My New Beginning is dedicated to providing some of the best bariatric surgery options in Dallas. Designed for those with a high body mass index (BMI), these surgical interventions limit the amount of food you’re able to eat, resulting in significant weight loss.
No matter what option you choose, we’ll work with you throughout every step of your transformation. Our goal is to make the transition into your healthy new lifestyle a smooth one.
Roux-en-Y Gastric Bypass
The bariatric surgeons on the medical staff at City Hospital at White Rock offer My New Beginning patients a weight-loss surgical procedure called gastric bypass surgery, also known as Roux-en-Y gastric bypass.
During this procedure, a portion of the stomach is closed off using a stapler device. This creates a small pouch that is then connected to the distal small intestine. During digestion, food bypasses the rest of the stomach and the upper portion of the small intestine. Food is absorbed differently because the stomach, duodenum, and upper intestine no longer have as much contact with the food. Because of the new structure of the stomach, patients are not able to eat as much food. This may lead to more weight loss these patients realize after surgery.
Gastric Bypass Advantages:
- Produces significant, long-term weight loss (60% to 80% excess weight loss)
- Restricts the amount of food that can be consumed
- May lead to conditions that increase energy expenditure
- Produces favorable changes in gut hormones that reduce appetite and enhance satiety
- Typical maintenance of >50% excess weight loss
Gastric Bypass Disadvantages:
- Is technically a more complex operation than AGB (adjustable gastric band) or LSG (laparoscopic sleeve gastrectomy), and potentially could result in greater complication rates
- Can lead to long-term vitamin/mineral deficiencies, particularly deficits in vitamin B12, iron, calcium, and folate
- Generally has a longer hospital stay than the AGB
- Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation and follow-up compliance
Gastric Band or LAP-BAND®
Also known as the LAP-BAND®, this procedure uses an adjustable silicone band to reduce the size of the stomach.
The band is placed around the top of the stomach, squeezing it so it becomes a small pouch that can hold a significantly smaller amount of food. The band allows food to pass through the digestive tract normally, so it does not interfere with food absorption.
Once in place, the gastric band can be adjusted by a professional to increase or decrease the size of the stomach pouch for optimal results. This allows the procedure to be customized to each patient’s needs. If necessary, the band can even be removed all together, and the stomach will eventually return to its normal size.
Gastric Band Advantages:
- Reduces the amount of food the stomach can hold
- Induces excess weight loss of approximately 40% to 50%
- Involves no cutting of the stomach or rerouting of the intestines
- Requires a shorter hospital stay, usually less than 24 hours, with some centers discharging the patient the same day as surgery
- Is reversible and adjustable
- Has the lowest rate of early postoperative complications and mortality among the approved bariatric procedures
- Has the lowest risk for vitamin/mineral deficiencies
Gastric Band Disadvantages:
- Slower and less early weight loss than other surgical procedures
- Greater percentage of patients failing to lose at least 50% of excess body weight compared to the other surgeries commonly performed
- Requires a foreign device to remain in the body
- Can result in possible band slippage or band erosion into the stomach in a small percentage of patients
- Can have mechanical problems with the band, tube, or port in a small percentage of patients
- Can result in dilation of the esophagus if the patient overeats
- Requires strict adherence to the postoperative diet and to postoperative follow-up visits
- Highest rate of re-operation
Sleeve Gastrectomy (Gastric Sleeve)
For bariatric patients who are obese but are not experiencing serious medical conditions such as diabetes and heart disease, gastric sleeve or sleeve gastrectomy may be an option.
Gastric sleeve surgery, or sleeve gastrectomy, is a weight-loss surgery option designed to reduce the size of the stomach by converting it into a narrow tube.
The bariatric surgeon starts this minimally invasive procedure by making a few small incisions into the abdomen. Then, a stapling device is used to remove the volume of the stomach by 75% to 80%. The new, smaller stomach is about 25% its original size (roughly the size of a banana), and it produces less of the hormone that causes hunger. This ensures that the patient will be able to consume less food while feeling just as full.
With this type of bariatric procedure, this is no surgery involving the intestines. The stomach is able to preserve its natural function because it is not re-routed, which leads to no malabsorption or severe vitamin deficiencies.
Gastric Sleeve Advantages:
- Restricts the amount of food the stomach can hold
- Induces rapid and significant weight loss that comparative studies find similar to that of the Roux-en-Y gastric bypass. Weight loss of >50% for 3-5+ year data, and weight loss comparable to that of the bypass with maintenance of >50%
- Requires no foreign objects (AGB), and no bypass or re-routing of the food stream (RYGB)
- Involves a relatively short hospital stay of approximately two days
- Causes favorable changes in gut hormones that suppress hunger, reduce appetite, and improve satiety
Gastric Sleeve Disadvantages:
- Is a non-reversible procedure
- Has the potential for long-term vitamin deficiencies
- Has a higher early complication rate than the AGB
da Vinci Surgery is a minimally invasive option for patients considering the gastric sleeve.
The duodenum, or first portion of the small intestine, is divided just past the outlet of the stomach. During a duodenal switch, a segment of the distal (last portion) small intestine is brought up and connected to the outlet of the newly created stomach. Now when the patient eats, food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream.
