Bariatric Surgery & Medical Weight Loss

During endoscopic sleeve gastroplasty (ESG), your surgeon uses a flexible tool (endoscope) to place sutures in the stomach. They stitch the stomach tissue into folds and shape it into a tube or sleeve. The stomach heals around the sutures to form a new shape. As a result, your stomach has less room to hold food, making you feel full faster and eat less. ESG doesn’t involve incisions, so you won’t have any scars. You’ll have a quicker recovery and lower risk of complications.

A sleeve gastrectomy is a restrictive procedure that reduces the amount of food you can eat. Your surgeon will remove up to 85% of your stomach, including the part that produces ghrelin, the hunger hormone. They will use the rest of the stomach to form a tube with a pouch that holds a small amount of food. This helps you eat less while still feeling satisfied.

Roux-en-Y gastric bypass is one of the most common bariatric surgery options. Your surgeon creates a small pouch with your stomach, about the size of your thumb. Then, they reroute your small intestine to connect one end with the newly created pouch.

The surgery reduces your stomach size and your hunger hormone levels. It also limits the fat, calories and nutrients your body absorbs, which affects your insulin secretion and decreases your bad cholesterol (LDL) levels.

Laparoscopic adjustable gastric band surgery is a restrictive procedure that reduces stomach size. Your surgeon places an adjustable, hollow silicone band around your stomach near its upper end. The band creates a small pouch and a narrow passageway into the rest of your stomach. This makes you feel satisfied after eating smaller amounts of food.

In single-incision laparoscopic surgery (SILS), your physician makes one small incision in your belly button. They’ll use this opening to access your abdomen and perform the same procedure used in traditional laparoscopic bariatric surgeries, like sleeve gastrectomy and gastric bypass.

The duodenal switch is a good surgery option if you have a high BMI and other health issues, like diabetes. It’s also effective if you have gained weight since a previous weight loss surgery. However, this surgery is not reversible.

The duodenal switch has two parts — restrictive and malabsorptive — that work together to help you lose weight. During the restrictive component, your surgeon performs a sleeve gastrectomy. This procedure restricts the amount of food you can eat, reduces your hunger hormone levels and helps control your blood sugar.

In the malabsorptive step, your surgeon reroutes your small intestine and connects the end just off your stomach. As a result, you’ll absorb less calories, fat and nutrients from the food you eat. The duodenal switch also helps control your insulin production and decreases your bad cholesterol (LDL) levels.

If you had a previous gastric bypass or sleeve gastrectomy but regained the weight you lost, an endoscopic revision may help. During the procedure, your surgeon inserts an endoscope through your mouth and into your abdomen. They use the tool to fix any issues and reduce the size of your stomach pouch or opening.

When you have a high BMI, your abdominal wall thickens, which can make traditional laparoscopic surgery difficult. The da Vinci robot surgical system can increase your surgery options.

The robotic arms allow your surgeon to operate in small spaces and navigate thicker abdominal walls. A 3D camera provides a better view while working around sensitive tissues. Your surgeon will have better control over precise movements and an increased range of motion.

Revisional surgery is an option if you had a previous unsuccessful weight loss surgery. However, revisional procedures carry a higher complication risk. Your provider will help determine if this option is right for you.

Adolescents looking to lose and manage weight may be eligible for laparoscopic sleeve gastrectomy. Parents play a key, supportive role in the treatment process. Together, we will discuss nutritional needs, exercise guidance and mental health support to help your child succeed long-term.

After surgery, your team of surgeons, nutritionists and psychologists will check in with you regularly. You’ll need to stick to soft foods for the first six weeks before switching to a regular diet. You can return to work about a week after the procedure. Avoid heavy lifting for four to six weeks.

It’s important to remember that surgery and medication are weight loss tools — not replacements for lifestyle changes. You’ll need to implement new habits to get the most successful weight loss results. We’ll help you:

• Follow a calorie-reduced, healthy eating plan
• Partake in regular exercise tailored to your abilities
• Find counseling, support groups and other programs to address mental health concerns

Weight loss drugs aren’t for everyone. You should avoid them if you:

• Are breastfeeding
• Are pregnant or trying to become pregnant
• Have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN2)

Weight loss medications can affect everyone differently. You may experience:

• Constipation
• Diarrhea
• Injection site reactions
• Nausea
• Acid reflux or gastroesophageal reflux disease (GERD)

In rare cases, they may lead to more serious side effects, including:

• Low blood sugar
• Pancreatitis
• Thyroid tumors or medullary thyroid cancer

We recommend checking with your insurance provider to find out the details of your plan’s coverage. You may be able to use a flexible spending account (FSA) to save on medical weight loss costs.