The S.L.I.M.M.S.™ Metabolic Procedure

Pioneered by Dr. Brian Quebbemann, 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. By combining the two operations, Dr. Quebbemann hopes his patients have more permanent success through

• Feeling full with small meals (the bypass effect), and;
• Having a sustained decrease in Ghrelin (the sleeve effect)

S.L.I.M.M.S.™-Metabolic, which stands for Surgically Limit Intake Manage Metabolic Syndrome, is designed for individuals who want to surgically improve their metabolism and lose weight: most patients that qualify for a Sleeve or a Bypass will also qualify for the S.L.I.M.M.S.™-Metabolic Procedure.

Why Combine the Sleeve and the Bypass:

The Gastric Sleeve procedure results in a decrease in production of the hunger hormone Ghrelin, and a feeling of fullness with smaller meals. The decrease in Ghrelin lasts, but the portions people can eat generally increase over time, sometimes resulting in weight regain and a return of diabetes and other metabolic conditions.

The Gastric Bypass also results in a decrease in production of the hunger hormone Ghrelin, and a feeling of fullness with smaller meals. While Ghrelin increases back towards normal levels after gastric bypass, most patients continue to feel full after small meals which helps with long-term weight loss.

By combining these two operations, Dr. Quebbemann hopes his patients will benefit from both a permanent decrease in Ghrelin and a permanent feeling of fullness after small meals. The intended result is more consistent weight loss and a more permanent improvement in metabolism, including diabetes, high cholesterol, infertility, chronic fatigue, and other metabolic conditions.

Until now, patients have had to choose either the gastric sleeve or the gastric bypass. The gastric sleeve offers a permanent decrease in Ghrelin, but a higher chance of weight regain and return of diabetes. The gastric bypass provides better long-term weight loss and control of diabetes, but Ghrelin production will increase and appetite may increase as well. 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 only to regain weight, have diabetes recur, or develop severe chronic heartburn and GERD. The treatment for these complications after gastric sleeve is often to convert that person to a gastric bypass. These patients will then have both a gastric sleeve and a gastric bypass similar to the S.L.I.M.M.S.™-Metabolic Procedure. The problem is that they will have had to undergo two separate operations, and they will not benefit from the power of both procedures combined at the same time. With S.L.I.M.M.S.™-Metabolic, you would benefit from the combined effects with only one operation.

The S.L.I.M.M.S.™ Lifestyle Procedure

Introducing the new S.L.I.M.M.S.™-Lifestyle Procedure for people who want to lose as little as twenty-five extra pounds! A new solution for intelligent people that desire permanent weight loss and a fit and healthy lifestyle.

Almost everyone has struggled to maintain their best weight, everyone has lost weight through dieting only to regain it back, and almost everyone’s weight seems to increase over time. Over and over, I hear clients tell me they succeeded with Weight Watchers, Jenny Craig, Keto Diets, or any one of dozens of other diet programs, only to regain all the weight they lost and more! On top of this, news articles and medical experts constantly remind us of the hazards associated with Yo-Yo dieting. But the medical world only offers one mildly successful pill after another, and surgeons only offer plastic surgery in the form of tummy-tucks or liposuction, both of which fail in terms of long-term weight loss and can have major complications or large scars.

A new option:

Dr. Quebbemann believes those people that know traditional weight loss programs and cosmetic surgery won’t work for them deserve a better solution. To help these clients, he invented a new Reversible, Minimally Invasive Stomach Procedure.

The new S.L.I.M.M.S.™-Lifestyle Procedure is designed to help you lose weight for lifestyle and cosmetic reasons, as well as to help you manage future metabolic problems through prevention, rather than waiting until they occur.

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. This is true with both tummy-tuck and liposuction, and all surgeons should know this.

The new S.L.I.M.M.S.™-Lifestyle Procedure is specifically designed to help people eat less, resulting in simple diet changes and rapid and permanent weight loss. And The N.E.W. Program clinic helps to coach patients through the easy DietaryRebuild™ program, written and published by Dr. Quebbemann, to help people make these simple diet changes for permanent success.

Reversible, Minimally Invasive, Outpatient:

S.L.I.M.M.S.™-Lifestyle Procedure is reversible, minimally invasive, and done as an outpatient. Safety is expected to be as high, or higher, than the safety of weight loss surgery for severe obesity, and our goals are client confidentiality and excellent results.

The new S.L.I.M.M.S.™-Lifestyle Procedure is available exclusively at The N.E.W. Program in Newport Beach, California.

Gastric Bypass

Reversible surgery for dramatic weight loss

A gastric bypass operation offers aggressive weight loss and metabolic improvement through a minimally invasive surgery. Patients who undergo a gastric bypass surgery feel full faster and eat less food as a result.

The Gastric Bypass was originally invented in 1967 and was then modified in 1979. The operation we do today is essentially the same as the operation done in 1979, meaning that the procedure has continued to have excellent results for 40 years. This operation is not only an excellent weight loss procedure, but often results in a dramatic improvement in diabetes as well as resolution or GERD.

