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Multiple Bariatric Surgical Options Available to Morbidly Obese Patients

dr-bonanniby Fernando B. Bonanni, Jr., M.D.

At Abington Memorial Hospital’s Institute for Metabolic and Bariatric Surgery (IMBS), we take the emphasis off the surgery and put it on the patient.  It’s not about the surgery; it’s about determining which patients are right for the surgery, what their best surgical option is and giving them the tools they need to successfully lose weight.  We ensure that each patient is prepared mentally, emotionally and physically.

The IMBS offers patients a comprehensive approach to weight loss that features a full range of services, including counseling, ongoing support, an exercise program, a nutrition plan and a lifelong commitment of health and wellbeing.  My colleagues (Gintaras Antanavicius, M.D. and Jeffrey Kolff, M.D.) and I perform the following procedures: Rouen Y Gastric Bypass (open, laparoscopic and robotic), Gastric Banding, Biliopancreatic Diversion with Duodenal Switch (open, laparoscopic and robotic), Vertical Sleeve and StomaphyX.

Gaining popularity over the last year, the Biliopancreatic Diversion with Duodenal Switch procedure, also known as malabsorptive weight loss, changes the normal process of digestion by making the stomach smaller and allowing food to bypass part of the small intestine, so fewer calories are absorbed.  This procedure is typically performed using a minimally-invasive laparoscopic approach – using small instruments and a camera to guide the surgery – but can also be done with robotic assistance. Biliopancreatic Diversion with Duodenal Switch is the most effective procedure, as the total excess body weight loss can be as high as 80 percent, with only a five to eight percent chance of regaining weight. The procedure also boasts a 99.7 percent reduction of non-insulin diabetes.

Another common procedure, the Vertical Sleeve Gastrectomy is a purely restrictive operation that generates weight loss by limiting the amount of food that can be eaten. The stomach is restricted by dividing it vertically and removing 85 percent or more, without bypassing the intestines or causing any gastrointestinal malabsorption.  On average, patients who undergo the Vertical Sleeve Gastrectomy procedure experience a 55 to 65 percent (sometimes higher) loss of excess weight. It is currently indicated as an alternative to the Adjustable Gastric Banding procedure for lower weight patients and as a safe option for patients with a higher BMI. 

My colleagues and I also perform revisional surgery, including StomaphyX, a surgical method of fastening tissue and modifying the gastrointestinal (GI) tract without incision.  The IMBS is the first in Pennsylvania to offer the StomaphyX procedure for post-gastric bypass surgery patients, and is widely recognized as the next step in the evolution of minimally invasive techniques.

I believe weight loss surgery is not a “magic bullet,” but an important first step and the beginning of a lifelong commitment that leads to a much healthier body and lifestyle for patients.

Our program has been recognized as a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery (ASMBS), and has been designated as a Blue Distinction Center for Bariatric Surgery from the Blue Cross & Blue Shield companies.

Dr. Bonanni is Director, Institute for Metabolic and Bariatric Surgery, Abington Memorial Hospital.




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