Weight-loss Procedures

Bariatric surgery on O’ahu

Adventist Health Castle offers three types of bariatric procedures, all of which are performed laparoscopically through small incisions, using a camera and instruments. These minimally invasive procedures are less painful, result in quicker recovery and fewer complications and don’t leave large incision scars.

Roux-en-Y gastric bypass

The gastric bypass procedure achieves weight loss by cutting the stomach in order to make it smaller and restrict food intake. Then, a section of the small intestines is bypassed so calories and nutrients from food have less time to be absorbed by the body.

For those who have many obesity-related diseases, bypass surgery is usually the procedure that leads to the greatest long-term weight loss. Bypass patients can usually expect to lose 60 to 70 percent of their excess weight. However, because fewer nutrients are absorbed by the body after this procedure is done, patients must take nutritional supplements for the rest of their lives. Also, there are greater risks associated with cutting the intestines, including the risk of infection, strictures and internal hernias.

Vertical sleeve gastrectomy

This procedure, known more simply as the gastric sleeve, has similar weight-loss advantages to bypass surgery, but uses the same less-invasive, single-incision belly button surgery used in the lap band. The procedure removes 85 percent of the stomach to limit its capacity for food. Unlike the bypass surgery, however, there is a lower risk of complications and a reduced need for ongoing nutritional supplements because the upper portion of the small intestine is not bypassed.

Typically, sleeve patients can expect to lose 50 to 60 percent of their excess weight.

Duodenal Switch

In this procedure 80 percent of the stomach is removed (like the gastric sleeve). In addition a lengthy portion of the small intestine is rerouted to create two separate pathways and one common channel. Patients lose weight due to the reduced amount of food needed to feel full along with the decreased absorption through the rerouted small intestine.

Due to the possible development of protein and vitamin deficiencies, this procedure is reserved for select individuals with poorly controlled diabetes and the surgeon’s recommendation. Patients can lose 80 to 90 percent of excess weight in the first two years after surgery. After this metabolic procedure, many patients experience remission of Type 2 diabetes.