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Selecting a Procedure

June 21, 2019

One of the most common questions I get from patients is: “which operation should I have?” That is actually one of the tougher questions to answer. There’s no one right answer for everybody, but there are guidelines that we go by and suggestions that we may give the patient. For instance, if somebody has fairly significant type 2 diabetes or they have horrendous heartburn and reflux, we may suggest the gastric bypass to them. Why? Because the gastric bypass is the most effective operation in treating type 2 diabetes and it is also an anti-reflux operation and usually cures an individual of their heartburn and reflux. On the other hand, if a patient has a strong family history of stomach cancer, let’s say that their mother or their father or their brother or some other relative has had stomach cancer and they are at an increased risk of that, we may suggest performing a sleeve gastrectomy because we are removing 85% of that patient’s stomach and that in turn reduces their risk of getting stomach cancer. It is also much easier to monitor a patient that has had a sleeve gastrectomy for screening with an upper endoscopy to check and see if they do have stomach cancer. With the lap band, that is generally a choice that the patient makes. Lap bands are the safest operation when it comes to the weight loss operations and it is also reversible. Because of that fact, patients often select the lap band because of those features. However, it’s important to note that the lap band does result in the least amount of weight loss when compared to the sleeve gastrectomy and the gastric bypass. When considering weight loss surgery, it’s important to have a lengthy discussion with your weight loss surgeon to decide which operation fits you best.

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