Advanced Surgical Bariatrics Procedures

Weight Loss, General and Natural Orifice Surgery in New Jersey

Bariatric (Weight Loss) Surgery

Bariatric Surgery, and most recently minimally invasive weight loss surgery, has been the catalyst in transforming the lives of thousands of morbidly obese people the world over. It is a viable and effective treatment option for people living with morbid obesity and especially for those who haven’t had long-term weight loss success with diet and exercise.

Dr. Sadek has had the opportunity to see the transition from primarily open bariatric surgery procedures to minimally invasive/laparoscopic procedures. Until recently, bariatric surgeons used only an open technique, which required a long incision and traditional medical instruments. With the advent of minimally invasive techniques, the surgeon performs the same operation with several 1/5 to 1/2 inch incisions and uses long-handled instruments. This usually results in faster recovery, less pain, and less scarring. A consultation with Dr. Sadek will determine if you qualify for minimally invasive surgery.

Dr. Sadek has extensive experience in the bariatric field and believes that patient education is paramount in understanding the benefits and risks of bariatric surgery. We therefore recommend attending one of our free seminars or scheduling a consultation with our office to learn more about the procedures, some of which are detailed below:

Gastric Banding

Our practice uses the REALIZE™ gastric banding system and the Lap Band System (ALLERGAN) Click here for REALIZE™ gastric banding system information. When performing the banding procedure, we implant two devices in the abdomen: a silicone band and an injection port. The silicone band is placed around the upper part of the stomach, creating two connected chambers of the stomach. The injection port is attached to the abdominal wall underneath the skin and connected to the band with soft, thin tubing.

The band is adjustable and several adjustments will be made periodically after the procedure is completed. Dr. Sadek will use a needle to inject saline solution into your band through the port, increasing the amount of restriction provided by the band, which in turn, helps you feel fuller.


What to Expect after the Gastric Banding Procedure

Recovery times will vary between patients, depending on the procedure and the patient’s general health. As a rule of thumb, however, the less invasive nature of the gastric banding procedure lends itself to a reduced recovery time. Dr. Sadek will advise you on when you can return to normal activity. Gastric Banding patients will usually see a loss of over 40 percent of their excess body weight, and in most patients, Type 2 diabetes, high blood pressure and cholesterol issues will be improved or resolved.

Considerations and Risks of Gastric Banding:

Gastric banding can help you feel satisfied sooner, but you will have to follow specific diet and exercise guidelines in order to reach and maintain your weight goals. Gastric banding requires more follow-up care than most other bariatric surgeries and since the band is adjustable, it will be tweaked over the course of several months. Even after reaching your ideal weight, you may need to see us periodically to adjust the band further. Risks include:

• Migration of implant (band erosion,
  band slippage, port displacement)
• Tubing-related complications
  (port disconnection, tubing kinking)
• Band leak
• Esophageal spasm
• Gastroesophageal reflux disease (GERD)
• Inflammation of the esophagus or stomach
• Port-site infection
• Inherent risks of any surgical procedure

Note: Complications may result in reoperations.

Gastric Bypass

The Roux-en-Y Gastric Bypass creates a smaller stomach. A Y-shaped section of the small intestine is attached directly to this pouch allowing food to bypass a large portion of the small intestine eliminating some food absorption. The smaller stomach pouch helps patients feel fuller sooner and eat less food.


What to Expect After the Gastric Bypass Procedure

Recovery time is moderate and most patients will be able to leave the hospital within a few days and return to work and semi-normal activity in less than a month. Gastric bypass patients typically lose over 50 percent of their excess weight, and in most patients, Type 2 Diabetes, high blood pressure and cholesterol will be improved or resolved.


