Gastric Bypass

Lap Band

i had a patient with the exact same scenario. She had lost a lot of weight to where the abdominal wall adjustment port was visible. This is actually more common in men, because men have less fat under the skin, where women tend to carry their fat there. My patient was thrilled with her weight loss but her port was visible even prior to abdominoplasty and requested port removal without band removal. My recommendation was actually port and band removal without conversion to gastric bypass to protect her from weight regain. After a long discussion, I removed all of the fluid from her port so she could experience what it would be like to have an empty band. If you just removed the port, there would be no way to adjust the band and the band would be empty. After a week or two like this the patient’s appetite had returned and she was starting to gain weight and requested fluid be put back in the band. I do see that your port/band is empty so this advice may not apply. It is not typical for females to lose enough weight for the port to be visible, but in people that lose more than average I have seen it. Lap-Band makes a smaller port, and it may be possible to exchange the port, but I have both ports in my office and even the smaller port would have been visible. Realize band is a lower profile port but much wider. Congratulations on your weight loss journey. One more point, is what to do long term with GLP-1’s. Most clinicians would say you need to be on them forever to prevent weight regain, maybe at same or lower doses. Ozempic has only been available since 2017 and Mounjaro since 2022, so there isn’t a lot of long term data following patients 5-10 years and beyond.

I have a lap band placed way back in 2009. I have had no problems or issues with it but I never lost significant weight with it either (maybe 15lb). I have finally lost the weight over the last 2 years (glp1) and will be getting a tummy tuck soon! My port kind of protrudes now so I can only imagine after the TT. Is removing only the port an option? I’d hate to have a full surgery to remove the band when it’s been unfilled for over a decade and not causing problems.

Removing lap band port only - Is it possible?

At your height of 5'5" and weight of 180 pounds, your BMI (body mass index) is 30.0 kg/m^2. this is too low to qualify for bariatric surgery. Bariatric surgery guidelines, for surgeries like gastric bypass, sleeve gastrectomy, gastric band, biliopancreatic diversion, the minimum  BMI is 35-40 if there are co-exisiting medical problems, such as heart disease, sleep apnea, hypertension, high cholesterol, diabetes. If the BMI is over 40, then most insurance policies would not require a co-existing medical problem.  A new option for your BMI is the intra-gastric balloon. There are two brands of this balloon, Orbera and ReShape. Basically it is a balloon that is fluid filled and remains in your stomach for a period of about 6 months, and then is deflated and removed. It is recently FDA approved but not covered by insurance.

28 yr old mother.csection.I'm 5"5 weigh 180lbs.40lbs from 2 years b4. Problem areas ? I see my stomach,arms flanks and waist and back.gastric candidate ?

I was wondering could I be a candidate for gastric by pass? (photos)

I calculated your BMI as 44.85 based on your current height and weight. Weight loss after bariatric surgery is expressed as percent of excess body weight lost. Your ideal weight is between 121 (=BMI 18.5) and 164 (=BMI 25). Then your excess weight is 131, meaning the amount over 164 (295-164=131). To lose 70% of 131 is losing down to 203 pounds. At 203 pounds your BMI would be 30.9.&nbsp; I am not saying it is impossible to lose down to 130-140, but losing about 100 pounds is more realistic. I tell my patients to wait and see where there lose skin is before pursuing plastic surgery.&nbsp; David Geller, MD Bariatric Surgery

Hi so decided gastric bypass surgery I am currently weighing 295 I'm 18yr old female and 5'8 I am hoping after this procedure I will get down to the weight I am suppose to be which I do believe is 130-140 is it possible and how much loose skin will I have most of it is on my thighs, arms & abdomen .. Will I be able to tighten skin after or will I have to get skin removed.

Is it possible after Roux-en-Y Gastric Bypass I'll weight around 130-140 lbs from 295 lbs?

yes it is true that patients with auto-immune disease like lupus should not have a gastric band placed. This is either Lap-Band or Realize band. It is thought to cause an increased risk of complications, mainly erosion of the band.&nbsp; I recommend patients with those contraindications to the band undergo sleeve gastrectomy or gastric bypass. In doing either of these stapling procedures, the staples are left in the GI tract forever, but are non-reactive and do not cause problems in patients with auto-immune disease.&nbsp; David Geller, MD

I read that people with an auto-immune disease can not have the band. What about the gastric bypass?

Yes. at a BMI of 43 you are eligible. Unfortunately, long term studies suggest at this BMI the chances of significant weight loss are very low with treatments other than surgery. There are several surgical options for weight loss, including banding,&nbsp; sleeve gastrectomy, gastric bypass, and biliopancreatic diversion. I list in increasing order of effectiveness and risk. In the last few years sleeve gastrectomy has become very popular, and if these trends continue, it will likely become the most commonly performed bariatric surgery.