This procedure decreases the amount of acid produced by the remaining stomach. Gastrin, a hormone produced by G-cells in the antrum (cavity within a bone), is responsible for stimulating the upper stomach to produce acid. After entering the upper stomach, food passes through a newly created connection (anastomosis) into the small intestine (alimentary limb). The bile and pancreatic secretions pass through the bypassed biliopancreatic channel and connect with the alimentary channel (where food travels) approximately 20 to 40 inches (50 to 100 cm) from the colon. Some of these secretions are reabsorbed in this channel before meeting the alimentary tract. The part of the intestines where bile and pancreatic fluids (from the biliopancreatic channel) and food (from the alimentary channel) mix is called the common channel. Surgeons use various formulas to determine the appropriate length of the alimentary and common channels.
Advantages of Duodenal Switch Weight Loss Surgery:
- Increased amount of food intake compared to the bypass and band
- Less food intolerance
- Possibly greater long-term weight loss
- More rapid weight loss compared with gastric banding procedures
da Vinci Robotic Surgery
da Vinci is a minimally invasive weight-loss surgery option for patients considering Gastric Sleeve surgery. The gastric sleeve procedure works by reducing the size of the stomach by converting it into a narrow tube.
The da Vinci System features a magnified 3D, high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. da Vinci enables your doctor to operate with enhanced vision, dexterity, and control.
Potential Benefits of Robotic-Assisted Weight-Loss Surgery:
- Less pain
- Decrease in blood loss
- Less scarring
- Fewer complications
- Shorter hospital stay
- Shorter recovery time
- Faster return to normal daily activities
- Better clinical outcomes
Although the gastric band procedure may lead to long-term weight loss success, there is a specific group of people for which the gastric band surgery ultimately may not be the best solution. We want you to know that if you have been unsatisfied with your weight-loss progress after the gastric band surgery, there are other options, including gastric band to gastric sleeve revision.
Converting the gastric band to gastric sleeve is about a 90-minute process and is performed by laparoscopy, meaning it is minimally invasive in making incisions on the abdomen.
What to Expect Before Surgery
Two weeks before surgery, we suggest that all bariatric surgery patients focus on changing their diets. This will prepare your body for significant changes and make your surgery safer.
What to Expect During Surgery
You will receive general anesthesia before your surgery. Your surgeon will then make tiny incisions on your abdomen to create or revise your new stomach, which will be ¼ the size of your regular stomach.
What to Expect After Surgery
It will take some time to recover, so it’s important to rest, monitor your caloric intake, and follow your doctor’s orders for diet and medicine. You won’t be able to exercise right away, but it will be crucial to gradually start an exercise program that you can follow.
Medical Weight Loss
Medication and Behavioral/Dietary Program
Whether you have 10 pounds to lose or are working on a more ambitious weight-loss goal, My New Beginning will work with you to create a personalized weight-loss plan. We have many patients who desire a non-surgical approach to weight loss, and at My New Beginning, we have developed a comprehensive plan to help you achieve your weight-loss goals!
To achieve optimal results, our medical weight loss program includes the following:
- Weight-loss medications
- Metabolic testing and assessment
- Vitamin and protein supplementation
- Individualized nutritional assessment and plan by a Registered Dietician
- "Am I Hungry?" Mindful Eating series/support group by a Licensed Clinical Psychologist
There are several FDA approved medications for medical weight loss. Patients can lose up to 10% of their excess body weight with these medications. Studies show that even a modest weight loss can offer significant health benefits. These include:
- Weight loss of just 3% will reduce blood glucose levels
- Weight loss of 5% to 10% will begin to lower blood pressure, raise high-density lipoprotein cholesterol levels, and diminish sleep apnea
During your initial consultation, we will evaluate your medical history and weight-loss goals. For many patients, insurance will cover their weight-loss medications. Patients are initially seen on a monthly basis to monitor their progress.
At My New Beginning, we believe that nutrition is essential to achieve and maintain your weight-loss goals. We begin your nutritional assessment by first performing metabolic testing. This gives both the dietician and the patient valuable information to set goals and develop a plan. We also offer B12 supplementation for metabolic support. Lab work and thyroid assessment is also essential for our patients. Patients are seen on a routine basis with our nutritionist during their medication management appointments.
"Am I Hungry?" Mindful Eating
Perhaps the most important and most effective tool in our non-surgical weight loss plan is participation in the “Am I Hungry?” Mindful Eating Program. Dr. Collins Hodges is among the few licensed clinical psychologists in the DFW area trained to work in the area of weight loss. The mindful eating program helps people recognize and examine the thoughts, feelings, and triggers behind mindless eating. Dr. Hodges leads both our behavioral program as well as all of our support groups.
To learn more about whether our Medication and Behavioral/Dietary Program may be an effective weight-loss treatment for you, or to schedule a consultation with one of our weight-loss surgeons, please fill out this form or call us at (214) 324-6127.
LAP-BAND® is a registered trademark of Allergan, Inc.
Important Information for Patients:
All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risks specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to other surgical techniques; the need for additional or larger incision sites; a longer operation or longer time under anesthesia than your surgeon originally predicts. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/safety.
All people depicted unless otherwise noted are models. © 2013 Intuitive Surgical. All rights reserved. All product names are trademarks or registered trademarks of their respective holders. PN 870791 Rev D 04/13
Snyder BE, Wilson T, Leong BY, Klein C, Wilson EB. Robotic-assisted Roux-en-Y Gastric bypass: minimizing morbidity and mortality. Obes Surg. 2010 Mar;20(3):265-70. Epub 2009 Nov 3. 4Hagen ME, Pugin F, Chassot G, Huber O, Buchs N, Iranmanesh P, Morel P. Reducing Cost of Surgery by Avoiding Complications: the Model of Robotic Roux-en-Y Gastric Bypass. Obes Surg. 2011 May 3. [Epub ahead of print]