Bariatric & Weight Loss Surgery

If you had previous gastric bypass surgery but regained the weight you lost initially, endoscopic revisions may be an option that boosts your efforts. During the procedure, your surgeon inserts a flexible tool called an endoscope into your abdomen through your mouth. The endoscope is used to reduce the size of your stomach pouch or stomach opening. The non-surgical procedure is an effective tool that allows your weight loss efforts to continue more successfully.

Benefits of endoscopic revision include:

• Continued weight loss
• Feeling of fullness after only a few bites of food
• Low risk of complications after the procedure
• No hospital stay
• Rapid return to regular activities

The duodenal switch may be a good bariatric surgery choice if you have multiple medical issues and a high BMI. It may also be an option if you've gained weight since a previous weight loss surgery. The duodenal switch can be an effective surgical treatment for diabetes. The surgery is not reversible.

The duodenal switch has two components—restrictive and malabsorptive—that work together to help you lose weight. During the restrictive component, our surgical team performs a sleeve gastrectomy. This removes up to 70% of your stomach and restricts the amount of food you can eat. It also reduces your ghrelin, or hunger, hormone levels and helps control your blood sugar levels. This means you’ll feel fuller, faster and after consuming less food.

In the malabsorptive step, our surgeons re-route your small intestine and connect its end portion to its first part, just off your stomach. This allows food to bypass roughly 75% of your small intestine during the digestive process. The change means you’ll absorb less of the calories, fat and nutrients that you eat. It also affects your insulin secretion and decreases your LDL or bad cholesterol level.

Benefits of the duodenal switch include:

• Rapid and sustained weight loss
• Smallest chance of regained weight of all the bariatric surgeries
• Up to 95% diabetes reduction, with most patients off medications within two days of surgery
• Up to 98% excess body weight loss

The duodenal switch is available at:

• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY).

Laparoscopic adjustable gastric band surgery is a restrictive procedure that reduces your stomach's size so that a small amount of food makes you feel satisfied. Your surgeon places an adjustable hollow silicone band around your stomach, near its upper end. The band creates a small pouch and a narrow passageway into the rest of your stomach. This allows you to feel satisfied after eating smaller amounts. Fluid inside the band lets your physician adjust the opening’s size as needed to help reduce your food intake. Although the band is intended to stay in place permanently, the procedure can be reversed if necessary.

Benefits of laparoscopic adjustable gastric band include:

• Better overall health with less serious illness such as heart disease, diabetes, sleep apnea, high cholesterol and high blood pressure
• Fewer complications than other bariatric procedures after surgery
• No cutting, stapling or changes to your anatomy for faster recovery with less pain
• No risk of malabsorption or vitamin deficiency
• Up to 70% excess weight loss over two to three years

Laparoscopic adjustable gastric band surgery is available at:

• Good Samaritan Hospital (West Islip, NY)
• Mercy Hospital (Rockville Centre, NY)
• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

Revisional surgery could be an option if you had unsuccessful weight loss surgery in the past. Some revisional surgeries carry a higher complication risk. Not everyone who regains weight or fails to reach their goal weight is a candidate for revisional surgery. Your physician will help you determine if this option is right for you.

If your gastric bypass was not successful, you may be eligible for:

• Duodenal switch
• Endoscopic revision
• Laparoscopic adjustable gastric band over your bypass
• Laparoscopic revision of gastric bypass

If your lap band surgery was unsuccessful, you may be eligible for:

• Band removal
• Gastric bypass
• Sleeve gastrectomy

If your sleeve gastrectomy was not a success, you may be eligible for:

• Duodenal switch
• Gastric bypass

Revisional bariatric surgery is available at:

• Good Samaritan Hospital (West Islip, NY)
• Mercy Hospital (Rockville Centre, NY)
• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

If you are more than 100 pounds overweight, robotic surgery may be an effective way to increase your chance of successful weight loss. When you have a BMI over 55, your abdominal wall thickens. This makes traditional laparoscopic surgery more difficult. Bariatric surgeons at Catholic Health use the da Vinci robot surgical system to increase the surgical options available to higher-risk bariatric surgery candidates.

With the da Vinci system, robotic arms allow your surgeon to perform surgery in small spaces and navigate thicker abdominal walls. A 3D camera provides a better view and greater clarity when operating around sensitive tissues. The robot gives your surgeon greater control over small movements and provides increased range-of-motion and precision.

Surgeries performed with robotic assistance include:

• Duodenal switch
• Roux-en-Y gastric bypass
• Sleeve gastrectomy

Benefits of robotic bariatric surgery include:

• Faster recovery with a shorter hospital stay
• Lower infection rates after surgery
• Quicker return to regular activity
• Reduced pain and scarring
• Significant reduction in gastrointestinal leaks after surgery

Robotic surgery is available at:

• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

Roux-en-Y gastric bypass is considered the gold standard of bariatric surgery options. The bariatric surgeons at Catholic Health use a minimally invasive laparoscopic approach for most of the weight loss surgeries they perform.

Your surgeon divides your stomach and creates a pouch about the size of your thumb. Your small intestines are re-routed, with one end joined to your newly created stomach pouch. The surgery is restrictive because it reduces your stomach's size and limits the amount of food it holds. It also reduces your ghrelin, or hunger hormone, levels.

