Procedures

Sleeve Gastrectomy Procedure
Price: $9,100 USD

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Unlike the lap band procedure, the sleeve gastrectomy does not require the implantation of an artificial device inside the abdomen.

This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part

of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1- 5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving 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.

The sleeve gastrectomy has a number of advantages
over other bariatric procedures:

•    It does not require disconnecting or reconnecting the intestines
•    It is a minimally invasive procedure that is technically simpler than the gastric
     bypass or the duodenal switch
•    The degree of weight loss is greater and more rapid than a gastric band procedure
     (similar to the gastric bypass)
•    Does not require periodic maintenance such as tightening and refills as in the case of
     the gastric band.
•    It may be a safer operation for patients with a body mass index (BMI) more than 60.

Lap band Surgery (at present it is $9,400, however we may be able to lower it below 9k pretty soon)

Procedure Overview

Before Surgery:
You will undergo an extensive work-up to determine whether this operation is indicated and safe in your case. The preoperative screening will consist of complete blood tests, imaging studies, a gastroscopy and consultations with various specialists.

The Operation:
The idea behind the operation is to create a small pouch in the upper part of the stomach with a controlled and adjustable stoma, without stapling, thus limiting food intake.

A gastric band device is introduced through tiny (1cm) incisions in the abdomen and is placed around the upper part of the stomach. The resulting pouch (or the "new stomach") dramatically reduces the functional capacity of the stomach. The band has a balloon from the inside that is adjustable and can reduce stoma size, thus prolonging the period of fullness.

The operation is performed under general anesthesia and can last between 30 minutes and 1 hour. The Band is fitted around the uppermost part of the stomach, forming a 15cc small pouch. It is designed so that it can be inflated or deflated at any time after the operation. This helps the patient continually lose weight until they reach their goals. The restriction takes place in the radiology suite and normally takes 15 minutes. This simple procedure is painless. They inject saline into a port placed under the skin in the wall of the stomach. The tube that comes off of the band leads to the port.

Advantages of gastric banding:
-No cutting of the stomach
- No stapling of the stomach
- Calibrated pouch and stoma size
- Can be adjusted to patient's needs after surgery with no operation to adjust the stoma
- Laparoscopic removal possible
- Fully reversible
- Short hospital stay (does not exceed 48 hours)

Gastric Bypass Surgery
$11,500 USD

Gastric bypass surgery, a type of bariatric surgery (weight loss surgery), is a surgical procedure that alters the process of digestion. Bariatric surgery is the only option today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise, and medication have failed.

There are several types of gastric bypass procedures, but all of them involve bypassing part of the small bowel by greater or lesser degrees. For this reason, procedures of this type are referred to as malabsorptive procedures, because they involve bypassing a portion of the small intestine that absorbs nutrients.

Some of these procedures also involve stapling the stomach to create a small pouch that serves as the “new” stomach or surgically removing part of the stomach.

Although a gastric bypass procedure is malabsorptive, it may also be restrictive because the size of the stomach is reduced so that the amount of food that can be eaten is “restricted” due to the smaller stomach. While malabsorptive procedures are more effective in causing excess weight to be lost than procedures that are solely restrictive, they also carry more risk for nutritional deficiencies.

Roux-en-Y gastric bypass, the most commonly performed bariatric procedure, is both malabsorptive and restrictive. This surgery can result in two-thirds of extra weight loss within two years. The procedure involves stapling the stomach to create a small pouch that holds less food and then shaping a portion of the small intestine into a “Y”. The “Y” portion of intestine is then connected to the stomach pouch so that when food is being digested it travels directly into the lower part of the small intestine, bypassing the first part of the small intestine (called the duodenum) and the first part of the second section of the small intestine (called the jejunum). The effect of bypassing these sections of the intestine is to restrict the amount of calories and nutrients that are absorbed into the body.

Potential candidates for bariatric surgery include:
•    persons with a Body Mass Index (BMI) greater than 40
•    men who are 100 pounds over their ideal body weight or women who are 80 pounds
     over their ideal body weight
•    persons with a BMI between 35 and 40 who have another condition such as
     obesity-related type 2 diabetes, sleep apnea, or heart disease

As with any surgical procedure, complications may occur. Some possible complications include, but are not limited to, the following:

•    infection
•    blood clots
•    pneumonia
•    bleeding ulcer
•    development of gallstones
•    Please note that these surgery prices include hospital costs, doctor fees,
     pre-operative exams, airport pick-up/drop-off and transfers to and from the hospital
     and the patient's hotel (lodging is not included in the price).
•    The hospital also provides nursing assistance for the patient once he or she returns
     to the hotel.