The S.L.I.M.M.S.^® Metabolic Procedure

The S.L.I.M.M.S.^® Metabolic Procedure combines the two best bariatric procedures in the world, the Gastric Sleeve and the Gastric Bypass, into one surgery. Invented by Dr. Quebbemann, the goal is to have a more successful metabolic procedure. The combination results in,

• A powerful full feeling with small meals (the bypass effect)
• A powerful decrease in the appetite hormone Ghrelin (the sleeve effect)

S.L.I.M.M.S. Metabolic stands for Surgically Limit Intake Manage Metabolic Syndrome. This procedure was specifically invented for individuals that want to dramatically improve their metabolism. An improved metabolism can result in:

• Weight Loss
• Lower Cholesterol
• Lower Blood Pressure
• Lower Triglycerides
• Resolution of PCOS
• Resolution of Diabetes
• Increased Testosterone in Men
• Better Hormone Balance in Women
• Improved Immune System
• Prevention of Weight Regain
• Better Sleep
• Improved Fertility
• Higher Sex Drive
• More Energy

Why Combine the Sleeve and the Bypass:

The Gastric Sleeve procedure results in a permanent decrease in the hunger hormone Ghrelin. However, over time, most people can eat a lot more because the stomach enlarges. Some people are able to maintain their weight loss, but a large percentage of people (some experts estimate over 50%) regain too much weight after a sleeve. Diabetes and other metabolic conditions can return as well.

The Gastric Bypass often results in a permanent feeling of fullness with smaller meals. However, over time the hunger hormone Ghrelin increases, and so does appetite. As a result, a significant percentage ofpeople regain more weight than they want over time.

Dr. Quebbemann wanted his patients to benefit from both a permanent decrease in Ghrelin, and a permanent feeling of fullness after small meals. He achieved this by combining the two procedures. The S.L.I.M.M.S. ® Metabolic Procedure offers The Power of Combined.

Safety of both procedures combined:

Some people ask if it is safe to have both procedures, the gastric bypass and the gastric sleeve. The answer is yes. Thousands of people in North America have undergone gastric sleeve and later converted to a gastric bypass when they regained weight, developed diabetes, or developed severe GERD. These patients have both a gastric sleeve and a gastric bypass, similar to the S.L.I.M.M.S. ® Metabolic Procedure. In addition, several surgery centers around the world have reported that there is no increase in complications when they remove the entire stomach during a bypass operation. The S.L.I.M.M.S.^® Metabolic Procedure does not involve removing the entire bypassed stomach.

The S.L.I.M.M.S.^® Lifestyle Procedure

The S.L.I.M.M.S.^® Lifestyle Procedure is for people that want to lose weight for lifestyle and cosmetic reasons. This procedure is not designed to be used for people with severe metabolic diseases associated with excess weight. It is for people with less excess weight (between a BMI of 25 and 35) that struggle to achieve permanent weight loss.\

S.L.I.M.M.S. Lifestyle stands for Surgically Limit Intake Make Me Sexy!

Almost everyone has struggled to maintain their best weight, and almost everyone’s weight seems to increase over time. The facts on recent weight loss drugs are that they work well for only 25% of people and must be taken for life. Also, Yo-Yo dieting has been shown to damage your metabolism. So, the S.L.I.M.M.S. Lifestyle Procedure was developed as a new solution for intelligent people that don’t want to be on life-long weight loss drugs, are tired of Yo-Yo dieting, and want a fit lifestyle and a healthy appearance.

Dr. Quebbemann has always believed that those people who know traditional weight loss programs and liposuction won’t work for them deserve a better solution, and bariatric surgery is for treating diseases associated with morbid obesity. So, he invented The S.L.I.M.M.S.^® Lifestyle Procedure, a Reversible Gastric Sleeve, for those people that don’t qualify for traditional bariatric surgery. (See Dr. Quebbemann’s new book, Permanent Surgical Weight Loss).

