Band-To-Sleeve Conversion with Medtronic’s New Signia Smart Stapler

Band-To-Sleeve Conversion

Band-to-sleeve conversion is becoming a more popular procedure amongst weight loss surgeons.  The gastric band, once the most popular weight loss surgery in the world, has worked well for many patients over the years. However, some patients either had issues requiring removal of their band, or perhaps didn’t achieve their weight loss goals due to the limited power of gastric banding in higher BMI patients. At JourneyLite, we have done over a thousand successful band-to-sleeve conversions and we typically find fantastic success in most patients who undergo this procedure. While it is a little more complicated than a routine gastric sleeve, in experienced hands it can be done safely and most of the time in a single operation. Take a look at this video, recorded by Dr. Trace Curry at JourneyLite Surgery Center in Cincinnati, to learn more about band-to-sleeve conversion surgery!

Weight Loss Surgery Revisions

Revisional Procedures

Despite our best efforts, some patients still need to lose more weight even though they have already had a weight loss procedure.  Lear about your options here!

JourneyLite low-res logo

If you are looking for a gastric band revision, gastric sleeve revision, or gastric bypass revision, the good news is that we have options for you.  JourneyLite Physicians has a combined decades of experience with weight loss surgery revisions and, in the right situation, patients can have great results!  If this describes you, click below on the procedure that you had done already to learn about your options & request an appointment with one of our expert weight loss surgeons.

Gastric Band Revision

gastric band

Gastric Sleeve Revision

vertical sleeve gastrectomy

Gastric Bypass Revision

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Other Revisions

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Endoscopic Sleeve Gastroplasty

An Incision-less Endoscopic Procedure

Endoscopic Sleeve Gastroplasty (also known as ESG, or “the accordian procedure” is a new endoscopic weight loss procedure.  With an ESG, we can reduce the volume of the stomach without removing any of it, and without making any incisions.

Outpatient Procedure, Minimal Down Time!

The procedure is most commonly performed with the Overstitch from Apollo EndoSurgery.  This device is used in combination with an endoscope, while the patient is sedated, to go down through the mouth and place sutures inside the stomach.  Unlike similar devices that have been used in the past, the Overstitch allows for much more secure “full-thickness” sutures to be placed.  This results in more durable sutures that are less likely to pull through in time, yielding better long term results than similar procedures in the past.

The image above shows how these endoscopic sutures are placed to “tuck” the stomach in on itself, which results in a more narrow diameter and a shorter overall length of stomach.  The result is smaller portion sizes.  As with any weight loss procedure though, long term success relies on healthy eating habits, regular exercise, and long term follow up.

The procedure is done under general anesthesia in an endoscopy suite on an outpatient basis.  Patients are typically back to work in a few days to a week, and diet is advanced slowly from liquids to pureeed, then finally soft solid foods.

Short-term results of the ESG have shown that the weight loss for this procedure lies somewhere between that of gastric band and gastric sleeve.  It is best utilized on lower BMI patients, in the 30-40 range.

As with any new weight loss procedure, we still await long-term data before we can say definitively that the lost pounds will stay off forever, but preliminary data is encouraging and it is always good to have new non-surgical treatments for the disease of obesity.

Click here for info on pricing and financing!

For information on current pricing, specials, and financing information click here.

Gastric Bypass

RNY gastric bypass

Gastric Bypass

For decades, Roux-en-Y gastric bypass surgery was the gold standard procedure for weight loss surgery. It is one of the most frequently performed weight loss procedures in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the small intestine, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the “Y” shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat. Many studies show that diabetes goes away in up to 80% of patients after surgery!

 

Advantages:

  • The average excess weight loss after the Roux-en-Y procedure can be higher in a compliant patient than with purely restrictive procedures.
  • One year after surgery, weight loss can average 77% of excess body weight.
  • Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
  • A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.

Risks:

  • Because some of the small intestine is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
  • Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
  • A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
  • A condition known as “dumping syndrome ” can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
  • In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.
  • The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

If you are a self-pay patient and want info on pricing and financing for gastric bypass, click here!

JourneyLite Physicians are among the most experienced gastric bypass surgeons in Cincinnati, Dayton, and Columbus!  Click on “Meet Dr. Curry Online” to learn more about your surgical weight loss options, or fill out the appointment request form below.

Click here to schedule a gastric bypass consultation!

Band-To-Sleeve Conversion with Medtronic’s New Signia Smart Stapler

Band-To-Sleeve Conversion Band-to-sleeve conversion is becoming a more popular procedure amongst weight loss surgeons.  The gastric band, once the most popular weight loss surgery in the world, has worked well for many patients over the years. However, some patients either had issues requiring removal of their band, or perhaps didn't achieve their weight loss goals [...]

40% Reduction in Risk of Death and Cardiac Complications After Weight Loss Surgery

Recently the Cleveland Clinic published a paper in JAMA looking at 2300 patients who underwent weight loss surgery (gastric sleeve, gastric bypass, gastric band, or duodenal switch) compared to 11,500  matched patients with similar medical issues who did not have surgery. The endpoint of the study was the occurrence of one of the following:  death, [...]

JourneyLite and Medtronic’s New Signia Smart Stapler

JourneyLite has adopted the use of Medtronic's new Signia smart stapling system for our linear staple lines.  This high-tech new stapler uses Adaptive Firing™ technology, which gives the surgeon real-time feedback, measuring tissue thickness and adjusting firing speed based on the tissue's thickness and variability.  This technology results in outstanding performance in variable tissue, leading [...]