is no removing or re-positioning of the intestines, though having laparoscopic adjustable banding surgery means that the band must be adjusted on a regular basis to be successful.
The stomach may also get used to a certain level of tightness, so what seems tight at two months may feel loose at six months.
Data has shown that the revision and reoperation rate can be as high as 40 percent in some studies. We would love to share their stories with you using our Media Center, as well as show you what a real LAP-BAND ® and REALIZE ® Band procedure looks like! Our comprehensive program will give you the tools you need to lose the weight you want and to keep it off. Jenny Seger, we have the unique opportunity to provide more complete weight management and wellness services than those which are available in other practices. We are committed to providing such care in a supportive, compassionate, and guilt-free environment. This operation provides the highest degree of malaabsorption and therefore the greatest excess weight loss compared to other operations. The key to success is to only drink liquids with zero calories, and to choose nutritious foods that make you feel full. Complications that could occur in the future include: unexplainable pain, malnutrition, vitamin deficiency, stricture of the connection between the pouch and the intestines, weight gain, inability to eat certain foods, nausea, vomiting, gallstones, diarrhea, constipation, bowel obstruction, ulcers, and death.
There is still usually 15-20 feet of small intestine left below the bypassed intestine, which is where most all medicines, antibiotics, vitamins and minerals are absorbed and is generally unaffected by weight loss surgery. They do nothing to change the way your body digests food, food consumed passes through the digestive tract in the usual order allowing it to be fully absorbed into the body so the risks of malnutrition are reduced.Laparoscopic Adjustable Gastric band (Lap Band)  In this procedure, no tissue is cut or stapled. A lap band procedure is NOT a metabolic surgery and requires maximum participation in our program to achieve what we consider outstanding results.
At BMI, we have not seen this high rate of complications; however, we feel that patients need to be informed of this data when they make the choice of what type of weight loss surgery they want to have.
The small intestine is divided and rerouted in such a way to create a component of malabsorption.
The remnant stomach still has a valuable function as it continues to make enzymes important for digestion. This part of the small bowel then brings the stomach enzymes, bile and pancreatic juice to the Y connection of the Gastric Bypass. The bypass does affect the absorption of certain vitamins, however, so supplementation is required after surgery. This can cause symptoms such as nausea, abdominal pain, flushing, diarrhea – you feel horrible! Using a laparoscopic approach may decrease the amount of time necessary to stay in the hospital, increase speed of recovery, and decrease the risk of some surgical complications. The expert surgeons at Atlanta Bariatrics agree with other experienced bariatric surgeons who understand the importance of disconnecting the small stomach pouch from the large stomach remnant. An adjustable band is placed high on the stomach, where the esophagus enters into the stomach.The band is adjusted down to create a restriction limiting how quickly food can pass into the stomach.
If you would like to learn more about lap band surgery in San Antonio with renowned bariatric surgeons at BMI of Texas, please call us to learn about your options. Soft foods are easier to eat but do not provide the same full feeling, which often leads to over eating and eventually will lead to weight gain.
This psychologically will change the way you look at sweet foods, thereby helping patients stay away from foods that got them into trouble in the first place. Some of these conditions include: Type II Diabetes, hypertension, obstructive sleep apnea, and gastroesophageal reflux disease (GERD). Nothing is removed in the Gastric Bypass, the intestines are merely rerouted to help bypass the stomach. Many patients who have Gastric Bypass cannot eat sugary foods as they make them feel weak, jittery, nauseated, and even sometimes painful. It can be a valuable tool to help patients stay true to a healthy diet, thereby keeping the weight off long-term. There have been multiple studies showing the success in maintaining the weight loss, something no diet or exercise plan can show. This allows the nutrients and vitamins (as well as the calories) to be fully absorbed into the body, reducing the risk of malnutrition. Both provide comprehensive care throughout the entire weight loss surgical process, from the initial consultation to post surgery procedures, follow ups, and beyond.
Since no stomach tissue is cut or stapled with the lap band procedure, the operative risk for this procedure is extreamly low.