Plastic surgery is great for body contouring and for removing excess skin but does not result in permanent weight loss – patients will always gain the weight back elsewhere, sometimes in particularly ugly places. The new S.L.I.M.M.S. Lifestyle Procedure is specifically designed to work similar to the standard gastric sleeve, decreasing appetite and helping people eat less, but has the advantage of being reversible.

S.L.I.M.M.S.^® Lifestyle Procedure is a reversible, minimally invasive procedure, designed for lifestyle and cosmetic reasons, and is done as an outpatient. It is available exclusively at S.L.I.M.M.S. Inc.

The S.L.I.M.M.S.^®
Revision of Gastric Bypass

A NEW APPROACH FOR RENEWED SUCCESS

The S.L.I.M.M.S. Revision of Gastric Bypass was invented by Dr. Quebbemann with the goal of offering a new path forward for gastric bypass patients that are unsatisfied with their weight.

Everyone’s body is alive and constantly changing. Even if your anatomy was initially correct after surgery, that doesn’t mean it will stay that way forever. If the opening between the gastric pouch and intestine enlarges, or the size of the gastric pouch “stretches,” many people will find that they regain weight. For other people, their anatomy may remain correct, but they developed an increased appetite and find that they are able to eat a lot more food than they could during the first few years after surgery. In these circumstances, revision of the gastric bypass to a S.L.I.M.M.S. Procedure may be the best option.

Needing a revision does not imply failure by either you or your surgeon, it simply means that “things changed” and need to be improved.

Scientific studies have shown that the hunger hormone Ghrelin decreases dramatically after a gastric bypass. However, it begins to increase at about 6 months after surgery and is normal after one year. When a surgeon performs a standard gastric bypass revision, there is no drop in the hormone Ghrelin. This has led to publications showing that traditional gastric bypass revision often does not help patients. With the S.L.I.M.M.S. Revision of Gastric Bypass, the portion of the already bypassed stomach that produces Ghrelin is removed. Dr. Quebbemann expects this type of revision to have superior results over the standard procedure.

The S.L.I.M.M.S. Revision of Gastric Bypass could be a great fit for individuals that have already had a gastric bypass but are unhappy with their current results.

Gastric Bypass

Reversible surgery for dramatic weight loss

The Roux-en-Y Gastric Bypass is the standard against which all bariatric surgical procedures are measured. This operation was originally invented in 1967 and was then modified in 1980 to the Roux-en-Y configuration still used today. Gastric bypass is not only an excellent weight loss procedure, but often results in a dramatic improvement in diabetes as well as resolution or GERD.

Expert in Gastric Bypass

Dr. Quebbemann was trained in the Gastric Bypass at the University of Chicago in the mid- 1990s. He has since performed thousands of these operations with excellent results. One of the first surgeons in America to perform laparoscopic gastric bypass starting in 1999, he takes the time needed to perform his surgery to very specific standards and uses unique, advanced laparoscopic techniques to lower surgical risk and maximize successful outcomes.

How it Works

For the Gastric Bypass, the stomach and intestine are cut in the manner shown in diagram. This creates a small upper stomach, or pouch (P), that fills up with food quickly during a meal. The lower part of the intestine is moved up and attached to the small upper stomach pouch. The bypassed lower portion of the stomach and intestine are connected so that all the stomach acid, enzymes and other fluids are still available to help digest food.

Why Gastric Bypass

It’s the Gold Standard Weight Loss Procedure in America

No other bariatric procedure has such a long and successful history in terms of dramatic weight loss, low complication rate and metabolic improvement.

It is Reversible

The bypassed stomach and intestine are left in place. Although it is very rare, if there is a reason to reconnect the stomach and intestine back to the original anatomy, it can be done. Of course, you will likely regain some of the weight you lost.

About ‘Dumping’

Dumping can occur when patients eat concentrated sweets, and this sugar enters the intestine before being properly digested. When this occurs, the intestine will “dump,” or flush these sweets through. This is often accompanied by a feeling of indigestion. If a patient eats a large amount of sugary food, they will likely have diarrhea. Dumping can be beneficial by discouraging patients from eating sweets.

