You might hear this procedure referred to by several other names, including:

• biliopancreatic diversion
• duodenal switch
• malabsorptive surgery
• biliopancreatic diversion with duodenal switch

As some of the names suggest, biliopancreatic diversion is two procedures in one. First, your surgeon will remove about 80 percent of your stomach, leaving a tube-shaped stomach pouch. This is similar to a sleeve gastrectomy.

Then, your small intestine is divided in two. The top portion is separated from the stomach. The second, lower portion is then brought up and connected to the pouch. This way, the food you eat bypasses about three-fourths of your small intestine.

Not only does your stomach pouch hold less, your body will absorb fewer of the foods you do consume. You’ll lose weight, feel less hungry, and have better control of your blood sugar.

In a vertical sleeve gastrectomy, sometimes just called a sleeve gastrectomy or “sleeve,” your surgeon removes about 85 percent of your stomach. The remaining banana-shaped section is closed off with staples.    

The new, smaller stomach holds less food and liquids, so you can’t eat or drink as much. As a result, you’ll lose weight and reduce your blood sugar. Removing a portion of your stomach also decreases levels of hunger hormones.

As with every other type of bariatric surgery, you’ll have to change your lifestyle to have long-term success with a vertical sleeve gastrectomy. This includes eating less and exercising.    

Fortunately, your team at CommonSpirit Health will be there to guide you. With our support in developing new habits, you’ll reduce your risk of complications and weight regain.

While gastric bypass has been available for more than 50 years, our surgeons use the most updated techniques and technology when they perform it.

When you have a gastric bypass, your surgeon will use staples to create a new, smaller stomach pouch. Because the pouch holds less food than a full stomach, you’ll feel satisfied sooner and consume less. Plus, you’ll absorb less, since food bypasses so much of your digestive tract. Your hormones and metabolism shift too, meaning you may see improvements in conditions like diabetes and acid reflux.

A successful gastric bypass surgery involves long-term lifestyle changes, such as eating smaller meals and exercising. Sticking to your treatment plan, with the help of your team, means you’ll avoid complications.

During laparoscopic adjustable gastric banding surgery, our surgeons wrap a silicone band around the upper part of your stomach to make a small pouch. Then the incisions are closed with stitches. The small size of the stomach pouch means you will feel full after you eat a small amount of food. Our providers can then adjust the size of the band by inflating or deflating it via a port.

The LAP-BAND procedure is minimally invasive and doesn’t require our surgeons to cut or staple the patient’s stomach. Accordingly, it can have a lower risk of complications than other bariatric procedures such as sleeve gastrectomies and gastric bypasses. This procedure is rarely, if ever done anymore due to disappointing long-term results but could be considered for select patients. We often see patients for band removal or revision to another bariatric procedure.

Referred to as SADI-S, the single anastomosis duodendo-ileal bypass with sleeve gastrectomy procedure is similar to the biliopancreatic diversion with duodenal switch (BPD) surgery with a couple notable differences. During a SADI-S, your surgeon will remove about 80 percent of your stomach, leaving a tube-shaped stomach pouch. The first part of the small intestine is then divided just after the stomach. Finally, a loop of intestine is connected to your stomach. 

Because it involves only one intestinal connection, the SADI-S is simpler and faster than the biliopancreatic diversion, and nutritional deficiencies tend to be less common than with BPD surgery.

Revisions may be needed to fix an issue or complication from a prior surgery or to address weight loss failure or weight regain. These revisions could include changing from a lap band to a sleeve or gastric bypass, making a sleeve smaller (re-sleeve gastrectomy), converting from a sleeve to a gastric bypass or SADI, or simply repairing a hiatal hernia.

Weight loss medicines may be an option for people who have obesity or who are overweight and have weight-related health problems, such as high blood pressure or diabetes. These medicines may help some people who haven't been able to lose weight with diet and exercise.

Prescription weight loss medicines include semaglutide (Wegovy, Ozempic), liraglutide (Saxenda), tirzepatide (Mounjaro, Zepbound), Dulaglutide (Trulicity) phentermine-topiramate (Qsymia), and naltrexone-bupropion (Contrave). These medicines work by helping you eat less. Another medicine, called orlistat (Xenical), prevents some of the fat calories you eat from being absorbed by your body.

Different weight loss medicines produce different results in each person. Many people are able to lose 5% to 20% of their body weight, depending on how they respond to the medicine. Our doctors can help you understand your options and decide what might be right for you.

Weight loss medicines are used long-term along with healthy eating and being more active. Many people regain some or most of the weight they lost if they stop taking the medicines. If you stop taking the medicine, healthy eating and activity may help limit how much weight you gain back.

Weight loss medicines don't work for everyone. If you are having trouble reaching your goals, talk with your doctor about other things you can try, including surgical options.

A successful bariatrics procedure begins long before you enter the operating room — and continues with daily shifts that last a lifetime. From the first time you contact our center, you’ll receive expert guidance on what to expect, how to take care of your health every day, and ways to make behavior changes stick.

Your support crew may include dietitians, nurses, trainers, and psychologists or other therapists. We’ll connect you to the best, most experienced clinicians in the community. You’ll also have the option of joining with support groups, in person or online. This way, you can get both practical advice and emotional reinforcement from others just like you, coping with the same challenges and victories.