At the New Life Center for Bariatric Surgery we understand that the decision to pursue weight loss surgery is a difficult and personal one. Deciding which procedure is right for you is the next step. At the New Life Center for Bariatric Surgery we offer all approved primary, revision and corrective procedures. We also offer the ROSE restorative endoscopic surgery. With so many options how does one choose?
In selecting the procedure that is right for you many factors must be taken into account including your starting body mass index, comorbid conditions, age, previous abdominal operations, desired weight loss and eating behaviors to name a few.
When describing the effectiveness of the different weight loss surgical options we usually do so by evaluating how much of the patient’s excess weight that they can expect to lose with that procedure. Excess weight is defined as the number of pounds you weigh over and above your ideal body weight. Everyone has an ideal body weight based on their gender and height. You can calculate your excess weight by the formula:
Knowing your excess weight, you can then easily calculate the percentage of excess weight lost with the formula:
Please see the Metropolitan Life Chart below to reference your ideal body weight.
|Height (ft)||Height (inches)||Weight (lbs)|
|Height (ft)||Height (inches)||Weight (lbs)|
The biliary pancreatic diversion with duodenal switch has been performed for over 30 years and like the gastric bypass helps patients lose weight by reducing the size of the stomach, bypassing some of the intestines and decreasing patient’s appetite. At the New Life Center for Bariatric Surgery we recomend biliary pancreatic diversion for patients whose initial body mass index is greater than 50. The super obese patient benefits from the biliary pancreatic diversion because it has the highest associated excess weight loss of all approved operations.
Patients who undergo a biliary pancreatic diversion with duodenal switch can reasonably expect to achieve excess weight loss of at least 85%. This allows the super obese patient to achieve a healthy body mass index. The BPD with DS bypasses approximately 80% of the small intestine. This extensive bypass requires extensive vitamin and mineral supplementation daily. Most vitamin regimens that adequately replace the patient’s needs have about 12 tablets and capsules daily.
The laparoscopic Roux-en-Y gastric bypass is considered the standard of care by many bariatric surgeons. It has been performed for over 40 years and there are volumes of information available about the risks, benefits and proper indications for its use. The safety of gastric bypass has been increased with the advance of laparoscopic surgery. Depending on the patients starting body mass index and compliance, the patient may expect to achieve a long-term weight loss of 70% to 75% of their excess weight. Because approximately 30% of the patient’s small bowel is bypassed with this procedure it is necessary to supplement a healthy diet with supplements to ensure that the patient’s metabolic needs are being met. Most vitamin regimens that are adequate contain 7 tablets and capsules daily.
The laparoscopic sleeve gastrectomy is an exciting option for patients. Thousands have been done in the United States and it appears to be best reserved as a standalone weight loss surgical procedure for patients whose body mass index is less than 50. It is considered a restrictive operation; however it also combines some of the metabolic advantages of the gastric bypass and biliary pancreatic diversion. In appropriately selected patients the excess weight loss with vertical sleeve gastrectomy is approximately 50% to 60% of the excess weight. Some consider it an advantage to achieve restriction without requiring the insertion of a foreign body. One disadvantage is that this is an irreversible operation because the stomach obviously cannot be re-implanted once is removed. Another disadvantage is that it is not covered by most insurance companies at this time. Although early results are promising, we do not have long-term data on this operation as a standalone weight loss surgical procedure. The sleeve gastrectomy has also been used as the first step in a staged operation for patients with body mass indexes of 50 or greater.
At the New Life Center for Bariatric Surgery we are able to offer both the Realize and Lap Band adjustable gastric banding options. The adjustable gastric bands have the advantage of being the lowest risk, least invasive and most easily reversible bariatric surgical operation. They are the restrictive procedure of choice, in our opinion, because of the ability to adjust the degree of restriction through a simple procedure in our Adjustable Gastric Band Evaluation Clinic. The disadvantages of the adjustable gastric bands include an overall expected weight loss that is less than other weight loss surgical procedures. On the average patients may expect to lose 40% to 50% of their excess weight with adjustable gastric bands. However, if the patient is particularly compliant they can expect much better weight loss (approaching that of a gastric bypass or malabsorptive procedure).
Patients with complications from a previous operation or who are in need of corrective surgical procedures may qualify for weight loss revision or conversion surgery at the New Life Center for Bariatric Surgery. Your needs are sometimes very complex and require an individualized approach to your evaluation and treatment. If you are experiencing complications or weight re-gain after previous weight loss surgery we are happy to evaluate and treat you. Call the New Life Center for an appointment.
Physicians Plaza 1, Suite 305
Turkey Creek Medical Center
10810 Parkside Drive
Knoxville, TN 37934