A Summary of Common Weight Loss Surgery Options

Your doctor may recommend bariatric surgery if you have a BMI greater than 40 and have had trouble losing weight other ways.  These surgeries change stomach capacity, modify nutrient absorption, or both to facilitate weight loss.  Here, we offer descriptions of the most common procedures performed by Dr. Christine Ren-Fielding and the NYU Langone Weight Management Program team.  These include lap band surgery, gastric balloon, gastric bypass surgery, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch.

Lap Band Surgery

During laparoscopic adjustable gastric banding, or lap band surgery, the surgeon places an inflatable band around the top portion of the stomach.  Inflation of the band creates a smaller stomach pouch so that hunger is relieved with smaller portion sizes.  A port is also placed during the procedure so the band can be easily adjusted without additional bariatric surgery.

Lap band surgery is reversible and has the added benefit of leaving nutrient absorption unchanged.  Unlike gastric bypass procedures which dramatically reduce stomach capacity all at once, lap band surgery reduces stomach capacity gradually.  Of all these bariatric surgery procedures, lap band surgery has one of the lowest rates of complications.

Gastric balloon

Gastric balloon (intragastric balloon) assists with weight loss by temporarily reducing stomach capacity.  In this procedure, an inflatable device is inserted into the stomach via the esophagus.  This gastric balloon is then inflated and can be kept for up to six months.  Sometimes this procedure is used as a primary method of weight loss. Gastric balloon can also be used to assist with weight reduction before another weight loss surgery.

Gastric Bypass

The Roux-en-Y Gastric Bypass is one of the more commonly performed permanent bariatric surgery procedures.  During this surgery, the stomach is divided near the top to create a small pouch.  The lower “remnant” pouch is retained and the small intestine is arranged to connect both.  

Gastric bypass surgery tends to be very effective for sustained weight loss.  The smaller stomach capacity means less food is necessary to feel full.  It is likely that fewer nutrients are absorbed since part of the small intestine is bypassed, too.  Research indicates that this weight loss surgery also positively influences gut hormones to reduce risk of type 2 diabetes.

Sleeve Gastrectomy

Another bariatric surgery that permanently changes the structure of the stomach is laparoscopic sleeve gastrectomy.  In this weight loss surgery, about 80% of the stomach is removed, leaving a tubular pouch.  

Sleeve gastrectomy works by dramatically reducing stomach capacity and calorie consumption.  Like gastric bypass, sleeve gastrectomy has been shown to reduce type 2 diabetes risk by altering gut hormones.  

Biliopancreatic Diversion with Duodenal Switch

Biliopancreatic diversion with duodenal switch is a weight loss surgery that modifies both the stomach and the small intestine.  First, the stomach is reformed into a small, tube-shaped pouch similar to that in the sleeve gastrectomy procedure.  In biliopancreatic diversion and duodenal switch surgery, the first portion of the small intestine (the duodenum) is then removed.  The new stomach pouch is then connected to the lower part of the small intestine.

Biliopancreatic diversion and duodenal switch reduces meal size initially, but eventually patients can resume eating more standard portions of food.  Food absorption and calorie consumption remain greatly impacted because so much of the small intestine is bypassed, however.  Studies have shown biliopancreatic diversion to be one of the most effective types of weight loss surgery for controlling diabetes.

Meet with Dr. Christine Ren-Fielding and her Team

Dr. Christine Ren-Fielding is a highly-skilled laparoscopic surgeon, much lauded during the course of her career. Dr. Christine Ren-Fielding received the Crain’s 40 Under 40 Award and was also named the University Healthcare Consortium’s Best Performer in Bariatric Surgery. Dr. Christine Ren-Fielding is passionate about helping patients achieve their weight loss goals.

Are you a good candidate for weight loss surgery?  To discuss your options, including lap band surgery, gastric balloon, gastric bypass surgery, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, please contact the NYU Langone Weight Management Program to schedule a consultation with Dr. Christine Ren-Fielding and her colleagues.