Specialized gastric interventions customized for your condition, providing effective treatment for digestive disorders, pain relief, and improved quality of life.
Dr. Nguyen specializes in a range of advanced stomach procedures tailored to address various digestive disorders and conditions. Each surgical approach is designed to effectively treat the underlying problem, alleviate symptoms, and restore proper gastric function while using the most appropriate techniques for your specific diagnosis.
Explore our stomach procedure options below to discover which approach might be most suitable for your specific condition and personal digestive health needs.
This precise surgical procedure removes part or all of the stomach to address serious conditions such as cancer, bleeding, perforation, or certain severe digestive disorders unresponsive to other treatments.
What happens during surgery?
Using either minimally invasive techniques or an open approach depending on your specific condition, your surgeon carefully removes the affected portion of the stomach. The remaining sections are reconnected to preserve digestive continuity whenever possible. For total gastrectomy, the esophagus is connected directly to the small intestine. The entire procedure typically takes 2-4 hours under general anesthesia.
Benefits:
Effective treatment or potential cure for gastric cancer and precancerous conditions
Resolution of uncontrollable bleeding or perforation issues
Relief from symptoms of certain advanced stomach disorders
Minimally invasive options available for appropriate candidates
Preservation of digestive function through careful reconstruction
Long-term solution for conditions unresponsive to medication or other therapies
Gastrectomy provides a definitive intervention for serious gastric conditions, effectively addressing the underlying problem while maintaining the best possible digestive function through meticulous surgical technique and reconstruction.
This specialized procedure addresses complicated peptic ulcers by modifying stomach anatomy and nerve supply to reduce acid production and improve stomach emptying, treating ulcers that haven't responded to medication.
What happens during surgery?
Using minimally invasive techniques when possible, your surgeon performs one or both components: pyloroplasty widens the stomach outlet (pylorus) to improve emptying, while vagotomy involves cutting specific branches of the vagus nerve to reduce stomach acid production. These precise modifications help prevent ulcer recurrence and complications. The entire procedure typically takes 1-3 hours under general anesthesia.
Benefits:
Effective treatment for ulcers resistant to medical therapy
Prevention of serious ulcer complications like perforation and bleeding
Reduced stomach acid production to promote healing
Improved stomach emptying and reduced pressure on the digestive tract
Relief from chronic pain and digestive discomfort
Decreased likelihood of ulcer recurrence
Ulcer repair surgery offers a durable solution for patients with complicated or treatment-resistant peptic ulcers, addressing both symptoms and underlying causes to provide long-term relief and prevent potentially life-threatening complications.
This precise anti-reflux procedure wraps the upper portion of the stomach around the lower esophagus, creating a stronger barrier that prevents stomach acid from flowing upward and eliminates chronic heartburn and GERD symptoms.
What happens during surgery?
Using minimally invasive techniques whenever possible, your surgeon accesses the junction where the esophagus meets the stomach. The upper part of the stomach (fundus) is carefully wrapped around the lower esophagus and secured with stitches, creating a one-way valve effect that allows food to pass down while preventing acid from refluxing upward. The entire procedure typically takes 1-2 hours under general anesthesia.
Benefits:
Significant reduction or elimination of acid reflux symptoms
Decreased dependence on daily acid-reducing medications
Protection of the esophagus from ongoing acid damage
Reduced risk of Barrett's esophagus and esophageal cancer
Improvement in related symptoms like chronic cough and asthma
Long-lasting results for most patients (typically 10+ years)
Nissen fundoplication offers a durable solution for severe GERD that doesn't respond adequately to medication, allowing patients to enjoy meals without painful reflux while protecting long-term esophageal health and improving overall quality of life.
This corrective procedure addresses the protrusion of the stomach through the diaphragm into the chest cavity, repositioning the stomach and reinforcing the weakened diaphragmatic opening to alleviate symptoms.
What happens during surgery?
