Laparoscopic gastric banding is the safest and least invasive bariatric surgery for patients interested in weight loss surgery.

The surgery is performed laparoscopically, which means less scarring, shorter hospital stays, less pain, quicker return to full activities, and fewer long-term complications. And it leaves the stomach fully intact.

The lap band is a small, saline-inflatable band placed around the upper portion of the patient’s stomach to create a small stomach pouch. The band restricts the amount of food consumed, slows the emptying of food from the stomach, and provides a constant sensation of being full. It allows you to finally gain control over your hunger.

Operating time is about 60 minutes, and most patients are ready to leave the hospital the same day. Most patients can return to work within a week or two.

How does it work?

The lap band is adjustable to fit your weight loss needs, which can control the amount of saline in the band with a fine needle through the skin. The average weight loss of lap band patients in a clinical study was approximately 36-38% of excess weight, two to three years after surgery. Most importantly, the procedure is 100% reversible, which means that at any point the band can be easily removed, leaving your body virtually unchanged.

Our bariatric program now accepts patients who wish to pay out of pocket for the lap band procedure. Many of our patients are surprised at just how affordable this option is. Patients often choose this alternative because their insurance carrier may feel that they do not meet their criteria for bariatric surgery or require a 6 month to one year wait before they will allow patients who otherwise qualify to undergo surgery. We are more than happy to discuss this very affordable option with you in greater detail at the time of your initial consultation.

Sleeve gastrectomy is a minimally invasive technique where the surgeon creates a small, sleeve-shaped stomach about the size of a banana. The stomach is about 15%-20% smaller than its original size. With this option, patients are expected to have 70% excess weight loss at 18 months. The sleeve gastrectomy is not a reversible procedure.

Sleeve gastrectomy is effective for patients who are morbidly obese and an alternative for patients suffering from morbid obesity whose health risks are too complicated for earlier weight loss methods. There is no foreign body present and no malabsorption as with the bypass. This procedure, which takes about an hour, involves at least an overnight stay, and does not involve any rerouting or reconnecting of the intestine.

Gastric bypass is usually performed laparoscopically and proven to be effective against diabetes and reflux. The stomach is divided with a stapler, shrinking the size of your stomach and leaving a small stomach pouch. The small bowel is then divided and attached to the small stomach pouch. This allows most of your stomach to be bypassed as well as part of your small intestines where absorption of calories and nutrients typically happen—this bypass helps contribute to weight loss.

Patients may lose up to 60-70% of their excess body weight. The gastric bypass has been around for over 40 years and there is significant data and research available. Today, gastric bypass is often done using advanced robotic surgical technique which lowers risk of complications.

Surgery takes 2-3 hours and hospital stay is 2-3 days. Insurance covers gastric bypass if a patient meets criteria for surgery, including BMI between 35-39, with at least one medical comorbidity associated with obesity or a BMI greater than 40.

Single-Anastomosis Duodenal Switch is now offered to patients who had the gastric sleeve and are either regaining weight or have lost weight but need to lose additional weight.

The duodenum is separated, just below the pyloric valve, from the remaining intestinal tract. Around 300 centimeters of the small intestine is measured from the terminal ileum and that loop is connected to the stomach. This longer channel leads to greater absorption of nutrients and vitamins and fewer bowel movements compared with the regular Duodenal Switch procedure (DS).

We also offer SADI-S (Single Anastomosis Duodeno-Ileal) bypass with sleeve gastrectomy. SADI is done robotically and patients spend less time in surgery with a reduced risk of complications.

Intragastric weight loss balloon is a non-surgical device. The balloon is endoscopically placed without incision and no part of your anatomy is altered. The device is placed into your stomach and filled, then removed six months later. Compared to other surgical options, the balloon is a temporary option.

The balloon is approved for adults with a BMI between 30 and 40 with at least one medical condition associated with obesity. Patients can expect to lose approximately 25-70 lbs., assumed that the program is followed correctly.

When a patient undergoes bariatric surgery and follows the post-operative instruction, they can expect to lose significant weight and maintain that weight loss. However, if a patient does not lose the anticipated weight after surgery or has lost weight but regained some or all of it back, revisional surgery can help get you back on your weight loss success journey.

Examples of revisional bariatric surgery include:

Minimally invasive endoscopic suturing after gastric bypass surgery. This procedure is nonsurgical, so there are no incisions and no recovery time needed. Our surgeon places an endoscope through the mouth and, with sutures, revises the stomach pouch to a smaller size.

Laparoscopic adjustable gastric band over gastric bypass. A gastric band is placed on the proximal part of the stomach pouch and is connected by tubing to a port under the skin. The port is accessed monthly and saline is added to the band to cause the patient to gain sensation of restriction of food.

Single-Anastomosis Duodenal Switch after laparoscopic gastric sleeve

As effective as modern bariatric surgery is, there are risk factors: some of weight loss may be regained, some types of surgery may put you at risk for nutritional deficiencies, and people who are obese have a higher risk of complications from surgery.

To minimize these risk factors, our comprehensive bariatric program requires you to commit to the following guidelines before surgery.

You must:

• Have a primary care physician who has been notified of your interest in surgery and is willing to work with you before and after surgery
• Obtain medical and psychological clearance
• Commit to long-term follow-up with our program
• Commit to life-long adherence to nutrition guidelines
• Attend an education seminar prior to surgery
• Receive insurance authorization or make self-payment arrangements
• Participate in pre-admission testing conducted at Maimonides