Why Choose Weight Loss Surgery?
Weight loss surgery serves as a great option for individuals who have struggled with obesity for many years, particularly those with a Body Mass Index (BMI) of 35 or higher. If conventional weight loss approaches have yielded limited long-term success, surgical solutions can serve as a helpful pathway toward achieving substantial and lasting weight loss.
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Surgery is suitable for individuals who face challenges in managing their weight through traditional diet and exercise alone. If you've struggled to attain a healthier BMI, weight loss surgery offers a comprehensive life-altering solution.
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Are You a Candidate for Weight Loss Surgery?
Surgical Options
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Gastric Bypass
Gastric Bypass is hailed as the gold standard in obesity surgery, offering long-term weight control. It achieves weight loss through two methods: restricting food intake volume and modest malabsorption.
Gastric bypass patients experience reduced hunger due to decreased ghrelin, the bodies' main hunger hormone.
Patients benefit from rapid and lasting weight loss, resolving co-morbidities like diabetes and high blood pressure.
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Results: Patients achieve an average of 75% excess weight loss by one year after surgery. Active participation in a comprehensive aftercare program, like ours at Nashville Weight Loss Solutions, has proven to enhance long-term success.
At Nashville Weight Loss Solutions, the Robotic Gastric Bypass is a minimally invasive procedure performed by skilled surgeons. Using small incisions and specialized instruments, the surgery creates an upper small gastric pouch, limiting food intake. The small intestines connect to this pouch through an anastomosis, promoting early satiety and fullness. Typically lasting 1.5 hours, the procedure allows patients to stay in the hospital for one night and return to work within one week, thanks to its minimally invasive nature.
Advantages
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Robotic procedure for faster healing
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Fat and sugar sensitivity side effects maximizes weight loss
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Reduced hunger hormone (ghrelin)
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No foreign device, less management
Disadvantages
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Stomach stapling poses a risk of leakage
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Marginal ulcerations
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Permanent re-routing of GI tract with malabsorption risks
Advantages to Sleeve
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Greater overall weight loss potential
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Better control of sugar cravings and dumping syndrome response
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Improved resolution of acid reflux and heartburn
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More significant impact on blood sugar regulation for Type 2 diabetes
Disadvantages to Sleeve
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No stomach function, so medications must be crushed.
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Avoid NSAIDs due to ulcer risk.
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Permanent GI re-routing causes iron and calcium malabsorption.
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Bowel obstruction risk from intestinal re-routing.
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Gastric Sleeve
The Gastric Sleeve is a minimally invasive weight loss procedure that involves shaping the stomach into a banana shaped sleeve by removing about 80% of its volume. This procedure restricts food intake, aiding weight loss through both restriction and a reduction in the "hunger hormone" ghrelin.
Ideal candidates for the gastric sleeve typically have a BMI of 35 or higher with or without co-morbidities such as diabetes, high blood pressure, sleep apnea, or high cholesterol. It is a preferred choice for those desiring significant weight loss without the GI tract re-routing required by gastric bypass.
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Results: On average, patients can expect to lose around 65% of excess body weight.
During this robotic surgery, small incisions allow the removal of about 80% of the stomach, creating a “sleeve” that reduces its size and limits food intake. The new stomach can only hold about 3-4 ounces of solid food at one time, leading to a significant reduction in meal size. Sleeve gastrectomy preserves the stomach’s pyloric valve, allowing for normal stomach emptying and a prolonged feeling of fullness with small bites. The remainder of the stomach is removed, an irreversible aspect of the procedure. This minimally invasive surgery lasts about one hour, allows patients to go home the same day, and return to work within one week.
Advantages
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Performed robotically, leading to reduced pain and quicker return to work
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Restrictive weight loss procedure with minimal malabsorption compared to gastric bypass.
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Less hunger due to the reduction of the "hunger hormone" ghrelin.
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No re-routing of the GI tract and no foreign device, lowering risks of certain complications.
Disadvantages
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Risk of stomach stapling complications, such as leakage or infection at the staple line
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Still considered a major abdominal surgery, carrying risks of bleeding, blood clots, and wound infection
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Permanent and irreversible reduction of the stomach size
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Potential for heartburn or acid reflux due to the level of restriction the sleeve provides
Advantages to Bypass
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No re-routing of GI tract so absorb nutrients normally and no risk of bowel obstruction.
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Preserves stomach function so can swallow medications and take NSAIDS.
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Long narrow stomach with pylorus muscle preservation leads to very full with small meals.
Disadvantages to Bypass
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Lower risk of long-term vitamin and mineral malabsorption
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No fat or sugar sensitivity (dumping syndrome)
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Simpler surgical procedure with shorter operative time
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Can lead to heartburn or reflux in some patients, with potential long-term risks
Duodenal Switch
The Duodenal Switch (DS) procedure combines stomach volume reduction via sleeve gastrectomy and fat calorie malabsorption through intestinal bypass, resulting in substantial weight loss and significant improvement in conditions like diabetes and high blood pressure.
However, its complexity also comes with a higher risk of complications compared to other weight loss procedures.
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The duodenal switch procedure may be more appropriate for people with very high BMIs of 55 or greater. A study found that the duodenal switch produced more weight loss than the Roux-en-Y gastric bypass in patients with a BMI of at least 50.