Gastric Bypass remains the “Gold Standard” procedure in bariatric surgery today.

Expert in Gastric Bypass

Dr. Quebbemann was trained in the Gastric Bypass at the University of Chicago in the early 1990s, 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 excellent surgery, and uses very specific and 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.

As you can see, a gastric bypass operation results in bypassing most of the stomach, and a relatively short portion of the intestine. The bypassed stomach and intestine are reattached so that all the acid, enzymes and other fluids produced by the lower stomach, liver and pancreas are still available to help digest food.

Food goes first into the small stomach pouch and then travels immediately into the intestine where absorption of nutrition takes place.

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 occurs when certain types of foods, primarily food with concentrated sugar (e.g., ice cream), enters the intestine before it’s been digested by the enzymes present in the bypassed stomach and intestine. When the intestine experiences concentrated sweets before they have been properly digested, the intestine will “dump,” or flush these sweets through.


This is often accompanied by a feeling of indigestion or cramping. If you eat a large amount of sugary food, you will likely have diarrhea. Remember, this occurs almost exclusively after eating concentrated sweets.

While unpleasant, experiencing adverse effects when you eat more than a couple of bites of a sugar-filled dessert is not necessarily a bad thing if a patient has gained a lot of weight due to a habit of eating high sugar foods. Most patients experience ‘dumping’ only in the mild form, and dumping can be beneficial by encouraging patients to avoid eating sweets.

Gastric Sleeve

STOMACH SHRINKING SURGERY FOR DRAMATIC WEIGHT LOSS

The gastric sleeve procedure is a true ‘stomach-shrinking’ operation. The concept is simple: since it only takes a small amount of food to fill the new stomach, or “sleeve,” a person will feel like she has eaten more food than she really has, and therefore will reduce food intake.

In addition, the portion of the stomach removed is the primary site in your body 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.

CHOOSING DR. QUEBBEMANN FOR YOUR VSG

Dr. Quebbemann has performed over one thousand successful gastric sleeve operations. By using the most advanced laparoscopic techniques your surgery will typically be less invasive and you will recover much faster.

Although the Gastric Sleeve operation is simple in concept, Dr. Quebbemann will take the time to perform your surgery to his highly demanding specifications. Having a world-class expert focus on performing your surgery as perfectly as possible will help to maximize your long-term results. Dr. Quebbemann includes several unique advanced laparoscopic techniques to lower surgical risk, speed up your recovery, and maximize your success.

Scar-Less Weight Loss Surgery

Look Your Best—Faster—With Minimally-Invasive Micro-Laparoscopic Surgery

The Vertical Sleeve Gastrectomy (also called Sleeve or VSG) is one of the most successful surgical options for weight loss. Using Micro-Laparoscopic Technology, and umbilical incisions (through belly button) Dr. Quebbemann can set you on the path to your best weight while minimizing visible incisions.

Dr. Quebbemann was the first surgeon in the world to successfully perform a single-incision gastric sleeve using the SPIDER® Surgical System, and he continues to demonstrate why he is one of the most skilled surgeons in North America.

How the “Scar-less” Technique Works

After a small incision is made through the belly button, the GelPOINT device is inserted, allowing him to perform the procedure. When the surgical operation is completed, the belly button incision is closed with absorbable suture and any micro-incisions are simply sealed with glue, leaving practically no visible scars behind.

Revision to Improve Prior Surgery

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.

The S.L.I.M.M.S. ™ Revision of Gastric Bypass

A NEW APPROACH FOR RENEWED SUCCESS

Based on the S.L.I.M.M.S.™-Metabolic Procedure, the S.L.I.M.M.S.™ Revision of Gastric Bypass offers a new path forward for patients that have regained weight.

Sometimes patients can regain success simply by improving their gastric bypass anatomy and following some simple lifestyle changes. Other patients need a bit more help.

Your body is living, and constantly changing. Even when your anatomy was correct initially, that doesn’t mean it will stay that way forever. In many people, the anatomic changes from gastric bypass can last a lifetime, but in others they may not. Needing a revision does not imply failure by either you or your surgeon, it may simply mean that “things changed” and need to be corrected. In other patients, the anatomy created at the time of the original surgery may have not been enough to succeed.

When dilation of the small stomach pouch, or disruption of the connection between the stomach pouch and intestine occurs, a standard gastric bypass revision may not help you succeed. Adding the power of a sleeve gastrectomy to the gastric bypass may provide a more powerful improvement.

The S.L.I.M.M.S.™ Revision for Gastric Bypass, invented by Dr. Quebbemann, does just this. It increases the potential benefits of a revision by decreasing your body’s production of the hunger hormone Ghrelin.

WHO MIGHT BENEFIT:

A S.L.I.M.M.S.™ Revision could be a great fit for individuals that have already had a gastric bypass, but want to improve their results for any of the following reasons:

• Unsuccessful Weight Loss
• Weight Regain after Initial Weight Loss
• Recurrence of Diabetes