The Woodlands & Houston Weight Loss Surgery | Vertical ( Gastric) Sleeve

The Woodlands Weight Loss Surgery - Vertical Sleeve Gastrectomy


The vertical sleeve gastrectomy is a restrictive surgery that involves the laparoscopic removal of about two-thirds of the stomach, leaving behind a sleeve shaped stomach with a capacity ranging from about 60 to 150 cc. With this bariatric procedure, the outlet valve and the nerves to the stomach remain intact and the function of the stomach is preserved. The preservation of stomach function provides the following advantages for sleeve gastrectomy:

  • Minimal complications - There is no bypass of the intestinal tract, meaning that complications, such as intestinal obstruction, anemia, osteoporosis, vitamin deficiency and protein deficiency, will likely not occur.
  • Fewer dietary restrictions -  Dietary restrictions regarding the types of food allowed are much more flexible compared to other weight loss surgeries.
  • Normal digestion and absorption - The procedure does not affect how the body digests food and absorbs vitamins, minerals and other nutrients. The risk of “dumping” is virtually eliminated.
  • Reduced desire to eat - The hormones produced in the stomach that trigger the feeling of hunger are virtually eliminated when the stomach is reduced in size.
  • Viable option for those not suited to other procedures - This can be a viable option for patients with medical conditions that place them at too high of a risk for other weight loss procedures.
  • More options for someone with a very high BMI -  The procedure provides a laparoscopic option to patients with a high body mass index, and can also be part of a two-surgery procedure allowing for the patient to have a bypass procedure done after enough weight has been shed.

However, this procedure, unlike other weight loss surgeries, is not reversible. Also, for some this restrictive procedure, like other purely restrictive procedures, does not always result in the weight reduction desired and can result in weight regain in the long term. Stapling of the stomach also runs the risk of leakage and of other complications in the post-operative phase such as bleeding, small bowel obstruction, pneumonia and even death. Typically, the risk of encountering any of these complications is however extremely small and varies from about 0.5 and 1 percent; with the risk of death extremely low at one quarter of a percent.

Gastric Bypass Roux-en-Y

Gastric Bypass Roux-en-Y is the most common form of bariatric surgery and is considered the gold standard in bariatric surgery today. It is designed to reduce the size of the stomach and to bypass part of the small intestine.

In the procedure, surgeons divide the stomach to create a small pouch that restricts food intake to about one ounce. This new stomach pouch is then attached to the small intestine, bypassing the lower stomach and a portion of the small bowel.

The surgery affects weight loss in two ways:

  1. It restricts food intake
  2. The food that is consumed is absorbed to a lesser extent

Gastric Bypass Roux-en-Y surgery can be performed in two ways. In an open procedure, an incision is made in the abdomen from the breastbone to the belly button, or umbilicus. In a laparoscopic procedure, six small incisions are made and surgeons use specialized instruments and a tiny camera to perform the surgery. More than half of our surgeries are performed laparoscopically.

The Gastric Bypass Roux-en-Y procedure has multiple advantages:

  • Rapid weight loss - Patients lose an average of 70 percent of excess body weight within 12 to 18 months after surgery.
  • Proven long-term track record - Studies show that 10 to 14 years after surgery, patients have maintained an average loss of 60 percent of their excess weight.
  • Reduced co-morbidities - The procedure significantly reduces, and sometimes, even eliminates conditions related to obesity, including high blood pressure, Type II diabetes and sleep apnea.
  • Reduced desire to eat - Patients report that they feel fuller faster and achieve satiety - the feeling of being satisfied - with less food; therefore, overeating is less likely to occur.
  • Reversibility - Under the care of our exceptional medical staff surgeons, the surgery can be reversed.

Complications can include leaks at the connection sites of the pouch and small bowel; infection; small bowel obstruction; internal hernia; pulmonary embolus and even death. Patients can avoid vitamin and mineral deficiencies with proper supplementation, and our staff is there to ensure that nutritional levels are regularly monitored.

Adjustable Gastric Banding or Lap Band® System

This procedure is designed to restrict and reduce your food intake without interfering with the body's normal digestive process.

A silastic band is placed around the upper part of the stomach, creating a small pouch. The pouch restricts food intake, and the narrow passage between the pouch and the lower stomach slows the emptying of food into the rest of the stomach, causing you to feel fuller, longer.

The diameter of the band can be adjusted to increase or decrease restriction. This is done by inflating or deflating the band with a saline solution introduced through an access port that is placed under the skin during surgery.

Adjustable gastric banding (lap band) is performed laparoscopically as outpatient surgery so patients can go home the same day. Adjustable gastric banding is safe and effective, with advantages that include:

  • Proven success -  Patients lose about 40 percent of their excess body weight within two years.
  • Reversibility -  Under the care of our exceptional medical staff surgeons, the surgery can be reversed.
  • Normal digestion and absorption -  The procedure does not affect how the body digests food and absorbs vitamins, minerals and other nutrients.
  • Less impact on the anatomy -  Adjustable gastric banding does not require the opening or removal of any part of the stomach or intestines.

Among the potential complications associated with adjustable gastric banding are tearing in the stomach or gastric perforation, which could require additional surgery; leakage or twisting of the access port; nausea and vomiting; slippage of the band; obstruction of the passage between the pouch and the stomach; enlargement of the pouch; and mechanical failure of the band implant. Learn more about the lap band surgery in Houston.

Gastric Bypass Roux-en-Y Revisions

Sometimes, an initial procedure may need to be revised. Reasons for revision include:

  • Mechanical failure of surgery
  • Regaining original weight lost
  • Intractable nausea & vomiting


Dr. Balette has performed hundreds of revision surgeries, giving our patients successful outcomes. Many times, a revision is exactly what a patient needs in order to be successful in their weight loss goals.

Pre-operative diagnostic tests may include:

  • Upper GI with Marshmallow Test
  • Endoscopy
  • Blood Work
Contact Dr. Balette's office today to learn more about which bariatric surgery best fits your unique situation.

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