A: Please call our clinic at 905-278-8000 or 1-888-278-7952 to make an appointment. We suggest you complete the current Patient Questionnaire and e-mail or fax it to the clinic or bring it with you to your consultation. You’re welcome to bring a family member or friend with you to your appointment.

For our Consultation Patient Questionnaire, click here.

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Q: Will I be able to see the port from outside the skin?

A: The port is not visible because it is anchored to the muscle below the skin and abdominal wall fat. The port will be placed in the centre of the abdomen somewhere between the umbilicus and lower end of the breastbone. If patients lose most of their excess weight they might see a little lump under the skin.

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Q: Will I need plastic surgery for the surplus skin when I have lost weight?

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Q: What can I eat and when?

A: Please refer to our “Living with the Lap-Band” for detailed instructions.

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Q: What types of foods should I avoid?

A: It is advisable to avoid nuts, soft breads and carbonated beverages. Many patients have trouble with white bread as well as rice and pasta unless it is cooked "el dente" (still firm in the centre) and then chewed well. Beef and pork have to be chewed well to pass across the band. Most other foods will pass without difficulty, but must be chewed well and eaten slowly.

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Q. How do I arrange a consultation?

A: Please call our clinic at 905-278-8000 or 1-888-278-7952 to make an appointment. We will need you to complete the Patient Questionnaire and e-mail or fax it to the clinic or bring it with you to your consultation. You’re welcome to bring a family member or friend with you to your appointment.
For our consultation Patient Questionnaire, click here

Q. What is the cost of a consultation?

A. There is no charge for a consultation with one of our surgeons. It will take place in the clinic for those who live nearby, while telephone consultations can be arranged for those who live further away.

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Q. Why should I choose the Surgical Weight Loss Centre?

A. Our Staff

We are the Canadian leader in weight loss procedures, offering Lap-Band surgery and the Gastric Balloon procedure
Performed more than 1,500 weight loss procedures and treat hundreds of new patients each year
Surgeons have all received advanced training in the evaluation, surgical treatment and post-operative care of Lap-Band and Gastric Balloon patients
Nurses have received Advanced patient care training and attend regular advanced training seminars
We have three surgeons and provide 24-hour coverage by pager for urgent and emergency concerns
Anaesthesia is provided by certified specialists in anesthesia who have extensive experience with morbidly obese patients
All surgeons have ACLS (Advanced Cardiac Life Support) training and remain at the clinic with patients until they are ready to be discharged from the clinic
Our surgeons have many years of experience in Advanced Laparoscopy
Our surgeons are on active staff at the Trillium Health Centre (which is located less than one mile from the clinic) and they have all served terms as Chief of Surgery or Chief of General Surgery

B. Our Facility

Advanced recovery facility and access to the availability of 24 hour nursing care for patients who require or request this service
Independent Health Facility license granted by the Ministry of Health in Ontario for provision of insured services
Regularly inspected by the Canadian Association for the Accreditation of Ambulatory Surgical Facilities
State of the art stand-alone surgical facility that meets or exceeds requirements of Ontario Building code for hospitals
Easily accessible from Pearson International airport in Toronto and close to major highways such as QEW and Hwy 427 in Mississauga
Our program operates in conjunction with The Plastic Surgery Clinic, which has been in operation for more than 20 years

C. Our Programs

Free pre-operative consultation, which is always with one of our three Lap-Band surgeons

Telephone consultations are available for long distance patients
All procedures are performed by a certified bariatric surgeon
Trained doctors and nurses in over 20 cities across Canada to help with post-op care and band adjustments
24-hour access to our surgeons for advice regarding medical concerns after Lap-Band surgery and Gastric Balloon procedures
Patient Coordinators to assist with your program and pre-operative planning
Ongoing follow-up with our Clinical Nurse Specialists in person, by telephone and by email
Access to a Registered Dietitian for nutrition and eating advice
Personalized, comprehensive counselling
The progress of all patients is recorded and monitored using our customized LapBase® database software
Post-operative advice on nutrition, physical activity and general health
Web-based educational seminars given by medical professionals
Online support forum giving patients the ability to interact with hundreds of other SWLC patients
Access to support groups across Canada
Annual SWLC Patient Symposium, which is a full day of presentations by leading bariatric experts and inspiring speakers and a time to socialize with SWLC staff and patients Complimentary plastic surgery and/or skin rejuvenation consultation with Dr. Frank Lista

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Q. Are the programs and procedures covered by OHIP, private insurance or other provincial health plans?