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Results: Significant weight loss occurs during the initial 12 to 18 months, with an expected excess weight loss of 80%.*
This is a robotic procedure which ensures reduced pain and quicker recovery with small incisions. Taking about 2.5 hours, the surgery involves a 1-2 night hospital stay, and patients often return to work within 2 weeks.
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In the stomach phase, we vertically divide and remove approximately 70% of the stomach, irreversibly reducing its volume. The remaining stomach, resembling a medium banana, can only hold 4-5 ounces of solid food. The Duodenal Switch focuses on preserving stomach function while reducing volume, in contrast to traditional gastric bypass.
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Subsequently, we rearrange and divide the intestines, creating fat and carbohydrate malabsorption. The extensive separation prevents full absorption of consumed fat and carbohydrate calories leading to a more sustained long-term weight loss. The trade off is also malabsorption of certain nutrients and protein that can lead to complications.
Advantages
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Performed robotically, leading to faster healing and reduced pain
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Results in the highest amount of weight loss compared to other procedures and minimizes the chance of weight regain
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Effectively reduces the hunger hormone ghrelin, helping control appetite
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Allows larger meals with no dumping syndrome
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Greatest resolution of co-morbidities
Disadvantages
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Potential risk of leakage and complications directly related to stomach stapling and interstinal re-routing
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Major surgery with inherent risks, ie bleeding, blood clots, intestinal obstruction, infection, and, in extreme cases, death
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Risks of malabsorption of vitamins and minerals, protein malnutrition, chronic diarrhea, foul-smelling stools, and gas
SADI-S
SADI-S (Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy) is a modification of the traditional duodenal switch procedure and is the newest procedure approved by the American Society of Metabolic and Basriatric Surgery.
SADI-S combines stomach volume reduction via sleeve gastrectomy and calorie malabsorption through intestinal bypass similar to DS, but it is simpler and takes less time to perform as there is only one surgical bowel connection (hence, the alternate names "Loop" Duodenal Switch or Modified Duodenal Switch).
​More of the bowel is maintained compared to traditional DS, so patients experience less issues with vitamin deficiences and diarrhea.
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SADI-S is a great option for patients looking for better weight loss compared to gastric bypass or gastric sleeve but reduced complications compared to duodenal switch.
Unfortunately, only a few insurance companies (Cigna and Aetna) are covering the SADI-S at this time.
This is a robotic procedure which ensures reduced pain and quicker recovery with small incisions. Taking about 2 hours to perform, the surgery involves a 1 night hospital stay, and patients often return to work within 1-2 weeks.
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In the stomach phase, we vertically divide and remove approximately 70% of the stomach, irreversibly reducing its volume. The remaining stomach, resembling a medium banana, can only hold 4-5 ounces of solid food. The SADI-S focuses on preserving stomach function while reducing volume, in contrast to traditional gastric bypass. As a result, patients can swallow pills and take arthritic medications like NSAIDS.
In addition​, we swing up a loop of intestines and connect it to the sleeved stomach creating modest fat and carbohydrate malabsorption. The single loop anastomosis lessens the malabsorption of nutrients and proteins, thus lowering the overall complications compared to duodenal switch.
Advantages to Duodenal Switch
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Shorter surgery so less pain, quicker recovery, and fewer complications.
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Lower risk of leakage and bowel obstruction with only one intestinal connection.
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Less malabsorption of vitamins and minerals.
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Lower risk of protein malabsorption.
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Less diarrhea.
Disadvantages
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Potential risk of leakage and complications directly related to stomach stapling and interstinal re-routing.
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Major surgery with inherent risks, ie bleeding, blood clots, intestinal obstruction, infection, and, in extreme cases, death.
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Malabsorption of vitamins and minerals
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Rare risk of protein malnutrition
Advantages to Bypass
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Higher amount of weight loss due to increased amount of intestinal re-routing
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Preserves stomach function so can swallow pills and take NSAIDS.
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Less bowel obstruction risk.
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No marginal ulcers.
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No dumping syndrome.
Advantages to Sleeve
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Higher amount of weight loss due to intestinal re-routing
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Less risk of heartburn due to straightening of the sleeve with bowel reconnection
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Greater resolution of co-morbidities
Nashville Weight Loss Solutions currently does not offer Lap-band surgery and ESG (Endoscopic Sleeve Gastroplasty) for specific reasons related to safety, efficacy, and evolving medical practices.
Robotic Assisted Surgery
Experience the Future of Bariatric Surgery
Dr. Houston, with 800+ successful robotic-assisted bariatric surgeries using the da Vinci® Xi™ System, provides unmatched precision and flexibility. Robotic surgery offers less pain, faster recovery, and improved visualization, making it ideal for complex cases. With wristed instruments and a 3D camera, the da Vinci robot excels in intricate procedures, ensuring superior outcomes and a quicker return to normal life.
Nashville Weight Loss Solutions
2200 Murphy Avenue
Nashville, TN 37203
Monday-Thursday | 8:30 am - 4:30 pm
Friday | 8:30 am - 3:30 pm
Saturday | Closed
Sunday | Closed
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