BARIATRIC SURGERY

Types of Surgery

Weight loss operations fall into three categories:

• Restrictive procedures make the stomach smaller to limit the amount of food intake
• Malabsorptive techniques reduce the amount of intestine that comes in contact with food so that the body absorbs fewer calories
• Combination operations employ both restriction and malabsorption

Restriction Operations

These procedures are the least commonly performed. They encourage weight loss two ways:

• Reduce the amount of food you can eat. We shrink your stomach by creating a small pouch at the top of the stomach where food enters from the esophagus. This makes it impossible for you to each much. At first, the pouch only holds about 1 ounce of food. It expands to hold 2-3 ounces over time.
• Slow the speed food empties from your stomach. The lower outlet of the pouch is only about 1/4 inch in diameter. Because it’s so small, food empties slowly and you feel full longer.

There are two types of restrictive operations:

• Gastric banding (”lapband”). A band of special material is placed around the upper end of the stomach. This creates a small pouch and narrow passage into the rest of the stomach.
• Vertical banded gastroplasty. This common procedure creates the pouch with both a band and staples.

Gastric Bypass Operations

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Gastric bypass procedures are combination operations. That is, they combine both restrictive and malabsorptive techniques:

• Create a small stomach pouch to restrict the amount of food you can eat.
• Construct a bypass of the duodenum and other parts of the small intestine to cause malabsorption.

There are two types of gastric bypass procedures:

View Roux-en-Y gastric bypass

Roux-en-Y Gastric Bypass (RGB). This is the most common bariatric procedure. First, we create a small stomach pouch with staples or a vertical band. This restricts food intake. Then we attach a Y-shaped section of the small intestine to the pouch to allow food to bypass the first and second segments of the small intestine. This reduces your body’s ability to absorb nutrients and calories. More about Roux-en-Y gastric DISTAL Gastric Bypass (Duodenal Switch, Biliopancreatic Division). In this procedure, a portion of the stomach is removed. The remaining small pouch is then directly connected to the last portion of the small intestine. The risk for nutritional deficiencies is highest with this procedure.