Gastric Sleeve Gastrectomy, Bypass or Lap Band?
With thanks to Dr Milton Owens & Rancho Speciality hospital California
The procedure was originally conceived of in England and has been further developed and utilized in the U.S, Germany and Belgium. The technique is an improvement over earlier gastroplasty procedures which included placement of foreign bodies, and left the excess stomach intact. It was originally used for very high BMI patients (~ 500 lbs.) to try to reduce the overall risk of surgery. It was then followed by a second surgery when the patient had lost enough weight to safely go through a second procedure like the Gastric Bypass.
The new procedure was started in England about 5 years ago as a stand alone procedure for patients of BMI’s of 35-45. It proved to be quite safe and effective even at 5 years post op.
U.S. studies have been very impressive; in one study of almost 100 very high risk, very high BMI patients there were no deaths, and only 1 leak, and 1 pulmonary embolus.
Dr. Owens has used this procedure for high risk, high BMI patients with good results. It can be considered by patients who are:
Concerned about bowel obstructions and leaks that may occur with Gastric Bypass due to the re-arrangement of the anatomy required.
Concerned about the dietary changes and vitamin supplements required by Gastric Bypass
Concerned about the foreign body introduced with the Lap Band placement
Concerned about the need for follow up, fills required with the Lap Band
It should also be considered for patients weighing over 500 lbs, patients with existing anemia, Crohn’s disease, or other conditions that make them too high risk for Bypass procedures.
Dr Owens is the first surgeon in Southern California to offer Sleeve Gastrectomy. His expertise in Sleeve Gastrectomy offers our patients another option to help them receive the best weight loss procedure for their individual needs. Vertical Sleeve Gastrectomy procedure also called Sleeve Gastrectomy, vertical gastroplasty, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction and Sleeve Gastroplasty is performed by approximately 18 surgeons worldwide.
Choosing the Sleeve:
 • Those who are concerned about the potential long term side effects of an intestinal bypass such as bowel obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency.
• Those who are considering a LapBand but are concerned about a foreign body or the need for fills and more frequent follow up.
• Those who have other medical problems that prevent them from having weight loss surgery such as anemia, Crohn’s disease, extensive prior surgery, and other complex medical conditions.
• Those taking anti-inflammatory medications that may need to be avoided after gastric bypass due to increased risk of ulcers. Advantages of the Sleeve:
• Stomach holds less but tends to function normally so most food items can be consumed in small amounts
• Thought to eliminate the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
• No dumping syndrome
• Minimizes the chance of an ulcer occurring.
• Very effective as a first stage procedure for high BMI patients (BMI >55 kg/m2).
• Limited results appear promising as a single stage procedure for low BMI patients (BMI 35-45 kg/m2).