A. The Ontario Health Insurance Plan (OHIP) and most other provincial or regional health plans in Canada currently do not cover either the Lap-Band or Gastric Balloon procedures or our programs. Private insurance plans may, however, cover a portion of the cost of the Lap-Band procedure. We recommend that you check with your insurance company and review your policy and coverage.
For more information, click here.

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Q. How long is the wait for a procedure?

A. We can usually arrange for your procedure to take place within four to six weeks from the time of consultation. Alternate arrangements can be made when necessary.

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Q. Do I need a referral from my family doctor?

A. No, you do not need a referral from your family doctor. However, you will have to see your family doctor for a pre-op physical and routine blood tests prior to your procedure. We encourage your family doctor to participate in your weight loss program in conjunction with the staff at the Surgical Weight Loss Centre. After each visit, our surgeon will follow up with your doctor by sending a letter or by having a consultation.

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Q. Are there any health problems that can affect my eligibility for Lap-Band surgery or the Gastric Balloon procedure?

A. Your surgeon will discuss this with you. For patients with compromising health problems or previous major upper-abdominal surgery, the procedure may be performed at the Trillium Health Centre in Mississauga.

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The Lap-Band Program

Q. Is there an age limit for the Lap-Band surgery?

A. You should be at least 18 years of age. Those over the age of 65 will be considered on an individual basis.

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Q. Does the Lap-Band contain any latex?

A. No. It’s latex-free and safe to implant even for patients who suffer from an extreme latex allergy.

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Q: Is follow-up after the surgery important?

A: Follow-up is critical to successful weight loss with the Lap-Band. Most patients require a number of adjustments to the band to achieve the optimal level of restriction. We call this the "sweet-spot", and it is variable from patient to patient. The number of visits is unpredictable. Approximately 10% of patients are able to lose weight at the desired rate without any adjustments to the band at all. Special arrangements are available for out-of-province patients.

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Q: How is the Lap-Band adjusted?

A: The first adjustment is usually considered at approximately four weeks after the operation. By this time you may notice minimal restriction in eating solids and may have also noticed that your weight loss has slowed. We recommend that you continue to monitor hunger and weight loss to decide when it is time for another adjustment.

We ask at least three questions to decide if a patient needs a band adjustment:

Has the weight loss reached a plateau?
Are you feeling hungry after a small meal?
Are you able to eat more than you feel you should?

If the answer to these questions is yes, then it is likely time for an adjustment to the band. We ask that patients call the clinic and speak to one of our clinical nurse specialists to discuss whether they should come in for an appointment.

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Q: How much fluid should be added to the band during the adjustments?

A: Every patient is unique. The amount of fluid added at each visit is tailored to the patient and the size of the Lap-Band and must be closely monitored by the clinic staff.

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Q: For how many years can my Lap-Band be adjusted?

A: The Lap-Band has been in use for more than 15 years. There are people who have had similar types of bands for 20 years and still have their band adjusted.

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Q: Will I be able to see the port from outside the skin?

A: The port is not visible because it is anchored to the muscle below the skin and abdominal wall fat. The port will be placed in the centre of the abdomen, somewhere between the umbilicus and lower end of the breast bone. If patients lose most of their excess weight they might see a little lump under the skin.

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Q: Will I need plastic surgery for the surplus skin when I have lost weight?

