Welcome to MISH Weight Loss Surgery Program

The Gastric Sleeve (sleeve gastrectomy) is one of the newer bariatric operations but has quickly gained popularity over the last 10 years. It is also known as the Vertical Sleeve Gastrectomy, Vertical Gastroplasty or Sleeve Gastroplasty, this procedure has become the most popular weight loss operation in the USA. It is mostly a restrictive operation – it works by controlling how much food can be eaten at one time. The operation also causes metabolic effects – which has great health benefits and improves weight loss even further. The sleeve operation is the removal of more than 85% of your stomach. The part that is removed is the most stretchable portion of the stomach. The stomach is divided and stapled vertically, creating a tube or pipe-shaped stomach pouch. The shape and length of the stomach causes serious restriction in the amount of food that can be eaten at one time. The most dramatic metabolic impact the RYGB operation has, is on diabetes. Even before any significant weight has been lost the diabetes has already improved and requires less medication to manage. Read more

The Roux-en-Y gastric bypass remains the gold standard to which other weight loss operations are compared. It is the oldest, and best studied weight loss operation. It is the second most frequently performed weight loss operation in the United States, after the sleeve gastrectomy. The gastric bypass takes advantage of both restriction and malabsorption to work. The restrictive part of the procedure is the creation of the small stomach pouch with a very small outlet. The stretchable part of the stomach is no longer used. The malabsorptive part of the procedure involves re-arranging of the small intestine to reduce how much of the intestine is involved in absorbing the small amount of food that is eaten. The operation also causes metabolic effects – which has great health benefits and improves weight loss even further. The most dramatic metabolic impact the RYGB operation has, is on diabetes. Even before any significant weight has been lost the diabetes has already improved and requires less medication to manage.. Read more

The Biliopancreatic Diversion with Duodenal Switch – abbreviated as BPD/DS – is a procedure with two parts. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy. Next, a large portion of the small intestine is bypassed (75%). The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach, so that when the patient eats, the food goes through the new stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream. Read More

One of the most common complaints that lead to revision weight loss surgery is heartburn or reflux. Often the symptoms experienced by the patients are caused by other reasons than acid alone. The heartburn - reflux like symptoms can be caused by:

Acid reflux

Herniation of the sleeve or bypass pouch into the chest in such a manner that it is now causing a partial obstruction to the passage of food

Bile refluxing up into the stomach and esophagus

Stricture / Obstruction formation

Torsion (twisting of the sleeve)

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Though the Lap-Band used for weight loss in individuals who have failed to lose weight through diet and exercise, many patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication.

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The Sleeve Gastrectomy operation is used in morbidly obese patients to lose weight. Some patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication. READ MORE

The Gastric Bypass operation is used in morbidly obese patients to lose weight. Some patients can experience sub-optimal weight loss despite the surgery, or develop complications. In such cases, revision weight loss surgery may be needed to induce or maintain weight loss or correct a complication. Read More

Many people who have lost 100 pounds or more are overjoyed at their success. After losing weight, loose, heavy folds of skin can interfere with walking, balance, hygiene, skin care, and simply getting clothes to fit correctly. Plastic surgery, in most cases, is the only effective long-term solution. Removal of excess skin can improve the fit of clothes, the ability to walk and/or maintain balance, maintain hygiene, and reduce chronic skin irritation and even infections. Improving body self-image is also a great motivator for patients to maintain their efforts in weight loss. There are several things that can be offered to deal with excess skin. Dealing with excess skin after large weight loss is mostly referred to as body contouring (also known as a body lift). Several body areas can be addressed including the abdomen, thighs, buttocks, arms, and breast. Read More