Our Procedures

The Bariatric Centers at Saint Thomas Health are premier comprehensive weight loss surgery programs, recognized nationally. We provide patients with proven surgical options to correct metabolic deficiencies, both open and laparoscopic. By offering patients a choice of surgical procedures, we believe the treatment team and patient will select a procedure that will ensure your best chance for success. It is important to understand the procedures and risks associated with weight loss surgery as well as the commitment required of the patient. In addition, a patient must meet set requirements to enter the program.
 
Note that not every procedure is available at both facilities.  Read the information on this website, attend the seminars and support groups, and talk with the medical professionals at the Centers to determine your best choice for surgical weight loss.
 
 

Your Surgical CHOICES

 
 

Laparoscopic Adjustable Gastric Band System

lap bandThe laparoscopic adjustable gastric band or LAP-BAND® System is a purely restrictive procedure that limits solid food intake by surgically inserting an inflatable band completely around the uppermost part of the stomach. This less traumatic reversible procedure does not include cutting or stapling the stomach and there is no bypassing of the intestines.
 
Saint Thomas Midtown patients: No Insurance. No Problem.
 

Advantages

 
  • Restricts the amount of food that can be consumed at a meal
  • Food consumed passes through the digestive tract in the usual order allowing it to be fully absorbed into the body
  • In multiple studies involving over 3,000 patients, excess weight loss ranged from 28-87%, with a minimum of 2 year postoperative follow-up
  • Band may be adjusted to increase or decrease restriction
  • Ability to let down with pregnancy
  • Surgery can be reversed
 

Risks

 
  • Gastric perforation or tearing in the stomach wall may require additional operationPatient must learn how to eat proteins first to reach the feeling of satiety
  • Access port leakage or twisting may require additional operation
  • May not provide the necessary feeling of satisfaction that one has had enough to eat
  • Nausea and vomiting
  • Outlet obstruction
  • Pouch dilatation
  • Band migration/slippage/erosion
 

Medical and Emotional Benefits

 
  • Significant weight loss
  • Improvement in type 2 diabetes
  • Lower blood pressure
  • Lower cholesterol
  • Relief of sleep apnea
  • Relief of acid reflux
  • Decreased joint pain, improved mobility
  • Improved mood and self-esteem
 
 

Laparoscopic Roux-en-Y Gastric Bypass

RYGBsThis is the most frequently performed weight loss procedure in the United States. It involves creating a small 1-ounce pouch from the original stomach and thereby limiting food intake. To allow food to pass into the intestine, a new connection must be created between the intestine and the newly-formed pouch. This operation works mainly through restriction, though there is some level of malabsorption. Learn More
 

Advantages

 
  • The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.
  • One year after surgery, weight loss can average 77% of excess body weight.
  • Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
  • A 2004 review and meta-analysis of studies representing 22,094 patients showed that a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
  • A condition known as “dumping syndrome” can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar is consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery. Of note, many consider dumping syndrome a complication of gastric bypass surgery; however, we feel it is a desired outcome after gastric bypass, since it discourages these eating behaviors.
 

Risks

 
  • Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
  • Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
  • A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
  • In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.
  • The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.
 

Medical and Emotional Benefits

 
  • Significant weight loss
  • Improvement in type 2 diabetes
  • Lower blood pressure
  • Lower cholesterol
  • Relief of sleep apnea
  • Relief of acid reflux
  • Decreased joint pain, improved mobility
  • Improved mood and self-esteem
 
 
 

Laparoscopic Sleeve Gastrectomy

sleeveThe sleeve gastrectomy is a restrictive procedure in which two-thirds of the stomach is removed. A long tube or “sleeve” of stomach remains. The valve at the outlet of the stomach remains. The removal of the large portion of the stomach helps decrease hunger hormones like grehlin. If inadequate weight loss were to occur, this procedure could be converted to a Roux-en-Y Gastric Bypass. Learn More
 
Saint Thomas Midtown patients: No Insurance. No Problem
 

Advantages

 
  • Other than restriction, the stomach continues to function normally
  • The major part of the stomach which produces hormones responsible for stimulating hunger is removed
  • Dumping is usually (but not always) avoided as the pylorus valve is left intact
  • Provides a solution for patients with conditions which place them at an unacceptably high risk from other forms of bariatric surgery
  • Doesn't require foreign body implantation, such as a silastic ring used in gastric banding
  • Mechanically decreases the stomach size and also the secretion of the hormone ghrelin which is responsible for the feeling of satiety (fullness)
  • benefit of decreased body weight for the severely obese in preparation for a staged procedure or future surgery
 

Risks

 
  • High BMI patients may require follow-up weight loss surgery to achieve their goal
  • Patients can slow weight loss if they do not make the appropriate dietary changes after surgery
  • Complications may occur as the result of stomach stapling, bleeding, stenosis, leak
  • The procedure is not reversible as part of the stomach is permanently removed
 

Medical and Emotional Benefits

 
  • Significant weight loss
  • Improvement in type 2 diabetes
  • Lower blood pressure
  • Lower cholesterol
  • Relief of sleep apnea
  • Relief of acid reflux
  • Decreased joint pain, improved mobility
  • Improved mood and self-esteem
     
 

Normal Digestive Track

normal  

Related Links

Contact Information

Saint Thomas Medical Partners Center for Surgical and Medical Weight Loss
Saint Thomas Midtown Hospital
2021 Church Street, Suite 104
Nashville, Tennessee 37203
Telephone: (615) 284-2400
Fax: (615) 284-4644
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Saint Thomas Rutherford
1840 Medical Center Pkwy.,
Suite 405
Murfreesboro, TN 37129
TelePhone: (615) 396-4965
Fax: (615) 396-5700

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