With the Lap band procedure, the band can be adjusted as an outpatient to increase or decrease restriction. Studies suggest that patients can maintain 50% of targeted excess weight loss with the adjustable band, and 65% of targeted excess weight loss with the sleeve gastrectomy.
Studies show up to 90% resolution of diabetes, 70-80% resolution of high blood pressure and high cholesterol, 85% resolution of sleep apnea, and almost 100% resolution of gastric reflux just to list a few of the benefits. For some health problems like diabetes or gastro-esophageal reflux, gastric bypass surgery is far superior at curing the condition than any of the other bariatric surgery procedures. The band can slip or migrate on the stomach causing obstruction.  This would require surgical repostioning of the band.


As is the case with all weight loss surgeries, readmission to a hospital may be required for fluid replacement or nutritional support if there is excessive vomiting and adequate food intake cannot be maintained.
Malabsorptive Procedures  While these operations also reduce the size of the stomach, the stomach pouch created is much larger than with other procedures. The primary goal is to alter the normal digestive process to produce a calorie wasting process.
The anatomy of the small intestine is changed to divert the bile and pancreatic juices so they meet the ingested food closer to the middle or the end of the small intestine. With the three approaches discussed below, absorption of nutrients and calories is markedly reduced resulting in weight loss.
Extended (Distal) Roux-en-Y Gastric Bypass (RYGBP-E)  RYGBP-E is an alternative means of achieving malabsorption by creating a stapled or divided small gastric pouch, leaving the remainder of stomach in place. A long limb of the small intestine is attached to the stomach to divert the bile and pancreatic juices. Gastric pouch size and the length of the bypassed intestine determine the risks for ulcers, malnutrition and other effects. The duodenum, the first portion of the small intestine, is divided so that pancreatic and bile drainage is bypassed. Advantages These operations often result in a high degree of patient satisfaction because patients are able to eat larger meals than with a purely restrictive or standard Roux-en-Y gastric bypass procedure. These procedures can produce the greatest excess weight loss because they provide the highest levels of malabsorption. In one study of 125 patients, excess weight loss of 74% at one year, 78% at two years, 81% at three years, 84% at four years, and 91% at five years was achieved. Long-term maintenance of excess body weight loss can be successful if the patient adapts and adheres to a straightforward dietary, supplement, exercise and behavioral regimen. Risks For all malabsorption procedures there is a period of intestinal adaptation when bowel movements can be very liquid and frequent. Close lifelong monitoring for protein malnutrition, anemia and bone disease is recommended.
It has been generally observed that if eating and vitamin supplement instructions are not rigorously followed, at least 25% of patients will develop problems that require treatment.
Changes to the intestinal structure can result in the increased risk of gallstone formation and the need for removal of the gallbladder.
Re-routing of bile, pancreatic and other digestive juices beyond the stomach can cause intestinal irritation and ulcers. Combined Restrictive & Malabsorptive Procedure  In recent years, better clinical understanding of procedures combining restrictive and malabsorptive approaches has increased the choices of effective weight loss surgery for thousands of patients. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients.
The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat. Roux-en-Y Gastric Bypass  According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for weight loss surgery.
The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption.
This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch.
The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption. Advantages The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures. Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by most patients. In 2000, study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved. Risks Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia.
This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids.
Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating.
The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur. Laparoscopic or Minimally Invasive Surgery  For the last decade, laparoscopic procedures have been used in a variety of general surgeries.
Although few bariatric surgeons perform laparoscopic weight loss surgeries, more are offering patients this less invasive surgical option whenever possible. When a laparoscopic operation is performed, a small video camera is inserted into the abdomen. Most laparoscopic surgeons believe this gives them better visualization and access to key anatomical structures.The camera and surgical instruments are inserted through small incisions made in the abdominal wall. This approach is considered less invasive because it replaces the need for one long incision to open the abdomen. A recent study shows that patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels.
Not all patients are candidates for this approach, just as all bariatric surgeons are not trained in the advanced techniques required to perform this less invasive method.
The American Society for Bariatric Surgery recommends that laparoscopic weight loss surgery should only be performed by surgeons who are experienced in both laparoscopic and open bariatric procedures.



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