There are five types of bariatric surgery procedures offered at Virtua, as well as revisional surgery to modify a previous bariatric procedure.
Laparoscopic sleeve gastrectomy is a restrictive bariatric surgery procedure where about 80% of the stomach is removed; the intestines are kept intact. The remaining stomach is formed into a vertical sleeve, which restricts the amount of food that can be comfortably consumed. It also limits the production of the appetite-regulating hormone ghrelin, which makes you feel less hungry. It doesn't affect the absorption of calories and nutrients in the intestines.
Laparoscopic roux-en-Y gastric bypass involves a combination of restriction and malabsorption techniques. The stomach is reduced to a small pouch, the size of an egg. This greatly limits the amount of food and beverages that can be comfortably consumed at one time. The new pouch is connected to the intestines, bypassing a portion of the small intestines. This limits the absorption of calories and nutrients.
Laparoscopic duodenal switch uses both restriction and malabsorption techniques. As in sleeve gastrectomy, about 60-70% of the stomach is removed leaving a "sleeve," which restricts the amount of food that can be eaten. Then, like gastric bypass, this sleeve is connected to the intestines, bypassing a portion of the small intestines. This limits the absorption of calories and nutrients.
Modified Duodenal Switch (SADI-S)
Modified duodenal switch (clinically known as single anastomosis duodeno-ileostomy with sleeve gastrectomy or SADI-S) is a newer procedure that uses both restrictive and malabsorption techniques. It's performed laparoscopically through small incisions and typically done in two separate procedures.
First, a sleeve gastrectomy removes approximately 80% of the stomach to restrict the amount of food that can be eaten.
After approximately six months, a malabsorption surgery, called an intestinal bypass, completes the process. The procedure bypasses all but 10 feet of your small intestine and strictly limits the amount of calories and nutrients you can absorb from food. Ideal candidates for modified duodenal switch have a BMI of 50 or higher and a metabolic syndrome such as diabetes, sleep apnea or increased fat around the waistline. Patients who previously had a sleeve gastrectomy and did not achieve or maintain the necessary weight loss are also candidates.
Revisional bariatric surgery is the conversion of one type of bariatric surgery procedure to another when medically necessary.
The lap-band restricts how much food the stomach can hold. Virtua no longer offers this procedure and recommends more advanced procedure options that deliver more effective long-term results.