Considerations and Risks of Gastric Bypass:

Patients must supplement their diet with a daily multivitamin and calcium and some patients will have to take vitamin B12 and/or iron. The stomach, duodenum, and parts of the small intestine cannot be seen easily using X-ray or endoscopy if there are complications after surgery such as ulcers, bleeding, or malignancy. As with any surgical procedure there are inherent risks. Other risks include:

• Dehiscence (separation of tissue
  that was stitched or stapled together)
• Leaks from staple lines
• Ulcers
• Dumping syndrome, an unpleasant side effect that may include vomiting, nausea, weakness, sweating, faintness, and diarrhea
• Increased gas
  
  
  
  

Sleeve Gastrectomy

During this surgery, the surgeon creates a small, sleeve-shaped stomach. It is larger than the stomach pouch created during gastric bypass at about the size of a banana. Sleeve gastrectomy is typically considered as a treatment option for bariatric surgery patients with a BMI of 60 or higher and is often performed as the first part in a two-procedure treatment, the second part being gastric bypass.

Courtesy Ethicon Endo-Surgery, Inc.

Laparoscopic General Surgical Procedures

Dr. Sadek is a highly trained and experienced in laparoscopic general surgical procedures, having spent years at some of the country’s best surgical facilities. Further, Dr Sadek speaks at many international conferences and teaches other surgeons about this very topic.

The laparoscopic procedures our facility performs use minimally invasive techniques that once required much larger incisions. With the use of several technological advances including cameras and specialized surgical instruments, laparoscopic surgery can reduce post operative pain and in many patients reduce recovery periods. Almost every procedure could be done laparoscopically

Our Practice performs a wide range of Minimally invasive general surgery procedures including:

• Laparoscopic Anti Reflux Surgery
• Laparoscopic Hernia Surgery
• Laparoscopic Colon Surgery
• Laparoscopic Liver surgery
• Laparoscopic spleen surgery
• Laparoscopic bowel surgery
• Laparoscopic gastric( stomach) surgery
• Laparoscopic appendectomy
• Laparoscopic cholecystectomy
• Laparoscopic Adrenalectomy

Please contact our office if you would like more information
on the general surgery procedures we perform.

Natural Orifice Surgery

Natural Orifice Surgery or NOS is a new technique of minimally invasive surgery allowing the surgeon to use existing orifices in the human body as entry points for surgical tools to perform the procedure. This technique all but eliminates visible scarring and the recovery period is relatively short compared to traditional surgery. Dr Sadek performs StomaphyX routinely.

StomaphyX is a method of pleating or folding the walls of the stomach or intestine to reduce its surface area and, in turn, reduce the absorption of calories. This pleating and fastening is performed 10-20 times during the surgery depending on the patient’s particular needs. StomaphyX is a very specialized procedure and Dr Sadek has had extensive training and experience in this surgical technique.


What to Expect After the StomaphyX Procedure:

It’s usually the case that patients return to work the next day or within a few days following their procedure. Patients will likely experience some discomfort in their chest, nose and throat for up to a week after surgery. Patients should keep physical activity to a minimum for about a week and will need to stick to specific dietary guidelines to help the healing process. A soft or liquid diet is usually required for 10 days to two weeks after the procedure.




Trans Oral Incision less Fundoplication with EsophyX (TIF)

A huge advance in the evolution of the treatment of GERD, the revolutionary TIF (Transoral Incisionless Fundoplication) procedure corrects the root cause of GERD, an anatomic deficiency at the gastroesophageal junction. Performed with the innovative EsophyX surgical device, the procedure reconstructs a durable antireflux valve and tightens the LES (Lower Esophageal Sphincter), reestablishing a barrier to reflux and restoring the competency of the gastroesophageal junction. The result is the effective elimination of GERD. Performed with the patient under general anesthesia, the EsophyX device is introduced into the body transorally (through the mouth) and advanced into the esophagus under visualization of a video camera inserted down the central shaft of the device. The EsophyX device is then used to form and fasten several tissue folds, or plications, to create a robust antireflux valve at the gastroesophageal junction, resulting in the effective elimination of GERD.