Melissa Mahboub had heard about the potential risks of weight loss surgery, so she did her research before deciding to have it herself.

"I heard death could be a factor with gastric bypass," she said. "I have a two-and-a-half year-old son and I want to see him grow up."

Mahboub decided on lap band surgery, a less invasive procedure than gastric bypass. And her choice of Durham Regional Hospital for her surgery put her in the hands of doctors who are national leaders in a new form of lap band surgery using just one incision.

"What was minimally invasive ten years ago is now standard of care," said surgeon Aurora Pryor, of the Duke Center for Metabolic and Weight Loss Surgery and director of minimally invasive surgery at Durham Regional. "And now we have new techniques that are less invasive than those original techniques."

Unlike gastric bypass, which creates a smaller stomach and connects it directly to the intestines, lap band surgery leaves the stomach intact.

"Food comes down the patient's esophagus and will go into a small gastric pouch, which is made by having that stomach above the band," said Pryor. "The band then causes restriction on the stomach and will keep the food in that top pouch for a while."

That gives the patient a sensation of feeling full after eating less. Doctors can tighten or loosen the band by injecting fluid into it through a permanent port that lies just under the skin in the patient's abdomen.

The single incision procedure is too new for long-term safety studies, but Pryor and her partners say it already has meant faster and less painful recoveries

"There are no great studies showing this data yet, but we have some initial data that suggests that pain may be better and wound issues may be better if you have smaller incisions or smaller sites of access," said Pryor.

And that's extra reassurance for patients like Mahboub.

Many insurance companies cover obesity surgery when the patient meets the criteria for "medical necessity" established by the National Institutes of Health:

• You are morbidly obese and have a BMI of 40 or higher
• You have been obese for the past five years or longer
• You have attempted, under your physician's care, other methods of weight loss for at least two years.
• You have a BMI of at least 35 with co-morbidities such as hypertension, diabetes, sleep apnea, degenerative arthritis, heart disease-that merit consideration of medical necessity for surgery.

Click on the extra video link in the photo boxes above to view video of a lap band procedure done at Durham Regional.

Related Links

1. Duke Center for Metabolic and Weight Loss Surgery