Advanced Surgical Partners of Virginia

At Advanced Surgical Partners of Virginia, our bariatric surgery (also known as weight loss surgery) program offers a comprehensive clinical approach to surgical and nonsurgical weight loss management for morbid obesity which includes more options than any other program of its kind in the Richmond area. We are the only program in the region offering a new minimally invasive nonsurgical endoscopic sleeve gastronomy (ESG) for patients with a lower BMI that struggle with weight loss success. Our surgeons perform surgery at Parham Doctors’ Hospital, which is accredited as a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®). We also offer years of expertise in general surgery for issues such as diverticulitis or esophageal reflux. Our goal is to offer high-quality care in a patient-centered setting. Our specialists offer care in two convenient locations in Richmond and Fredericksburg.

Richmond
7702 E. Parham Road
Suite 304
Richmond, VA 23294

Fredericksburg
4604 Spotsylvania Parkway
Suite 125
Fredericksburg, VA 22408

For more information about our bariatric surgery (weight loss surgery) options, please watch our online video seminar or request an in-person consultation.

Expert surgical care

Our team of surgeons is made up of accomplished professionals serving the Mid-Atlantic region. We specialize in bariatric surgery (weight loss surgery), nonsurgical weight loss options, and surgery for gastroparesis — led by Matthew Brengman, MD, one of the nation's leading gastroparesis experts. We also offer a wide range of general surgical treatments.

Our team uses a collaborative approach to ensure that patients receive an accurate diagnosis and individualized treatment plan to get the care they deserve.

Nonsurgical weight loss options

We offer patients a wide range of treatments for weight loss, including nonsurgical options. These options include endoscopic procedures which are minimally invasive and don’t require an overnight hospital stay as well as our medical weight loss program. Some of these options include:

• Gastric balloon — A minimally-invasive endoscopic procedure where a saline-filled balloon is inserted into the patient’s stomach to reduce the amount of food that the stomach can hold.
• Endoscopic sleeve gastrectomy (ESG) — A minimally-invasive endoscopic procedure that reduces the size of a patient’s stomach limiting the amount they can eat.
• Medical weight loss — A medically supervised personalized weight loss plan working closely with our team to combine medical, nutritional, exercise, and psychological support.

Bariatric surgery (weight loss surgery)

Bariatric surgery is a tool used to help patients who are experiencing morbid obesity lose weight. There are multiple kinds of bariatric surgery, all of which involve reducing the size of the stomach. This limits calorie intake, which results in weight loss.

Our bariatric surgery program includes:

• Caring and specially trained nursing and support staff
• Commitment-free educational seminars that are held once a month (for a list of dates and to sign up for a seminar, use our online scheduling tool)
• Experienced weight loss surgeons trained in the latest minimally-invasive surgical techniques
• Individualized treatment plans to assure the best patient outcomes
• Long-term follow-up care
• Monthly support group meetings held every fourth Thursday
• Preoperative and postoperative nutritional and support staff
• Preoperative patient education classes to prepare patients for weight loss surgery

Our expert bariatric surgeons provide a range of surgical options. Each option provides its own risks and benefits, and our team provides each patient with a personalized treatment plan and will guide them through the process of making an informed decision about what it best for them. Surgical options include:

• Adjustable gastric band — A restrictive band is placed around the outside of upper part of the stomach and adjusted over time to change the amount of food that will fit into the stomach.
• Sleeve gastrectomy — Removes part of the stomach to make it smaller.
• Roux-en-Y gastric bypass — A small pouch is created from the stomach and connects directly to the small intestine.
• Duodenal switch procedures — Reduces the size of the stomach and intestines.

Bariatric surgical revisions

For patients suffering from weight recurrence or in need of a surgical correction after a bariatric surgery, we will conduct a full evaluation and tailor a treatment and surgical plan to target your specific needs and weight loss goals.

Take the first step toward a healthier tomorrow

If you’re considering a bariatric option for weight loss, the first step is to watch our free online seminar. This seminar will provide you with detailed information about the procedures offered, their risks and benefits, who makes a candidate, as well as what to expect after you have a procedure.

View Our Full Video Playlist on Youtube

Comprehensive gastroparesis care

Gastroparesis, a gastrointestinal (GI) disorder, occurs when the stomach has difficulty emptying food. This leaves food sitting in the stomach for an extended period of time. When this happens, patients can experience a variety of symptoms, including:

• Abdominal pain
• Bloating
• Nausea
• Reflux
• Vomiting

When gastroparesis is severe, these symptoms can lead to little or no food intake. This ongoing lack of nutrition can result in significant weight loss, hospitalization, dehydration and malnutrition.