The procedure is malabsorptive because it reduces the fat, calories and nutrients your body absorbs. This affects your insulin secretion and decreases your LDL or bad cholesterol levels.

Benefits of gastric bypass include:

• Better overall health with less serious illness such as heart disease, diabetes, sleep apnea, high cholesterol and high blood pressure
• Long, well-documented track record of success
• More rapid weight loss than with other surgical options
• No foreign objects, such as a lap band, are put into your body, so there is nothing to break or erode
• Up to 70% excess weight loss in the first year, with goal weight loss accomplished in the following three to six months

Roux-en-Y gastric bypass is available at:

• Good Samaritan Hospital (West Islip, NY)
• Mercy Hospital (Rockville Centre, NY)
• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

In single-incision laparoscopic surgery (SILS), your physician makes a small incision in your belly button to perform your surgery. Once inside your abdomen, your surgeon performs the same procedure used with traditional laparoscopic bariatric surgery. The difference is in the number of incisions made.

At Catholic Health, our bariatric surgeons use SILS to perform sleeve gastrectomy and adjustable gastric band procedures.

Benefits to SILS include:

• Almost unnoticeable scar in your belly button
• Faster recovery times
• Fewer complications than other types of bariatric surgeries
• Less pain during recovery
• Quicker return to normal activities

Single-incision laparoscopic surgery is available at:

• Good Samaritan Hospital (West Islip, NY)
• Mercy Hospital (Rockville Centre, NY)
• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

A sleeve gastrectomy is a restrictive procedure that reduces the amount of food you can eat. The procedure is typically performed laparoscopically at Catholic Health. Your surgeon makes five or six small incisions in your abdomen and uses them to insert a special video camera and long instruments to reduce your stomach’s size. During sleeve gastrectomy, up to 85% of your stomach is removed, including the portion that produces ghrelin, or the hunger hormone. The rest is used to form a tube with a pouch that holds a small amount of food. This allows you to eat less food while still feeling satisfied.

Benefits of sleeve gastrectomy include:

• Better overall health with less serious illness such as heart disease, diabetes, sleep apnea, high cholesterol and high blood pressure
• Fast recovery with few complications
• Less risk of vitamin deficiency since intestines remain unchanged and nutrient absorption is not reduced
• Stomach function remains normal
• Up to 70% excess weight loss in the first year following surgery
• Weight loss similar to gastric bypass surgery in less time

Sleeve gastrectomy is available at:

• Good Samaritan Hospital (West Islip, NY)
• Mercy Hospital (Rockville Centre, NY)
• St. Catherine of Siena Hospital (Smithtown, NY)
• St. Charles Hospital (Port Jefferson, NY)
• St. Francis Hospital & Heart Center® (Roslyn, NY)

Surgical options are offered at St. Charles Hospital (Port Jefferson, NY) and nonsurgical options are offered at St. Francis Hospital & Heart Center® (Roslyn, NY).

St. Charles Hospital

The hospital's bariatric program for adolescents was one of the first of its kind on Long Island. Patients have the option to consider laparoscopic sleeve gastrectomy to lose weight and maintain weight loss throughout their life.

Our multidisciplinary approach reviews nutritional needs, evaluates psychosocial support concerns and provides a comprehensive medical evaluation. Parents play a key supportive role in the process.

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Catholic Health's bariatric and weight loss surgery team are committed to delivering the highest level of care. Our team includes:

• Board-certified bariatric surgeons
• Internal medicine and family practice physicians
• Registered dietitians
• Registered nurses
• Bariatric coordinators
• Social workers
• Care managers
• Physical therapists
• Endoscopists
• Interventional radiologists

Catholic Health offers bariatric support groups supervised by a health care professional. The groups are free and open to anyone interested in learning more about bariatric surgery and whether it’s right for them. They provide education and support, both before and after surgery. Discussions span various topics from protein drinks and well-tolerated foods to exercise regimens and other lifestyle changes.

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Bariatric surgery is weight-loss surgery that limits the size of the stomach so an individual feels full quickly. As a result, less food is consumed and a patient loses weight. Additionally, the surgery also helps decrease the hunger hormone ghrelin, and in some cases, also limits the absorption of some of the calories that are eaten.

Obesity is multifactorial. There are many factors that contribute to why an individual is overweight, including behavioral, environmental and genetic.

The most common surgery currently is laparoscopic sleeve gastrectomy. It is performed through a minimally invasive technique with one to five very small quarter-inch incisions. The stomach is then stapled and divided to make it into a thin narrow tube—the shape of a sleeve. In some cases, we perform laparoscopic gastric bypass through five small incisions and create a stomach pouch about the size of an egg. A piece of small intestine is connected to this little pouch. The food eaten goes into this stomach pouch and directly into the intestines, bypassing most of the stomach and a portion of the small intestine.

Patients are monitored by a comprehensive team of surgeons, nutritionists and psychologists. They are on a soft diet for the first six weeks following surgery then they advance to a regular diet. They need to avoid heavy lifting for the first four to six weeks following surgery. Most are able to return to work a week after the procedure.

Patients need to eat slowly. They need to avoid drinking within 30 minutes of eating and stop eating when they feel full.

Exercise always plays an important role in weight loss. The more a patient exercises, the more calories are burned and the more successful the surgery.