Programs and Services
Weight Loss Surgery
The Weight Management Center at University Hospital (WMCUH) provides three distinct weight loss surgical procedures. Our dedicated team will guide you in making an informed choice that aligns with your health and lifestyle needs. These procedures comprise:
Gastric Sleeve
The gastric sleeve, or sleeve gastrectomy, is the most common operation in the United States and provides durable, long term weight loss. It is also one of the safest operations.
How Laparoscopic Sleeve Gastrectomy Works
Using a laparoscope, the surgeon removes approximately 60 percent of the stomach. Weight loss occurs because the remaining size of the stomach restricts the amount of food that a person can eat. (This procedure may be the first part of a two-stage operation.)
Early reports indicate that it is safe and effective in reducing weight and decreasing obesity-related medical conditions, such as diabetes and high blood pressure. Since no long-term data on the safety and effectiveness of the procedure exist, the Expert Panel* considers it investigational, but it may be considered if other weight loss surgery options are ruled out.
Potential Risks
When looking at the risks associated with weight loss surgery, it is important to remember that obesity itself carries a high risk of mortality due to obesity-related illnesses. For many patients, the potential risks from not having the surgery may be greater than the risks from possible complications of having the procedure.
*Information provided by the Massachusetts Expert Panel on Weight Loss Surgery Summary from the Betsy Lehman Center for Patient Safety and Medical Error Reduction within the Department of Public Health.
Gastric bypass
Gastric bypass surgery, also known as Roux-en-Y gastric bypass (RYGB), may be preferrable in heavier patients with diabetes and reflux. RYGB is surgical procedure that involves making changes to the digestive system to promote weight loss. There are two surgical approaches for this procedure
Open RYGB or Laparoscopic RYGB
In a traditional or “open” RYGB, a large incision is made into the abdomen in order to perform the surgery. When the laparoscopic technique is utilized, several small incisions are made in the abdomen. A laparoscope connected to a video camera is inserted through the incisions. The physician is then able to perform the procedure assisted by viewing the internal organs on a television monitor.
How RNY Gastric Bypass Works
In both open and laparoscopic Roux-en-Y bypass surgery, the stomach is divided, creating a small pouch, which is closed by several rows of staples. The remaining portion of the stomach is not removed but is “bypassed” and plays a diminished role in the digestive process. A Y-shaped portion of the small intestine is then attached to the pouch. The volume the pouch is capable of holding is approximately one ounce. Weight loss occurs as a result of reduction of calories, alteration in gut appetite hormones, and decreased nutrient absorption.
Benefits of RNY Gastric Bypass
The Roux-en-Y gastric bypass is considered the “gold standard” for weight loss surgery. Proven benefits identified with both the open and laparoscopic technique include:
- Significant weight loss
- Improvement in obesity-related health problems (including cardiovascular disease, hypertension and type 2 diabetes)
- Reduction in patient mortality
Compared to an open procedure, when the laparoscopic approach is utilized, the post-operative recovery is shorter, and the patient is less likely to develop certain complications (such as hernia). However, laparoscopic surgery is technically more complex, and it is extremely important that highly trained, qualified laparoscopic weight loss surgeons perform the procedure.
Potential Risks
As with all surgical procedures, there are some risks associated with bariatric surgery. Complications, which may occur with the Roux-en-Y gastric bypass, include:
- Stomal obstruction (5 – 15 percent of patients)
- Postoperative bleeding (1 – 5 percent of patients)
- Small bowel obstruction (1 – 3 percent of patients)
- Gastrointestinal leak (1 – 3 percent of patients)
- Deep vein thrombosis (1 – 2 percent of patients)
- Splenectomy (1 percent of patients)
- Pulmonary embolus (0.5 percent of patients)
- Death within 30 days (0.5 – 1 percent of patients)
- Protein-calorie malnutrition (< 1 percent of patients)
Information provided by the Massachusetts Expert Panel on Weight Loss Surgery Summary from the Betsy Lehman Center for Patient Safety and Medical Error Reduction within the Department of Public Health.
LAP-BAND®
The laparoscopic adjustable gastric band (LAGB or LAP band) procedure has been performed in the United States since 2001.
How LAP Band Works
During a LAP band procedure, several small incisions are made in the patient’s abdomen, and using a laparoscope for guidance, the surgeon places an adjustable band around the upper portion of the stomach.
The band is connected to a reservoir, which the surgeon can tighten or loosen. Weight loss occurs because the newly created upper pouch will only allow the patient to consume small amounts of food at a time.
LAP band has been shown to produce short-term weight loss. Since the procedure has only been available since 2001, the effect on long-term weight loss will continue to be monitored. This procedure is less invasive, fewer complications are seen, and patients experience an improvement in obesity-related health issues. The surgeon and the patient will determine the type of weight loss surgical procedure that is suitable for everyone.
Potential Risks
Complications that may occur with LAGB surgery include:
- Slippage of the band (2 – 3 percent of patients)
- Band erosion (1 percent of patients)
- Port infection (1 percent of patients)
- Injury to adjacent organs (0.5 percent of patients)
- Death within 30 days (< 0.5 percent of patients)
When looking at the risks associated with weight loss surgery, it is important to remember that obesity itself carries a high risk of mortality due to obesity-related illnesses. For many patients, the potential risks from not having the surgery may be greater than the risks from possible complications of having the procedure.
Information provided by the Massachusetts Expert Panel on Weight Loss Surgery Summary from the Betsy Lehman Center for Patient Safety and Medical Error Reduction within the Department of Public Health.
Robotic Surgery
Robotic surgery, also known as robot-assisted surgery, is a type of minimally invasive surgical procedure where a surgeon uses a robotic system to perform surgery with enhanced precision and control. Unlike traditional open surgery that involves large incisions, robotic surgery uses small incisions and advanced technology to assist the surgeon in performing complex procedures.
