For more information on Laparoscopic Roux-En-Y Gastric Bypass - LRYGB or sleeve gastrectomy, please contact our practice serving New Jersey, New York, Connecticut, and beyond.
Center for Bariatric Surgical Specialties
at Syosset Hospital, the Center for Surgical Specialties, part of the North Shore-LIJ Health System.
221 Jericho Turnpike
Syosset, NY 11791
(516) 714-5431
Laparoscopic Sleeve Gastrectomy, Gastric Bypass, and More at Our New York Practice
Laparoscopic sleeve gastrectomy and gastric bypass surgery are just two of the many procedures our physicians provide to residents of the New York, New Jersey, and Connecticut area. In addition to LAP-BAND® System surgery for patients who are morbidly obese, Dr. Alan Geiss and Dr. Colin Powers can use innovative laparoscopic surgery techniques to treat patients with gallstones and other conditions.
Laparoscopic Gallbladder Surgery
The gallbladder is a pear-shaped organ located under the liver. Its function is to store bile, aiding in fatty food digestion. Sometimes, the amount of bile and other chemicals inside the gallbladder becomes imbalanced, leading the chemicals to take a solid form (gallstones). Gallstones can irritate the wall of the gallbladder or be "silent" and cause no symptoms. However, they can also travel to the cystic duct and block it, causing upper abdominal pain, heartburn, back pain, nausea, and vomiting. When this occurs, the gallbladder will become infected and lead to more problems. Also, if a gallstone gets stuck in the common bile duct, or has trouble passing through, it causes pain and conditions such as jaundice, pancreatitis, or cholangitis.
Laparoscopic gallbladder surgery at our New Jersey, New York, and Connecticut-area practice can repair or remove the gallbladder with state-of-the-art medical techniques. A tiny camera is inserted through small incisions so that our physician can visualize the area and then conduct the procedure with long, narrow instruments. If the gallbladder must be removed, it is brought through a small incision in the navel. The entire surgery lasts about an hour, and patients typically go home the same day.
Laparoscopic Roux-En-Y Gastric Bypass - LRYGB
In the laparoscopic Roux-en-Y gastric bypass (LRYGB), the surgeon creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely divided and stapled shut from the stomach pouch. The outlet from this new stomach pouch empties directly into the lower portion of the small intestine (jejunum), thus bypassing the gastric enzymes and caloric absorption. The operation restricts food intake very effectively, especially in the first year. This is the time of maximum weight loss. Ultimately, a patient with a LRYGB will be able to eat about a cup of food per meal three times a day, experiencing satisfaction and fullness from this amount of food while losing weight. Hunger is controlled, particularly if the patient is compliant with the diet. The average expected weight loss with the LRYGB procedure is around 70% of excess weight. Most patients have at least improvement , if not resolution of their weight-related medical problems. The changes in the patient’s digestive system are permanent and will affect their eating habits for the rest of their life.
Laparoscopic Sleeve Gastrectomy - LSG
The laparoscopic sleeve gastrectomy (LSG), also known as gastric sleeve or vertical gastric sleeve, is a restrictive bariatric surgery, which generates weight loss by restricting the amount of food and calories that can be eaten by removing 80 to 90% of the stomach without bypassing the small intestines. During this procedure the surgeon, rather than creating a pouch, creates a small sleeve-shaped stomach by removing the majority of the stomach. What is left is larger than the stomach pouch created during a Roux-en-Y gastric bypass, and is about the size of a banana.
The removed section of the stomach is actually the portion that “stretches” the most in other bariatric procedures. The long sleeve or “tube” shaped stomach that remains is the portion least likely to expand over time and it creates resistance to volumes of food. In addition, the nerves to the stomach and the outlet valve (pylorus) remain intact and therefore preserve the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. Ultimately a sleeve gastrectomy patient will be able to eat about a cup to two of food per meal three times a day, experiencing satisfaction and fullness from that amount of food while losing weight. Hunger is controlled, particularly if patient is compliant. The average expected weight loss with the LSG in the first year is about 45% to 55% of the excess body weight.
Revision of Roux-en-Y Gastric Bypass - ROSE
ROSE, which stands for Restorative Obesity Surgery, Endolumenal, is a new, safer, incisionless, gastric bypass revision. It is not a primary method of weight loss surgery, but a procedure that is specifically designed for gastric bypass patients with weight regain.
The ROSE procedure is indicated for gastric bypass patients who were initially successful in losing the excess weight but are now regaining some of the lost weight because the stomach and stoma have stretched out and no longer effectively control hunger and food intake. After an initial screening, you will undergo a series of evaluations including nutritional and dietary counseling, a full medical exam, and endoscopy to determine if you are a good candidate.
Why is the ROSE procedure performed?
The purpose of the ROSE procedure is to reduce the size of the stomach and stoma to recreate the restriction of the original gastric bypass.
Most gastric bypass patients are able to lose a significant amount of excess weight following surgery and keep it off long-term. While slight weight regain after the first 18 to 24 months is common, some patients gain back more weight than desired.
In many cases of failed gastric bypass, weight regain is due to the stomach pouch and stomach outlet (stoma) stretching out over time. Stretching often occurs from poor portion control. When the stomach and stoma become enlarged, they no longer effectively restrict food intake or reduce hunger sensations.
Additional Laparoscopic Procedures
In addition to treatments designed to facilitate weight loss, Dr. Alan Geiss and Dr. Powers also perform a number of other laparoscopic surgery procedures for New York, New Jersey, and Connecticut-area patients. These include:
- Gastric resections
- Large and small bowel resection
- Diagnostic exploration
- Appendectomies
- Correction of paraesophageal hernias
- Excision of intra-abdominal and retroperitoneal adenopathy
- Splenectomies
Our experienced physicians and staff offer a comprehensive array of treatments for a range of conditions. We aim to help patients with minimally-invasive procedures geared toward quick recovery time and as little pain and discomfort as possible.