A: Most patients will not need plastic surgery because of the gradual and steady weight loss obtained with Lap-Band. However if plastic surgery is desired it will not usually be considered for at least a year or two after the operation. Exercise and good nutrition are both important to help with skin elasticity. We recommend that patients give the skin the time it needs to adjust before deciding to have more surgery. The cost of subsequent plastic surgery is not covered in the cost of the Lap-Band surgery. Should you choose to consider cosmetic surgery, we will offer you a complimentary Plastic Surgery and/or Skin Rejuvenation consultation with Dr. Frank Lista. Dr. Frank Lista is the medical director and founder of the Plastic Surgery Clinic. The cost of subsequent plastic surgery is not covered in the cost of the Gastric Balloon Program.

For more information on plastic surgery, call 905-278-7077 from the Toronto area or toll free at 1-866-803-6515. Or visit the website at: www.theplasticsurgeryclinic.com

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Q: What can I eat and when?

A: Immediately after the operation, you can have sips of water or suck on ice cubes.

The day after the operation, you can take more fluids, but they should be mostly water. You should only take a small amount at a time. In addition to water, you may also consume liquids such as soup broth, clear juices and Jello.

All fluids are fine during the first week after surgery. We suggest that you consider continuing with the Optifast (that will have been prescribed pre-op) for a time after surgery. This will ensure adequate and complete nutrition while you learn to adapt to a new eating pattern. If preferred, you can choose another meal replacement liquid diet such as SlimFast in the post-op period.

Liquids that are recommended for the first week are:

Clear broth or soup (without vegetables or meat and not creamy)
Low-fat yogurt
Milk (preferably skim)
Jello
Clear fruit juices or puréed soft fruit

Based on your adjustment period and guidelines, you will be transitioned from liquids to puréed foods, to soft foods and eventually to solid foods by about week four.

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Q: What types of foods should I avoid?

A: It is advisable to avoid nuts, soft breads and carbonated beverages. Many patients have trouble with white bread as well as rice and pasta unless it is cooked al dente (still firm in the centre) and then chewed well. Beef and pork have to be chewed well to pass across the band. Most other foods will pass without difficulty, but must be chewed well and eaten slowly.

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Q: What if I go out to eat?

A: We recommend that you order a small amount of food and eat it slowly. That way you will finish at the same time as your dining companions. We suggest that you might want to let your host or hostess know in advance that you will be eating small portions.

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Q: What about alcohol?

A: Alcohol is a concentrated form of calories. Therefore, it should be avoided as much as possible. A single serving of alcohol (beer or glass of wine) occasionally is acceptable. Alcohol can also irritate the lining of the stomach leading to discomfort.

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Q: How much weight will I lose?

A: Studies show that, on average, Lap-Band patients will sustain weight loss of 60% to 70% of their excess weight (Obes Surg, 2003). Results will vary due to numerous factors including the level of activity, age and metabolism and the calories consumed. You need to be committed to a new lifestyle and eating habits. We expect that weight loss will be at a safe and healthy rate of one to two pounds per week. Many patients will find that their weight loss will plateau from time to time. This is usually an indication that a band adjustment may be necessary. (See above). 12 to 18 months after the operation, the rate of weight loss usually slows down.

Studies show that the weight loss achieved with the Lap-Band is sustained. It is very unusual to regain weight unless the band is not adjusted through follow-up visits or patients choose to consume large amounts of high-calorie liquids such as chocolate, ice cream, alcohol or fruit juice.

Many patients will lose more than 70% of their excess body weight, but this generally requires a commitment to exercise and adjusting to the eating and lifestyle changes of the Lap-Band. The Lap-Band is a tool to help you successfully achieve sustained weight loss.
Losing weight too fast creates health risks and can lead to a number of problems. Rapid weight loss can lead to a loss of muscle mass, which can make you weak, and fatigue quickly. The safe, gradual rate of weight loss with Lap-Band surgery allows the body to reduce fat without affecting muscle mass. The goal is to have a weight loss that prevents, improves, or resolves the health problems connected with obesity.

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Q: Will I suffer from constipation?

A: Constipation is uncommon after Lap-Band surgery. There may be some reduction in the volume of your stools, which is normal after a decrease in food intake, because patients eat less fiber. It is recommended that patients eat lots of fresh vegetables and salads to keep your fibre intake adequate.

