COMPARISON OF BARIATRIC SURGICAL PROCEDURES

Gastric band Realizr FrenchWe do not discuss Gastric Banding procedures (e.g. Lap Band).

WLS DOES NOT OFFER THIS SURGERY DUE TO HIGH LONG TERM (>5 YEARS) COMPLICATION RATES.

 

Re-Shape Duo in place1

We also do not currently offer the Gastric Balloon.  This is a TEMPORARY solution to obesity as the balloon must be removed after 6 months. All lost weight can be regained after the balloon is removed.   It is just like going on another type of diet!!! Some balloons especially the single type have burst, migrated into the gut and have caused severe complications and sometimes death.

Here is a side-by-side comparison of current surgical procedures. We present the 3 established (approved) procedures as well 2 new procedures with minimal experience, thus considered “experimental”. Dr. Christou’s recommendations are shown at the end of the table.

Roux-en-Y Gastric
Bypass
Vertical Sleeve
Gastrectomy
Duodenal Switch One Anastomosis Gastric Bypass Single Anastomosis Duodenal Ileostomy
Graphic
Representation
Gastric Bypass Realize ENG VSG Realize ENG PPDDS_ENG_REALIZE OAGB SADI
World wide Popularity

 Most common(“Gold Standard”)  New Procedure Becoming popular  <2%  <2%  ”Experimental”
Hospital Stay  2 days  1 day  2-3 days  2 days 2 days
Return to work?  2 weeks  2 weeks  2 weeks 2 weeks 2 weeks
Is the surgery
reversible?
 YES  NO  NO  YES  NO
Does the procedure
eliminate hunger?
 YES YES YES  YES YES
Chance of dying
within 30 days
of surgery
 0 – 0.5%  0 – 0.5%  0 – 1.6%  0 – 0.5%  Unknown as yet
Average weight
loss 10 years after surgery
 70% of excess
weight
 55% of excess
weight
 75% of excess
weight
Unknown as yet Unknown as yet
How fast will I
reach my maximum
weight loss?
 18 months  2 years  18 months 18 months 18 months
Can I regain
weight after
this procedure?
 +  ++  + ++ Unknown as yet
Type-2 Diabetes
control
 +++  ++  ++++  ++  Unknown as yet
High Blood Pressure
control
 +++  ++  +++  ++  Unknown as yet
Lipid & Cholesterol
control
 +++  ++  ++++  +  Unknown as yet
Sleep Apnea
control
 +++  ++  +++  + Unknown as yet
Reduction in
risk of dying 5
years after
the procedure
 34 – 89%  No data  No Data No Data  Unknown as yet
 Life-Long
complications
Anemia ++
VitaminDeficiency ++

Kidney Stones +

Dumping if dietary advice not followed

Anemia ++
Vitamin Deficiency ++
Anemia +++
Vitamin
Deficiency +++
Kidney Stones ++
Low Albumin +
Frequent bowel
movements +++
Anemia ++
Vitamin Deficiency ++
Kidney Stones +

Bile reflux

Dumping if dietary advice not followed

Unknown as yet
 Dr. Christou’s Recommendations Reccomended  for patients with a BMI of >40 kg/m2.

It is considered the “Gold Standard Procedure” for weight loss in North America.

The majority of our patients chose this procedure.
Best for patients with
BMI=32-50 kg/m2(with at least one obesity associated disease like diabetes) who enjoy participating in an
exercise program and are more disciplined and can follow dietary restrictions.

This is our second most popular procedure.
Best for patients with BMI>60 kg/m2 who accept certain inconveniences like frequent bowel movements, flatulence etc.

Dr. Christou’s main reservation is the need for rigid adherence to diet supplements which most patients fail to follow long term.


Reccomended  for patients with a BMI of >40 kg/m2.

Bile reflux and bile esophagitis (an irritation of the tube connecting the stomach and mouth from bile coming up the single anastomosis to the pouch and the esophagus) can lead to cancer (rare)
Not enough experience available world-wide to make recommendation.The American Society of Metabolic and Bariatric Surgery position statement is that SADI is an experimental procedure and requires further study.