I've been over weight and on a diet ever since I was about 12 years old. I've tried almost every diet out there gone to the gym and paid for trainers and nothing seems to help me lose more then 10lbs and then I gain it all back and then some. I've been looking in to weight lose surgery and the gastric sleeve seems live a good option, and I wanted to know if I'd be eligible

I'm 24 years old 5'2 and weigh 235. Am I eligible for gastric sleeve?

Every procedure does carry some risks. There is even a very small risk of death. Overall the risk is related to the medical problems of the patient going into surgery. But as far as weight-loss surgery goes for most people the long-term risks are lower after weight-loss surgery compared to not having weight-loss surgery. That includes the risk of dying. In other words for most people, it is safer to undergo surgery and lose weight then it is to do nothing at all. I hope this helps. David Geller, MD bariatric surgeon

He has many health problems, asthma, emphyzema, low blood pressure. I believe thats it.

My father is going in for gastric bypass, what are the chances he won't make it through surgery?

Success with weight-loss surgery depends not only on a well performed surgery but also on careful compliance and follow up. Results from revision surgery are all over the board. If the cause of weight regain is related to a stretched out pouch, there are several options for making this smaller. One is performed endoscopic and is not covered by insurance and is called Rose procedure. Another is to surgically make the pouch and intestinal connection smaller, but this is the most difficult surgery to do and it could still stretch out again. Another option is to place a gastric band around the pouch. This is what I perform most frequently and it gives the patient and I the ability to adjust the surgery.&nbsp; In the long-term, following the rules and watching your diet is the most important thing. There is an app called MyFitnessPal, or lose-it which work on android and iPhone and is fantastic for logging your diet. after all, being accountable is the key. I hope this helps. David Geller, MD

In 1991, I had this procedure when I was 25 years old and was too young to understand about it. Even though I lost an extreme amount of weight within the first two years, I regain this weight. I now have to get a bag of iron and a b12 shot every 8 weeks to keep me at normal levels. I have been having this treatment for the last 20 some years. I am willing to take the risks into consideration, and willing to do this for myself, whether it kills me or not. What is your opinion?

What will Gastric Bypass do to me if I have it done a second time?

When there is pain involved and the patient has a slipped band I consider this urgent evaluation and treatment may just be to remove fluid. But in the case of the gastric prolapse it is possible that the herniated stomach through the &nbsp;band can die as a result of strangulation and need a bigger surgery to resect the stomach. This is very rare and I have never had to do this is over 1500 band surgeries, but I have seen ischemia of the stomach where the stomach turns blue from strangulation and became normal as soon as the band was unbuckled.&nbsp; Just make sure your surgeon is aware of all of your symptoms.&nbsp;

My symptoms were bloating and shoulder pain

Have slipped band and liquid will be removed on tuesday. Shoulder pain is more persistent. Should I worry?

There are three main surgeries. Gastric bypass, gastric band, and sleep gastrectomy. They are all good choices. Gastric bypass obviously the bigger surgery with most and fastest weight loss and most impact on diabetes. Sleeve gastrectomy I consider intermediate. Both in aggressiveness and the speed of weight-loss. And then the gastric band which has the slowest weight loss, but is the simplest to perform. I try to leave the choice of surgery up to the patient after they have been educated on the different options. Another option which is much less common is the biliopancreatic diversion which makes up about 3% of all surgeries in this country. I hope this helps. David Geller, MD bariatric surgeon Louisville, KY

In the endoscopy, the doctor discovered a 3 cm hiatal hernia cos of which he said I'm more suited for the gastric bypass than the sleeve. I am terrified!

I want to get weight loss surgery. Which is the best option?

Yes the stomach can stretch after gastric bypass. In fact, many surgeons believe that stomach stretching is the reason that a typical gastric bypass patient will regain a small amount of their weight back after two years after surgery. Ultimately, the weight loss with any bariatric surgery occurs from a change in your diet. But, when the gastric pouch or stoma, which is the opening leading from the stomach into the intestine, has stretched, the restriction or full feeling may go away.

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	If the pouch is significantly stretched, there are several surgical options that may help, including 1) recreating a smaller pouch, 2) placing a gastric band around the gastric pouch, or 3) ROSE procedure or endoscopic suturing inside the stomach.

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	Over the years the trends have been to create a smaller and smaller stomach pouch, where nowadays surgeons typically aim for a pouch between 1/4 and 2 ounces in capacity.

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im 35 years old and 12 years ago i had a gastric bypass, the results were fantastic, but now after 2 children i find myself unable to loose the weight i gain and the amount of food intake is much much larger which leads me to believe that my stomach has been stretched out. i also stating to have issues with my BP is much higher now and also i get heartburn which those were gone after i had my bypass. thank you

Does the Stomach Stretch After Gastric Bypass? If So, Can I Have a Second One?

David R. Geller, MD

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Bariatric surgeons have advanced training in surgical procedures of the gastrointestinal system that treat obesity by restricting the amount of food the stomach can hold and the nutrients it can absorb.

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