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Q: What are the physical limitations after surgery?

A: It is recommended that you start walking up to 30 minutes per day as soon as you are able. Very strenuous exercise is not recommended until after 4-6 weeks post-op. You should not lift more than 10-15 pounds for at least two weeks. Depending on the physical requirements of their job, patients can usually return to work within a week after your surgery. Water-based exercise programs are an excellent way to introduce a fitness program. It is safe to drive a car a few days after surgery, unless travelling a long distance or taking narcotic pain medication

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Q: How long after surgery can I begin swimming or sit in a bathtub or hot tub?

A: You should keep the incisions dry for the first two days. We recommend that patients wait at least 4 weeks before sitting in a bathtub or hot tub and 3 weeks before swimming again to reduce the risk of infection. Showering is fine two days after surgery and patients can wash normally with soap and water.

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Q: Will I have pain after surgery?

A: During the first 24 hours, Lap-Band patients may feel some discomfort in the shoulder and chest. This is "gas pain" and is due to the residual gas in the abdominal cavity after the surgery. The sooner patients become mobile and walk, the faster the gas pain will go away. You may also feel a bit of stinging around the incisions, but this should be easily controlled with the prescribed pain medication. If it is felt that the pain is excessive, or if you develop a fever, we recommend that you contact the clinic or family doctor as soon as possible.

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Q: What is a hiatus hernia and will this be repaired at the time of surgery if I have one?

A: A hiatus hernia is a weakness or defect in the diaphragm muscle at the site where the esophagus joins the stomach. If you are known to have a hiatus hernia, or if one is detected at the time of surgery, it will be repaired by the surgeon at the time of the Lap-Band surgery. This is done to ensure that the Lap-Band is placed in the correct position on the upper stomach. It will also reduce the chance of heartburn and slippage after surgery as the band is adjusted or tightened. Many patients who have heartburn prior to Lap-Band surgery will find that their heartburn is resolved and they no longer need medication after surgery. There is no extra charge if a hiatus hernia is detected and repaired.

We find that many of our patients will have either a minor or major repair of a hiatus hernia at the time of surgery. This can lead to shoulder discomfort that may last a few days, but it will resolve. The benefits of the hiatus hernia repair will be sustained and will minimize future potential problems.

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Q: Should I expect to have any oozing or bleeding from my incision sites?

A: There may be some oozing or bleeding from the port site. This should stop within 24 hours. If you are concerned about the incisions, we recommend that you contact the clinic. The bandages (Steri-strips) placed over your incision will usually fall off within seven to ten days.

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Q: What if I develop an infection at the port site?

A: If you believe there may be an infection at any of the incision sites, we recommend that you contact the clinic or go to your Family Doctor as soon as possible. This may need treatment with antibiotics.

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Q: How much swelling or bruising should be expected after surgery?

A: There is usually mild swelling on the port site, and minimal swelling on the other incisions. This should subside after a week or two. There can be some bruising on the incision sites although it is more common on the port site. It is helpful if swelling occurs to apply a cloth soaked in warm water for 20 minutes several times a day. If it does not improve, please contact the clinic.

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Q: Will I feel nausea after the operation?

A: The Lap-Band limits food intake in a patient-friendly way. If you feel nauseated on a regular basis, it may mean you are not chewing your food well. It could also mean you are not following the eating guidelines properly. It is also possible there could be a problem with the placement of the band. If you are concerned, you should contact the clinic. Vomiting should be avoided as much as possible. It can cause the small stomach pouch to stretch and could lead to slippage of part of the stomach through the band.

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Q: How do I take medications after surgery?

A: Most prescription medications can be taken, but will need to be crushed or opened (if capsules) for the first three to four days after surgery. It may be possible to find liquid or chewable forms of your medications. Contact the pharmacist, family doctor or our clinic if there are questions about any medications before or after the surgery.

It is recommended that big tablets be crushed or split in half so that they do not get stuck in the band opening. This should be discussed with the doctor who prescribed the medication to ensure that it is safe to crush the medication in question.