Gastric Sleeve

STOMACH SHRINKING SURGERY FOR DRAMATIC WEIGHT LOSS

The gastric sleeve procedure is a true ‘stomach-shrinking’ operation. Approximately 2/3 of the stomach is removed, and the upper stomach can only hold about 20% of the food it was able to hold prior to surgery.

The portion of the stomach removed is the primary site where the hormone Ghrelin is produced. Ghrelin is thought to be the main hormone causing appetite, or hunger. Removing this portion of the stomach has been shown to cause a permanent reduction in Ghrelin, and therefore a decrease in appetite. Of course, with the stomach being dramatically smaller, it only takes a small amount of food to feel full.

CHOOSING DR. QUEBBEMANN FOR YOUR VSG

Dr. Quebbemann was the first surgeon in Orange County to perform the gastric sleeve. He takes the time to perform your surgery to his highly demanding specifications. This includes several unique advanced laparoscopic techniques to lower surgical risk, speed up your recovery, and maximize your success.

General Revision

A Second Chance

Inadequate weight loss or significant weight regain after a gastric sleeve or gastric bypass are indications you may need a revision of your weight loss surgery.

The main thing that bariatric surgery does is to change your anatomy so that you will have a much easier time losing weight and keeping it off. If your anatomy is not working, then it will be very difficult to succeed at permanent weight loss.

Dr. Quebbemann is an expert in bariatric revisions and has been performing revisions and corrections of prior bariatric surgeries since 1997. He is methodical about assessing your anatomy to determine the best possible way to improve your situation. Rather than simply blaming patients. he understands that the causes of weight regain include your physiology and your surgical anatomy.

Choosing Dr. Quebbemann

Dr. Quebbemann has been treating bariatric complications, in particular inadequate weight loss and weight regain, for over 25 years and has performed hundreds of surgical revisions with excellent results. Complications he has treated include lack of weight loss, weight regain, gastroesophageal reflux, band slip and erosion, stomach dilation and others.

Dr. Quebbemann is one of the very few bariatric surgeons that specialize exclusively in weight loss surgery. This means he doesn’t spend any significant amount of time performing other surgical procedures – he’s not a “Jack of All Surgery” – although he is Board Certified in General Surgery. As one of the most experienced surgeons in America, patients struggling with complications after bariatric surgery can be comfortable knowing they are in good hands and being treated by a true expert.

Why Revision?

The most common reason an individual may require a revision of their Gastric Bypass, Gastric Band or Gastric Sleeve is a significant weight regain or return of weight-related medical problems such as GERD or diabetes.

Anatomically, the most common reasons for weight regain are:

• Stomach Dilation: This is a condition where the gastric sleeve or gastric bypass pouch dilates, stretches, or enlarges.
• Anastomotic Dilation: This is a condition where the connection between the gastric bypass pouch and the intestine stretches or dilates.
• Initial Surgery: If you failed to lose weight after your initial surgery, or you lost weight for several months but then regained weight despite following dietary recommendations, the anatomy created at the time of your initial surgery may not have been the best anatomy for you.

A N.E.W. Start Begins with Assessment of your Anatomy

Dr. Quebbemann has helped patients from across the country solve problems they’ve experienced after weight loss surgery. He personally oversees the x-ray evaluation of their anatomy, then reviews the x-rays with each patient, to help them understand his recommendation.

More Options

Dr. Quebbemann Tailors solutions to your specific needs:

SLIMMS Revision for Gastric Bypass: This procedure adds the “gastric sleeve” resection to the overall revision surgery, while also improving your gastric bypass anatomy. By adding the gastric sleeve (removal of a portion of your already-bypassed stomach) Dr. Quebbemann hopes to decrease your hunger hormone, Ghrelin.

Re-Sleeve: re-creating the ideal gastric sleeve anatomy

Bypass Revision: making the gastric pouch, stomach connection, or both smaller

Conversion of Sleeve to Bypass: Change a Gastric Sleeve to a Gastric Bypass, generally to treat diabetes or heartburn.