Angeles, Calif.
"It's primarily
being done by
people who are
pushing the
boundaries, and
the patients tend
to be young and
relatively
healthy."
The sleeve gas-
trectomy has
become the figu-
rative gold standard, according to Dimitrios Stefanidis, MD, PhD, the
medical director of the bariatric program at Indiana University
Health in Indianapolis. By his estimate, 60% of U.S. bariatric patients
opt for sleeve gastrectomy; 30% have gastric bypass, and the remain-
ing 10% choose from among the other bariatric procedures. The
sleeve gastrectomy involves removing most of the stomach and shap-
ing the remainder into a tubular pouch. He says patients like it
because of its favorable safety profile as a means of predictable,
long-term weight loss.
Intragastric balloon and endoscopic suturing also work well in the
outpatient setting. Although these endoscopic procedures have less risk
than surgery and often require only sedation, they are "still emerging" in
the U.S. market, says Stacy Brethauer, MD, a bariatric surgeon with the
Cleveland (Ohio) Clinic.
There's also stomach aspiration, a nonsurgical and reversible proce-
dure that lets patients eat as they normally do and then lavage their
stomach with saline to evacuate some of the stomach's contents
1 0 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 7
• BATTLE OF THE BANDS Laparoscopic gastric banding has fallen out of favor in recent years.