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Q: What medications should not be taken before or after the surgery?

A: Some medications can irritate the stomach and cause gastritis. The most common drugs known to be associated with gastritis are Aspirin and non-steroidal anti-inflammatory medications that are used to treat arthritis. These medications should be avoided two weeks prior and two weeks after the surgery. Please discuss these medications with your family physician or our clinic staff.

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Q: What if I take medication for diabetes?

A: Medications taken to treat diabetes should be used cautiously in the immediate post-operative period because the intake of calories will be much lower. You should also be careful during the pre-operative period when you are taking the prescribed VLCD (very low calorie diet) meal replacement. Regular monitoring of blood sugar levels will help guide the need for these medications. These medications should be discussed with the clinic and/or your family doctor.

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Q: Will I need to take vitamin supplements?

A: We recommend that you take a chewable multivitamin daily after surgery and this should be continued unless recommended otherwise. Other supplements may be recommended by the family physician specific to other medical conditions. Women who are planning pregnancy should take other extra folate (800mcg/day) or a special prenatal vitamin preparation.

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Q: Are there concerns regarding pregnancy?

A: For women, fertility may be improved with weight loss because menstrual cycles may become more regular. Studies have shown that the Lap-Band is very safe for both mother and baby during pregnancy. Babies born to mothers who have had Lap-Band surgery are usually normal weight at birth. This is in contrast to the risk of low-birth weight or malnourished babies after gastric bypass or other malabsorptive weight loss surgery.

If patients require more calories while pregnant, the band can be loosened by removing fluid from the reservoir. After the pregnancy, the band can be adjusted so that the patient can go back to losing weight.

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Q: What can happen if I begin eating solids too soon after surgery?

A: This may cause vomiting or distension of the upper stomach pouch. Although it is rare, patients can develop slippage of the band if they have excessive vomiting, especially early after the surgery.

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Q: What is Lap-Band "slippage"?

A: Slippage occurs when the Lap-Band moves down the stomach so that the pouch above the band is larger than it should be. This allows more food to be consumed and weight loss may slow. As well, patients may notice regurgitation of food or heartburn at night when they lay down.

Slippage of the band is rare and occurs in approximately 2% to 3% of patients. It can present with acute symptoms of abdominal pain, difficulty eating solid food, or as a failure to lose weight. The acute symptoms are pain, bloating and possibly vomiting. Patients with Lap-Band slippage may experience some difficulty in swallowing liquids and solids. If slippage of the band is suspected, it can be diagnosed with a barium study of the stomach or endoscopy. Slippage can usually be repaired with a laparoscopic procedure and only rarely is it necessary to remove the Lap-Band. If a patient develops Lap-Band slippage there is no additional charge to repair or replace the Lap-Band.

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Q: What is Lap-Band erosion?

A: Lap-Band erosion occurs when the band slowly works its way through the stomach wall and is no longer outside the stomach. Due to changes in the surgical technique used to implant the band, this complication now occurs in fewer than 1 in 1,000 patients. Erosion may present as infection in the abdominal wall near the port and is rarely an emergency. If erosion occurs, the Lap-Band will need to be replaced, usually with a laparoscopic procedure. There is no extra charge for repair or replacement of the band if Lap-Band erosion occurs.

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Q: Can the band be removed?

A: Although the Lap-Band is meant to be a permanent implant, it can be removed if necessary. This may be required due to complications such as slippage or erosion. Usually the Lap-Band can be removed laparoscopically. The stomach returns to its original shape once the band is removed. Studies show that if the Lap-Band is removed patients are at risk of regaining any weight that has been lost. There will be an additional charge to the patient if they request that the Lap-Band be removed in the absence of a medical indication to do so.

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Q: Do I need to take any precautions if I need other surgeries and I have a Lap-Band?

A: If you have had the Lap-Band surgery and you require another unrelated surgical procedure, it is very important that you contact the staff at SWLC. Depending on the nature of the operation and the type of anesthetic, you may need to have fluid removed (de-fill) from your Lap-Band. This is important to minimize potential problems with vomiting after the operation which could increase the risk of slippage of the Lap-Band. Not all operations require a de-fill, but it is important to let the clinic know and we will advise you accordingly.

