Surgical Options

The SILS™ technique involves placing multiple instruments through a single access point. The ability to articulate allows the surgeon to approach the surgical site from different angles, thereby restoring triangulation and improving visualization.

Roux-en-Y Gastric Bypass

The Roux-en-Y Gastric Bypass (RYGB) allows a patient to lose weight primarily by restricting the amount a person can eat, secondarily by decreasing the amount of calories that are absorbed. This is accomplished by creating a small, 30cc gastric pouch using stapling techniques. This pouch is attached to a portion of small bowel by a tiny opening <2cm. This bowel is then reattached to itself downstream, creating a short intestinal bypass.

The procedure takes about two hours. Hospital stay averages two days. Recovery time is about two weeks. Patients can expect to lose between 70-75% of their excess weight. Potential complications include leaks, bleeding, stricture and obstruction. The RYGB is currently the most common weight loss surgery in the United States.

To view animation of the Gastric Bypass procedure, click here.

 

Laparoscopic Gastric Banding (Lap-Band®)

The Lap-Band is the latest innovation in weight loss surgery. It allows a patient to lose weight primarily by restricting the amount a person can eat and controlling hunger. A plastic band with an inner balloon is wrapped around the top portion of the stomach to create a very small gastric pouch. This band is attached to tubing that is ultimately connected to a small access port sitting on the patient’s abdominal wall. Saline can be injected into or removed from the access port to inflate or deflate the band.

The procedure takes about one hour. It can be performed as an outpatient or with an overnight hospital stay. Recovery time is approximately one week. The advantages of the Lap-Band are its low risk profile (the lowest of all weight loss procedures), adjustability and reversibility. Excess weight loss averages about 55%, although long-term data continues to show improvement as programs like ours become more experienced. Potential complications include band slippage and port problems.

To view animation of the LAP-BAND procedure, click here.

 

 
Laparoscopic Adjustable Gastric Banding with Plication


Southeast Bariatrics now offers the newest technical advance in gastric banding—the Band with Plication or I-Band®. This technique involves “folding in” or “imbricating” the fundus of the stomach (“fundoplasty”) with two rows of sutures below the traditional band placement. This creates a narrow tube below the band. The band itself is managed in a similar fashion to the traditional technique with band adjustments based on patients’ needs.

The procedure takes about an hour. Like the standard adjustable gastric banding, most procedures are performed as an outpatient. Recovery time is about one week. The potential advantages of the new technique are a decrease in band slips and an improvement in both the amount and rapidity of weight loss. Southeast Bariatrics is the first group in the Charlotte region to adopt this technique.

 

 

Laparoscopic Vertical Sleeve Gastrectomy

 

The Vertical Sleeve Gastrectomy (VSG), like the adjustable gastric band, is a restrictive procedure that limits the amount of food that a patient can eat. The stomach is converted from a “bag” into a narrow tube with stapling techniques.

The VSG is primarily used as a staging procedure in patients with very severe obesity. However, it is becoming increasingly used as the only surgery in selected patients.

The procedure takes about one hour to perform. Hospital stay is typically two days and recovery time one week. Weight loss varies greatly from 25-60% excess weight loss. 20 to 30 percent of patients require a secondary procedure once their initial weight loss plateaus.

To view animation of the Sleeve Gastrectomy procedure, click here.

 

 

Bilopancreatic Diversion (BPD) with Duodenal Switch

The Biliopancreatic Diversion with Duodenal Switch (BPD-DS) is primarily a malabsorptive procedure using a long intestinal bypass to severely decrease the amount of calories a patient can absorb. It

also restricts the amount of food a patient can eat, but not to the extent of the gastric bypass or the adjustable gastric band. The stomach is stapled into a narrow tube to create this restriction and is then reconnected to the extensive intestinal bypass.

The procedure typically averages 3.5 hours to perform. Hospital stay is 2-3 days and recovery time is around two weeks. The BPD-DS is considered the best long-term weight loss procedure with excess weight loss averaging 80%. Patients can also eat more normally because of the larger gastric reservoir. Potential complications include leaks, bleeding, obstruction and nutritional deficiencies.

To view animation of the Sleeve Gastrectomy procedure, click here.

 

 

Band over Bypass (BoB)

 

Whether you expected to lose more weight after your gastric bypass, or even regained your weight long term, placing a Lap-Band over your gastric bypass can give you the restriction that you felt in the early phase of your initial surgery.  A failed weight loss procedure can be defined as less that 50% loss of excess weight. The BOB procedure can provide you the necessary tool to limit your food intake and promote a feeling of fullness after your meals.  This procedure can be done laparoscopically, even if your initial gastric bypass was performed as an open operation.  

Dr. Voellinger is one of the only surgeons performing this type of revision in the southeast! In order to expedite your pre-operative evaluation, please obtain a copy of your previous operative reports for Dr. Voellinger to review prior to your Initial Consult.

 

 

Incisionless Surgery: Rose Procedure

Your stomach pouch or stoma (the connection between the pouch and small intestine) may have stretched out in the years since your original surgery, reducing the feeling of fullness after you eat.

To resolve this problem, surgeons at Southeast Bariatrics can use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. Our surgeons perform the procedure entirely through the mouth without making any external incisions into the body making it a true incisionless procedure.

Due to the lack of external incisions, the ROSE procedure is expected to provide important advantages, including less risk than traditional open or laparoscopic surgery, minimal postoperative pain, fast recovery time, and no scarring.

Keeping your weight down after bariatric surgery is vital to improve your health and reduce the co-morbidities associated with obesity such as Type II diabetes, heart disease, joint disease, and respiratory conditions. If you have started to regain weight since your initial surgery, contact Southeast Bariatrics at 704-316-7760 to see if the ROSE procedure might be right for you.

Our surgeon at Southeast Bariatrics, Dr. David Voellinger, has the largest series of ROSE patients in the Southeast. For more information, or to see a video of the procedure, please see our Incisionless Weight Loss Surgery Website.

 

SEB Surgical Techniques:  Discover your Options

Bariatric Surgery utilizing the da Vinci® Robotic System. With this breakthrough surgical technology, there is a new category of minimally invasive surgery for which you may be a candidate. 

Single Incision: The SILS™ technique.  This surgical technique involves placing multiple instruments through a single access point with the ability to articulate allows the surgeon to approach the surgical site from different angles, thereby restoring triangulation and improving visualization.