Using minimally invasive techniques in most cases, your surgeon carefully returns the portion of stomach that has moved into the chest cavity back to its proper position below the diaphragm. The enlarged opening in the diaphragm is narrowed with sutures, and the area is often reinforced. A partial fundoplication may be performed simultaneously to prevent reflux. The entire procedure typically takes 1-2 hours under general anesthesia.
Benefits:
Significant reduction in heartburn, regurgitation, and chest pain
Relief from difficulty swallowing and the feeling of food getting stuck
Prevention of serious complications like strangulation
Reduced risk of aspiration pneumonia and respiratory issues
Minimized post-operative discomfort with laparoscopic approaches
Long-lasting correction of the anatomical defect
Hiatal hernia repair offers effective treatment for persistent symptoms and structural abnormalities, allowing patients to eat comfortably and sleep without the discomfort of stomach contents entering the chest cavity or chronic acid reflux.
This vital procedure creates a direct opening into the stomach through the abdominal wall, allowing for the placement of a feeding tube when normal eating is impossible or insufficient to maintain adequate nutrition.
What happens during surgery?
Using either an open surgical approach or minimally invasive techniques when appropriate, your surgeon makes an incision in the upper abdomen to access the stomach. A small opening is created in the stomach wall, and a specialized feeding tube is inserted and secured in place. The tube is then brought through the abdominal wall, creating a stable pathway for nutrition delivery. The entire procedure typically takes 30-60 minutes under general anesthesia.
Benefits:
Reliable route for nutrition, hydration, and medication delivery
Bypasses swallowing difficulties caused by neurological conditions or head and neck disorders
More comfortable and discreet than long-term nasogastric tubes
Reduces risk of aspiration pneumonia in patients with swallowing dysfunction
Easily maintained and managed once healing is complete
Potential for removal if normal eating ability returns
Open gastrostomy provides essential nutritional support for patients unable to eat adequately by mouth, ensuring proper nutrition and medication delivery while improving comfort and quality of life for those with long-term feeding challenges.
This targeted procedure creates a direct opening into the jejunum (middle section of the small intestine) through the abdominal wall, allowing for feeding tube placement when stomach access is contraindicated or bypassed.
What happens during surgery?
Using either an open or minimally invasive approach based on your specific needs, your surgeon makes an incision in the abdomen to access the jejunum portion of the small intestine. A small opening is created in the intestinal wall, and a specialized feeding tube is inserted and secured in place. The tube is then brought through the abdominal wall, establishing a stable pathway for nutrition delivery beyond the stomach. The entire procedure typically takes 45-90 minutes under general anesthesia.
Benefits:
Provides crucial nutritional support when stomach feeding isn't possible
Bypasses the stomach entirely for patients with gastric outlet obstruction or after gastric surgery
Reduces risk of aspiration in patients with severe gastroesophageal reflux
Allows for specialized formula delivery directly to the small intestine
Can be temporary or permanent depending on the patient's needs
Preserves nutritional status during treatment of complex gastrointestinal conditions
Jejunostomy offers essential nutritional support for patients with upper digestive tract disorders, ensuring proper delivery of nutrients to the small intestine while avoiding the stomach when necessary due to disease, obstruction, or previous surgical intervention.
All our stomach procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques. We're committed to providing you with the most effective, specialized care for gastric conditions because we believe you deserve:
Relief from chronic stomach pain and digestive discomfort
Expert treatment of conditions like ulcers, tumors, and reflux disease
Minimally invasive approaches when appropriate for faster healing
Preservation of stomach function and digestive capabilities
Improved nutritional absorption and overall digestive health
Reduced dependency on long-term medication regimens
Comprehensive care from diagnosis through recovery and beyond
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.
Bariatric surgery offers life-changing benefits for those struggling with severe obesity. Beyond significant weight loss, it can dramatically improve or resolve many serious health conditions associated with obesity. Research shows that approximately 300,000 deaths in America annually are linked to obesity-related complications, making this intervention potentially life-saving for many patients.