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Gastric Balloon

Q. Are there any people who shouldn’t consider the gastric balloon?

A. The gastric balloon system is NOT right for you if:

You have a BMI of less than 27.
You are pregnant or breast-feeding
You have had previous gastric surgery, or any of the following conditions:

A history of gastrointestinal motility disorders
Uncontrolled eating disorders, such as bulimia
Any inflammatory disease of the gastrointestinal tract
Potential upper-gastrointestinal bleeding conditions
A large hiatal hernia (larger than 5 cm)
A structural abnormality in the esophagus or pharynx, such as a stricture or diverticulum
You are addicted to drugs or alcohol
You are unwilling to participate in an established, medically supervised diet and behaviour modification programs
You are taking chronic, high doses of aspirin, anti-inflammatory agents, anticoagulants, or other gastric irritants.

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Q. Do I need to follow a special diet in the weeks immediately following the procedure?

A. Yes. You will be restricted to a liquid diet for the first three days following the procedure. After a few days on a liquid diet, you will be ready to begin the transition to semi-solids such as porridge, thicker soups and fruit purées. You will begin solid food after approximately one week. How quickly you make this transition will depend on your progress and how well your body is tolerating the liquids. It is important to make the transition slowly, and to try not to rush the adjustment process.

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Q. How does weight loss with the Gastric Balloon compare to diet programs?

A. You can expect to lose more weight with the balloon than with traditional diets. The balloon gives you a feeling of satiety and thus you are better able to control your eating, allowing you to make healthy changes in your habits.

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Q. Can I eat anything I want? Are there any food restrictions?

A. The balloon will give you a feeling of satiety or fullness so you will not feel like eating as much as you used to. Overeating while the balloon is in place can be dangerous and result in severe vomiting.

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Q. Can I drink alcohol?

A. Alcohol in moderation is acceptable but keep in mind that it is calories without nutrition.

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Q. Do I have to participate in the follow-up to be successful?

A. Yes. The balloon is not a miracle, but rather a tool to help change your lifestyle. Taking part in our program will give you the education and support to change your lifestyle and eating habits and give you a better chance for long-term success. Follow-up can be done in person or by telephone with our dietitian, nurses and surgeons.

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Q. Can the balloon be punctured once it is inside me?

A. This is very unlikely. The balloon is constructed of a high-quality silicone elastomer, which makes it resistant to gastric acidity and sharp pieces of food.

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Q. What happens if the balloon leaks?

A. This is a very rare event but if the balloon should spontaneously deflate, you may no longer have a feeling of satiety and the physical sensation of the balloon will disappear. If you suspect this may be the case, notify the clinic as soon as possible. A simple abdominal X-ray can determine whether either has occurred. We will arrange for the deflated balloon to be removed with a gastroscopic procedure similar to how the balloon was inserted. The surgeon will place a coloured dye inside the balloon in order to help patients clearly identify early deflation by a change in the colour of their urine.

Q. Can the Gastric Balloon be left in longer than six months?

A. Longer periods of use than six months are not recommended because the acidic content of your stomach can weaken the balloon material and cause the balloon to deflate. Should your surgeon recommend use of the balloon for longer than six months, it must be replaced with a new balloon at the end of the six-month period.

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Q: Will I need plastic surgery for the surplus skin when I have lost weight?

A: Since the Gastric Balloon does not cause malabsorption of nutrients and the weight loss is at a healthy rate, most patients will not need plastic surgery. However, should you choose to consider cosmetic surgery, we will offer you a complimentary Plastic Surgery and/or Skin Rejuvenation consultation with Dr. Frank Lista. Dr. Frank Lista is the medical director and founder of the Plastic Surgery Clinic. Exercise and good nutrition are both important to help with skin elasticity. We recommend that patients give the skin the time it needs to adjust before deciding to have more surgery. The cost of subsequent plastic surgery is not covered in the cost of the Gastric Balloon Program.

