Dr. Madan And Colleagues Compare Three Weight Loss Surgeries: Gastric Sleeve, Gastric Bypass, and Lap Band Surgery, Based on an Article Released By JCEM On April 2013

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The two most common methods of weight loss surgery are still gastric bypass and gastric banding, with sleeve gastrectomy as a distant third. Dr. Atul Madan reviews recent studies, and recommends that patients struggling with obesity may want to take another look at LAP-BAND® as a viable surgical method.

Media reports have circulated about the good weight loss effects of gastric bypass, versus the bad effects of lap band surgery, but these depictions may not be quite so clear-cut. ABC Local ran a story in 2011 that favored gastric bypass over lap band surgery because of more weight loss and type 2 diabetes remissions, but did say that some patients would be better served with lap band. Other media reports are not so balanced, and some ignore the fact that certain types of gastric bypass (such as the Roux-en-Y) are often a two-part procedure that includes the insertion of the lap band as the second step. Bariatric surgeon Dr. Madan reviews two recent studies, and does encourage patients to properly research the procedures, including the possibility that lap band may be the best long-term surgical option.

Of course, there are other methods of weight loss and bariatric surgery than just gastric bypass and lap band, but they are the two top procedures for now. The sleeve gastrectomy, or stomach stapling procedure, is picking up speed as a new method. However, it's important to know that few long-term studies exist that have tracked the results of the sleeve gastrectomy, and most just examine the post-operative results after one year. On April 2013, General Surgery News posted a one-year follow-up praising the sleeve gastrectomy, along with an admittance that “the sleeve gastrectomy has a higher risk for complications but greater weight loss”.

The same may be true of gastric bypass. Despite many true reports that gastric bypass does indeed help patients lose weight faster in the first year than lap band procedures, weight loss should last for more than a few years. In fact, the same General Surgery study showed that open gastric bypass had a rather high readmission rate of more than 16%, whereas laparoscopic gastric bypass patients were readmitted at a rate of over 11%. Over a three-year period, more than 12,000 patients had lap band surgery, and almost 15,500 had gastric bypass surgery of some kind, though laparoscopic was more common by a 14 to 1 ratio. Reoperations were much more common with open gastric bypass than lap band, by a nearly 10% difference.

More recent studies, such as the study done on type 2 diabetes remission mentioned on Feb 28, 2013 in Medscape, indicate that gastric bypass dramatically reduces type 2 diabetes. However, it's still not clear why a permanent re-routing of the intestines has such a dramatic effect on diabetes before weight has been lost. Some researchers claim that, since the full weight loss effects of lap band surgery takes patients one to two years to see, that gastric bypass is better. A study posted in the Journal of Clinical Endocrinology and Metabolism on April 2013 (Titled: Weight Loss Induced by Roux-en-Y Gastric Bypass But Not Laparoscopic Adjustable Gastric Banding Increases Circulating Bile Acids) says that lower numbers may be an effect of increased plasma bile acids, which doubled in extremely obese patients only after a gastric bypass operation.

What is clear is that lap band surgery is still a viable option. Normally a one-day operation, a lap band can be easily removed, whereas both gastric sleeve and bypass operations are permanent. Many lap band patients lose between 50 to 100 pounds, and the weight stays off when lap band surgery is combined with timeless methods: eating less, eating healthier, and more physical activity. Dr. Madan says that this is really the unbeatable combination for obesity, and suggests that many unsuccessful cases may be due to a lack in one of those three areas. In fact, Obesity Surgery posted a study within the last month indicating that lap band is a “safe and effective procedure in patients with a BMI” of under 35. Over eight years, every one of 34 patients with co-morbidities showed remission or improvement, after just one year.

Dr. Madan has written 175 articles, and was the first in Memphis to perform a laparoscopic gastric bypass. To date, he has performed over, and was first to offer an incision-less treatment for post-operative weight gain. As the former Chief of Laparoendoscopic and Bariatric Surgery Division at the University of Miami, Dr. Atul Madan may well be considered an expert in his field. Dr. Madan won the 2007 SAGES Young Investigator Award, was honored by the American Medical Association Physican's Recognition Award, among others. Dr. Madan's patient reviews are consistently high, and he received the 2011 and 2012 Patients' Choice Award.
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For more information on Dr. Atul Madan or the LAP-BAND procedure, call 1-800-472-4900, or review more on Dr. Madan on http://dr-madan.com/

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