What is the Best Bariatric Surgery Procedure?
Advancements in bariatric surgery have yielded an unprecedented number of options for patients looking to improve or eliminate the diseases associated with morbid obesity and lose weight along the way. Each of the many weight loss surgery options present strong benefits and risks. Minimally invasive, non-surgical procedures such as the weight loss balloon may be appropriate for some patients, while a combination malabsorptive and restrictive procedure such as the gastric bypass may be appropriate for others. Following, we will briefly describe the ideal candidate for each procedure, however it is important to remember that the patient’s circumstance and their suitability for one surgery versus another can only be established during a consultation – This is purely a rough guide:
The Gastric Band (Lap-Band®)
The gastric band was once one of the most popular bariatric surgeries available and is still appropriate for a small number of patients who want to lose weight but want an adjustable and reversible surgical option. The band offers a relatively lower weight loss potential than stapled procedures and requires significantly more follow up, in the form adjustments, after surgery. Long term complication rates are higher than stapled procedures, which is why we limit our use of the technique to specific cases.
The Gastric Sleeve / Sleeve Gastrectomy
The gastric sleeve or sleeve gastrectomy procedure is presently the most popular bariatric surgery in United States. The sleeve is a simple procedure that provides restriction and, in turn, excellent weight loss and disease resolution results. Gastric sleeve is appropriate for many patients suffering from obesity with a BMI of 35 or over, however patients with severe, uncontrolled acid reflux/GERD or those with severe type II diabetes may find a gastric bypass to be preferable.
The Gastric Bypass
The Roux-en-Y gastric bypass is a tried-and-true procedure that has been around for over 40 years and has been performed laparoscopically for over 20 years. The gastric bypass offers excellent weight loss and disease improvement or resolution potential because it employs both restriction and malabsorption. Patients suffering from poorly controlled type-2 diabetes or chronic acid reflux/GERD will most likely opt for a gastric bypass.
Weight Loss Balloon
The intra-gastric balloon does not require any surgical intervention. This procedure may be appropriate for those who do not have a significant amount of weight to lose and are low or relatively lower on the BMI scale. Insurance does not cover the gastric balloon therefore patients should have the finances available. The ideal patient will be able to continue the long-term lifestyle modification that is necessary to keep the weight off after the balloon is removed. Here at ASA, we do not perform the balloon procedure because it does not offer long-term mechanical restriction of food consumption and relies heavily on patients continuing a strict diet and exercise regimen. Further, patient costs associated with the balloon are significant.
There truly is no single best bariatric procedure for every case. However, today’s techniques offer patients options that they never had before. Attending a weight loss seminar and a subsequent pre-operative consultation is the best way for a prospective patient to learn more about their options and choose which procedures right for them.Back To All Posts