Following bariatric surgery, patients typically experience remarkable health improvements, often within just a few months. Medical conditions that may be greatly improved include:
Type II Diabetes: More than 90% of patients achieve excellent results, usually within weeks—normal blood sugar levels, normal Hemoglobin A1C values, and freedom from medications, including insulin. No other medical treatment can achieve such profound effects.
High Blood Pressure: At least 70% of patients who take medications for hypertension are able to stop all medications and achieve normal blood pressure within 2-3 months after surgery.High Cholesterol: More than 80% of patients develop normal cholesterol levels within 2-3 months following the procedure.
Sleep Apnea: Dramatic relief occurs as weight is lost, with many patients completely resolving their symptoms within a year and no longer needing CPAP machines.
Joint Pain and Arthritis: Patients typically experience considerable relief from degenerative arthritis and back pain, often with the first 25-30 pounds lost within a month after surgery.
Respiratory Problems: Improved breathing ability and exercise tolerance usually occur within the first few months, allowing many patients to participate in activities they previously couldn't manage.
Gastroesophageal Reflux Disease (GERD): Relief of all reflux symptoms usually occurs within days of surgery for nearly all patients.
Stress Urinary Incontinence: This condition responds dramatically to surgical weight loss and typically becomes completely controlled.
Heart Disease: While direct reduction can't be definitively proven, improvements in related conditions like high blood pressure, high cholesterol, and diabetes suggest significant risk reduction.
Bariatric surgery is worth considering when traditional weight loss methods have been unsuccessful and your health is at risk due to obesity. Our team is committed to helping you determine if this transformative option aligns with your health goals and personal circumstances.
Candidates for bariatric surgery typically have a body mass index (BMI) of 40 or higher (approximately 100 pounds overweight) or a BMI of 35-39.9 with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. We also consider patients who have tried multiple structured weight loss programs without achieving lasting results.
During your consultation, our experienced surgical team will review your complete medical history, weight loss attempts, and current health status to determine if bariatric surgery is the right option for your unique situation. Our goal is to help you find the most effective path to improved health and quality of life.
Bariatric surgery is typically considered successful when a patient loses 50 percent or more of their excess body weight. However, success extends far beyond the numbers on a scale. Many patients experience significant health improvements that can be life-changing or even lifesaving—such as resolution of type 2 diabetes, reduced blood pressure, improved sleep apnea, decreased joint pain, and enhanced mobility.
While complete loss of excess weight is uncommon, the health benefits achieved often dramatically improve quality of life and longevity. It's important to understand that bariatric surgery is a powerful tool, not a quick fix. Long-term success depends on your commitment to adopting new lifestyle habits, including regular physical activity, mindful eating patterns, and ongoing follow-up care with our team.
Yes, there are temporary activity restrictions following bariatric surgery to ensure proper healing and optimal results. During your initial recovery period, strenuous activities, heavy lifting, and intense exercise should be avoided to allow your body time to heal properly. However, walking is not only permitted but strongly encouraged as an essential part of your recovery process—it helps prevent complications like blood clots and promotes healthy circulation.
We advise patients not to drive while taking prescription pain medications, as these can impair judgment and reaction time. Most patients can switch to over-the-counter pain relievers like Tylenol within a few days after surgery, at which point driving may be resumed if you feel comfortable.
During your first follow-up appointment, your surgeon will evaluate your progress and provide personalized guidance about returning to work and gradually increasing activity levels. While recovery varies by individual and procedure type, most patients return to work within three to six weeks after surgery.
Many insurance companies now recognize obesity as a substantial health risk and do provide coverage for bariatric surgery procedures. However, coverage varies significantly between insurance providers and specific plans. Most insurers require documentation of medical necessity, which typically includes:
A body mass index (BMI) of 40 or higher, or BMI of 35-39.9 with obesity-related health conditions
Evidence of previous structured weight loss attempts
Medical records documenting obesity-related health problems
Psychological evaluation confirming readiness for surgery
Participation in a medically supervised weight loss program
We recommend contacting your insurance provider directly to understand your specific coverage details, and our team is always available to help you understand the process and maximize your benefits for these life-changing procedures.