Diagnosis of gastroparesis

Gastroparesis is generally diagnosed after a patient experiences the common symptoms and confirms the diagnosis with a physician-ordered diagnostic exam, such as:

• Breath testing
• Endoscopy
• Esophagogastroduodenoscopy
• Gastric emptying scans
• X-ray
• Upper GI endoscopy

Types of gastroparesis

There are multiple types of gastroparesis, including:

• Idiopathic gastroparesis — Idiopathic gastroparesis is the most common, however, the origin is unknown. Sometimes it can follow gastric illness or respiratory diseases, but most often is identified by the symptoms alone. These include fullness, bloating and pain—when eating, at night and interfering with sleep. Idiopathic gastroparesis tends to improve over time and appears mostly in young to middle-aged women.
• Diabetic gastroparesis — Diabetic gastroparesis can affect those who have type 1 or type 2 diabetes, with obesity being a major predictor of the disease in those who have type 2 diabetes. Diabetic gastroparesis has multiple root causes, all involving the decrease of GI movement and nerve functions. Frequent vomiting is the most common symptom for this group.
• Postsurgical gastroparesis — Postsurgical gastroparesis is considered a complication of routine procedures, such as those used to correct reflux, treat peptic ulcer disease (vagotomy) and promote weight loss.

In addition to the causes above, gastroparesis may be a result of:

• Crohn's disease
• Eating disorders
• Hormonal disruption diseases
• Neurological disorders (such as Parkinson's disease, stroke, multiple sclerosis or spinal injuries)
• Pregnancy
• Radiation therapy
• Smoking

Children are rarely affected by gastroparesis but may develop it as a result of viral infections.

Gastroparesis treatment

There are many ways, both surgical and non-surgical, to help reduce the symptoms of gastroparesis. These include:

• Botulinum toxin injections — Botulinum toxin, commonly referred to as Botox, injected directly into the pylorus (the opening from the stomach into the small intestine) has been shown to assist in both gastric emptying and symptoms of gastroparesis.
• Dietary changes — Most patients can manage their condition with dietary changes. The most common recommended dietary change is to eat smaller, more frequent meals, and avoid high fiber and high fat foods, as they cause delays in stomach emptying. Your physician can help tailor your diet to meet your nutritional needs while addressing the symptoms of the disease.
• Medication management — When symptoms cannot be managed through dietary changes, another common treatment option is medication management. Common medication management for gastroparesis includes prokinetics (drugs that enhance GI movement), or insulin changes for those with diabetes.

Gastroparesis surgery

Some patients with severe gastroparesis are not able to manage symptoms with dietary changes or medication, which is when surgical treatment is considered.

Our doctors offer multiple kinds of surgical procedures to treat gastroparesis, including:

• Enteral feeding tube — Enteral feeding tubes are devices that are able to provide nutrition directly into the gut.
• Gastric electrical stimulation — Gastric electrical stimulation is a treatment wherein a gastric “pacemaker” is implanted in the patient. It is most effective in treating patients who are diabetic or have post-surgical gastroparesis.
• Pyloroplasty — Pyloroplasty is the surgical widening of the muscle in the lower part of the stomach to allow for increased emptying into the small intestine. The procedure is performed using a minimally invasive technique and improves gastroparesis symptoms in at least 80 percent of patients.

The combined therapies listed above commonly lead a person suffering from gastroparesis back to a more normal body function. These therapies have been shown to improve and stabilize nutrition, reduce hospitalizations and improve quality of life.

Gastroparesis patient seminar

Gastroparesis is difficult to diagnose, and is often misunderstood or mistaken for something else. Because of this common confusion, Dr. Brengman hosts a recorded seminar on YouTube for his patients to understand the background of gastroparesis, what causes it, how physicians identify the condition, and ultimately, the options for treatment.

Watch the Gastroparesis Patient Seminar on Youtube

General surgery

We offer many general surgical procedures to treat a wide range of conditions, including:

• Colon cancer
• Diverticulitis
• Esophageal reflux
• Hernias
• Morbid obesity

We also treat diseases of the:

• Esophagus
• Gallbladder
• Pancreas
• Small intestine
• Spleen
• Stomach