Choosing a Type of Weight Loss Surgery
Maestro Rechargeable System
What it is: The Maestro Rechargeable System works like a pacemaker to deliver electrical pulses to a nerve between the stomach and brain, called vagus nerve. This nerve tells the brain when the stomach is full. The device is implanted in the abdomen and has a remote control that can adjust it from outside the body. The system is programmed to deliver a pulse -- 5 minutes on and 5 minutes off -- to the vagus nerve during your waking hours, and it's supposed to turn off during the hours you sleep.
Pros: Implanting this device is the least invasive of the weight loss surgeries. The outpatient procedure may take up to an hour and a half while the patient is under general anesthesia.
Cons: The device has to be charged once or twice a week. If the battery completely drains, a doctor has to reprogram it. Side effects can include nausea, vomiting, heartburn, problems swallowing, belching, mild nausea, and chest pain.
Risks: Infection, pain at the implantation site, or other surgical complications.
What it is: This is a more drastic version of a gastric bypass. The surgeon removes as much as 70% of your stomach and bypasses even more of the small intestine.
A somewhat less extreme version is biliopancreatic diversion with a duodenal switch, or “the duodenal switch.” It's still more involved than a gastric bypass, but this procedure removes less of the stomach and bypasses less of the small intestinethan biliopancreatic diversion without the switch. It also makes dumping syndrome, malnutrition, and ulcers less common than with a standard biliopancreatic diversion.
Pros: Biliopancreatic diversion can result in even greater and faster weight loss than a gastric bypass. Although much of the stomach is removed, what's left is still larger than the pouches formed during gastric bypass or banding procedures. So you may be able to eat larger meals with this surgery than with others.
Cons: Biliopancreatic diversion is less common than gastric bypass. One of the reasons is that the risk of not getting enough nutrients is much more serious. It also poses many of the same risks as gastric bypass, including dumping syndrome. But the duodenal switch may lower some of these risks.
Risks: This is one of the most complicated and riskiest weight loss surgeries. As with gastric bypass, this surgery poses a fairly high risk of hernias, which will need more surgery to correct. But this risk is lower when the doctor uses minimally invasive procedures (called laparoscopy).