Following bariatric surgery, you will need to follow a structured dietary progression that allows your newly modified digestive system to heal while providing essential nutrition. This process typically unfolds in several phases over the first few months after surgery:
Phase 1 (1-2 weeks): Clear liquids and protein shakes to allow for initial healing
Phase 2 (2-4 weeks): Pureed foods with a focus on protein sources
Phase 3 (4-6 weeks): Soft foods that are easy to digest
Phase 4 (6+ weeks): Gradual transition to regular healthy foods
Long-term dietary guidelines typically include eating smaller, protein-focused meals; chewing food thoroughly; separating liquids from solid foods; avoiding sugary, high-fat, and highly processed foods; and staying well-hydrated throughout the day.
We strongly recommend working with a registered dietitian who specializes in bariatric nutrition, as professional guidance is crucial for optimal results. Regular consultations with a dietitian can help ensure you're getting adequate nutrition while maximizing your weight loss results.
Exercise is a vital component of your post-surgical recovery and long-term success. Light exercise, particularly walking, should begin almost immediately after surgery—even while you're still in the hospital. These gentle movements promote healing, reduce the risk of blood clots, and help prevent complications.
During your first month after surgery:
Start with short, gentle walks several times daily
Gradually increase your walking distance and time as your energy improves
Focus on proper breathing and maintaining good posture
Avoid lifting anything heavier than 10-15 pounds
By weeks 4-6, many patients can begin incorporating more varied activities as approved by their surgeon. More vigorous exercise will typically be introduced around 6-8 weeks post-surgery, assuming your recovery is progressing well.
Exercise offers numerous benefits beyond weight loss—it helps preserve muscle mass during rapid weight loss, improves cardiovascular health, enhances mood through endorphin release, and increases your overall energy levels. Many patients find that regaining the ability to engage in physical activities they once enjoyed is one of the most rewarding aspects of their bariatric journey.
During your follow-up appointments, we'll discuss appropriate exercise progression based on your individual healing process and fitness goals. Remember that consistency is more important than intensity, especially in the beginning—creating sustainable exercise habits now will support your weight loss and health improvements for years to come.
Weight loss after bariatric surgery follows a predictable but individualized pattern. Excess weight loss begins immediately after surgery and typically continues steadily for 18-24 months, though individual experiences may vary.
During the first three months, patients often experience rapid weight loss as their body adjusts to the surgical changes and reduced caloric intake. Many patients lose 25-35% of their excess weight during this initial phase. The rate of weight loss then typically slows but remains steady through the first year, when most patients achieve 60-70% of their total excess weight loss.
Weight loss generally continues at a slower pace during the second year, with many patients reaching their maximum weight loss between 18-24 months after surgery. After this period, weights typically stabilize, and the focus shifts to maintaining the significant results achieved.
Several factors influence your specific weight loss timeline, including:
The type of bariatric procedure you undergo
Your starting BMI and health status
Your adherence to dietary guidelines
Your exercise routine and physical activity level
Your metabolism and genetic factors
During your follow-up appointments, we'll monitor your progress, celebrate your milestones, and provide guidance to help optimize your results. Remember that while the scale is one measure of success, the improvements in your health, mobility, and quality of life are equally important achievements throughout this journey.
Yes, it is possible to regain weight after bariatric surgery, though bariatric procedures have an excellent long-term track record for helping individuals with severe obesity maintain significant weight loss compared to non-surgical approaches. Understanding the factors that influence long-term success can help you maintain your results.
Most patients reach their maximum weight loss around 18-24 months after surgery. After this period, some degree of weight fluctuation is normal, and minor weight regain (5-10 pounds) is not uncommon. However, substantial weight regain is preventable in most cases with proper adherence to post-surgical guidelines.