For more information, call 905-278-7077 from the Toronto area or toll free at 1-866-803-6515. Or visit the website at: www.theplasticsurgeryclinic.com

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General

Q. What are my non-surgical weight loss options?

A. Non-surgical methods of losing weight, other than the Gastric Balloon, include diets, exercise and/or medications that work to decrease appetite and/or reduce fat absorption. Unlike the Gastric Balloon, these options do not address the hunger associated with dieting, and suffer from very high dropout and failure rates. In fact, studies show that non-surgical methods have not been effective in achieving long-term weight loss in obese adults.

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Q. Are there other operative weight loss options?

A. Yes. There are 3 categories of obesity surgical treatment:

Restrictive – reduces the amount of food the stomach can hold but doesn’t interfere with normal digestion of food and nutrients.

Malabsorptive – shortens the digestive tract to limit the number of calories and nutrients than can be absorbed.
Combination – restricts the amount of food the stomach can hold and reduces the number of calories absorbed by altering the digestive tract.

Laparoscopic Gastric Banding (LAGB or Lap-Band procedure)

The Laparoscopic adjustable gastric banding procedure restricts the amount of food the stomach can hold by placing an inflatable silicone band around the upper part of the stomach. The new, small upper stomach pouch limits the amount of food that can be consumed at one time and a narrowed stomach outlet increases the time it takes for the stomach to empty. The subsequent reduction in food intake results in weight loss.

Advantages

Lowest mortality rate
Least invasive surgical approach
No stomach stapling or cutting or intestinal re-routing
Adjustable
Reversible
Lowest operative complication rate
Low malnutrition risk

Disadvantages

Slower initial weight loss than Gastric Bypass or BPD
Regular follow-up critical for optimal results
Requires an implanted medical device
In some cases, effectiveness can be reduced due to band slippage
In some cases, the access port may leak and require minor revisional surgery

This surgery is offered at the Surgical Weight Loss Centre. Click here for more information.

Biliopancreatic Diversion (BPD)

Biliopancreatic Diversion (BPD) is a malabsorptive procedure and is a more extreme alteration of the digestive process. Roughly three-fourths of the stomach is removed and the stomach pouch is connected to the final segment of the small intestine. By diverting food through this new "limb," the nutrients are separated from the bile and pancreatic enzymes that would break them down.

As a result, BPD greatly reduces nutrient absorption and caloric intake.

Advantages

Greatest amount of initial weight loss due to the high levels of malabsorption
Allows larger meals because of larger stomach pouch
Higher total average weight loss reported than with VBG, Gastric Bypass or Lap-Band

Disadvantages

Requires cutting and stapling of stomach and bowel
More operative complications than with Lap-Band, VBG or Gastric Bypass
Portion of digestive tract is bypassed, reducing absorption of essential nutrients
Requires lifelong monitoring for protein malnutrition, anemia and bone disease
Increased risk of intestinal irritation and ulcers
Non-adjustable
Extremely difficult to reverse
“Dumping syndrome” can occur
Highest mortality rate as compared to other procedures

This surgery is not offered at the Surgical Weight Loss Centre.

Gastric Bypass

Gastric Bypass (also known as the Roux-en-Y) is a combination procedure using both restrictive and malabsorptive elements. With this surgery, first the stomach is stapled to make a smaller pouch. Then most of the stomach and part of the intestines are bypassed by attaching (usually stapling) a part of the intestine to the small stomach pouch. The result is that you cannot eat as much and you absorb fewer nutrients and calories.

Advantages

Rapid initial weight loss
Minimally invasive approach is possible
Higher total average weight loss reported than with Lap-Band or VBG

Disadvantages

Cutting and stapling of stomach and bowel are required
More operative complications than with Lap-Band
Portion of digestive tract is bypassed, reducing absorption of essential nutrients
Medical complications due to nutritional deficiencies
“Dumping syndrome” can occur
Non-adjustable
Extremely difficult to reverse
Higher mortality rate than Lap-Band or VBG procedures

This surgery is not offered at the Surgical Weight Loss Centre.

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