Key factors that help prevent weight regain include:
Consistent adherence to the recommended dietary guidelines
Regular physical activity and exercise
Attending all scheduled follow-up appointments
Participating in support groups or counseling when needed
Addressing emotional or stress-related eating patterns
Monitoring nutritional intake and vitamin levels
Even if some weight regain occurs, it typically represents only a fraction of the original weight loss, and most patients maintain significant improvements in their health and quality of life.
Remember that bariatric surgery is a powerful tool, but long-term success depends on your commitment to permanent lifestyle changes. With dedication and proper support, most patients maintain life-changing results for many years.
Like any major surgery, bariatric procedures involve certain risks that should be carefully considered. In general, the more extensive the operation, the greater the potential for complications. Understanding these risks is an important part of making an informed decision about weight loss surgery.
Potential surgical complications include:
Abdominal hernias (more common with "open" surgery than laparoscopic procedures)
Leakage through staples or sutures (rare)
Ulcers in the stomach or small intestine
Blood clots in the lungs or legs
Stretching of the pouch or esophagus
Persistent vomiting and abdominal pain
Inflammation of the gallbladder
Failure to lose weight (very rare)
Gallstone formation is a common concern, affecting more than one-third of bariatric patients during rapid weight loss. This risk can be reduced with preventative medication taken for the first six months after surgery.
Long-term health considerations include:
Nutritional deficiencies (affecting nearly 30% of patients) such as anemia, osteoporosis, and metabolic bone disease, which can be prevented with lifelong vitamin and mineral supplementation
Medication restrictions, particularly non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin-containing products
Increased health risks from smoking, which can cause ulcers after surgery
For women of childbearing age, pregnancy should be avoided for 18-24 months after surgery until weight stabilizes, as rapid weight loss and nutritional deficiencies can affect fetal development.
Modern laparoscopic techniques have reduced many surgical risks, resulting in smaller incisions, shorter hospital stays, and quicker recovery periods compared to traditional open surgery approaches.
How long will I stay at the hospital?
Most patients undergoing bariatric surgery will be admitted for a one-night stay and be discharged the following day.
Your surgical team will monitor your initial recovery, including pain management, hydration, and mobility.
For some patients requiring additional observation, hospital stays can be extended on a case-by-case basis.
What can I eat after surgery?
During your first week after surgery, you'll follow a full-liquid diet until your initial post-operative appointment, which allows your newly modified digestive system to heal properly.
Your bariatric manual contains detailed information about:
Dietary progression stages
Recommended protein intake
Hydration requirements
Supplement schedules
How do I care for my incisions?
For laparoscopic procedures, your incisions are closed with a special medical-grade adhesive.
Care instructions:
You may shower or bathe the day after surgery
No special dressings or bandages are needed
Avoid swimming pools and hot tubs for at least 2 weeks
Monitor for signs of infection (redness, swelling, discharge, increased pain)
When can I drive after my surgery?
Do not drive while taking prescription pain medications
Resume driving once you've switched to over-the-counter pain relief
Most patients return to driving within 1-2 weeks
Only drive when you feel comfortable and can react quickly if needed
Do I have any medication restrictions?
For the first 4 weeks after surgery:
Crush medications or take in liquid form when possible
Avoid extended-release medications and soft gels
Discuss diuretic medications with your physician
Consult our team before starting any new medications
When can I drink coffee or alcohol?
Coffee:
Only decaffeinated coffee for the first 4 weeks
Caffeine can irritate your healing stomach
Alcohol:
Generally acceptable after about 4 weeks (varies by patient)
Effects may be more intense after surgery
Carbonated beverages should be avoided indefinitely.
What if I am nauseous after surgery?
Nausea management:
Take prescribed anti-nausea medications as directed
Stay hydrated with small, frequent sips of clear fluids
Avoid strong odors
Contact our office immediately if you experience persistent nausea or vomiting
What if I am constipated after surgery?
Constipation is common after surgery. To manage it:
Drink at least 64 ounces of fluid daily
Take fiber supplements like Metamucil mixed with water
Engage in regular light walking
Use any prescribed stool softeners
Contact our office if constipation persists despite these measures.