Below you will find a menu of weight loss surgeries to choose from, with each having its own benefits and risks and statistics on success rate.
Roux-en-Y is still the preferred method of surgery for most bariatric surgeons. It's been around for quite awhile and involves stapling the stomach pouch in order to create a smaller stomach area. Passage of food is also faster because you bypass a section of the small intestine. We call that rapid transit time. The smaller stomach area, coupled with the bypass of some of the intestine allows for dramatic weight loss if you follow dietary and exercise guidelines. In the hands of an experienced surgeon, this surgery can be life-altering for chronically obese patients.
Billiopancreatic diversion with duodenal switch is a procedure that involves removal of about 80% of the stomach in order to create a thin "sleeve-like" pouch. The surgery also bypasses the majority of the small intestine and connects the end portion of the intestine to the duodenum, located near the stomach. There is a greater risk with this surgery for malnutrition and vitamin deficiencies, since food digestion time is limited and much more rapid, meaning that there is less time to absorb and process nutrients from food being eaten. Patients need to be closely monitored and this surgery is often reserved for someone who's BMI lurks above 50.
A new less permanent option that involves no surgical cutting of the digestive tract is the Lap-Band adjustable gastric banding, which uses an inflatable band that is fitted over the external aspect of the stomach and placed halfway down, so your stomach is literally divided in half with a very narrow center channel. The band holds the diameter of that channel static, so that the amount of food you can eat in one sitting is limited by the "halved upper stomach area" and the narrowed channel slows the emptying and digestion of that portion of food in the lower half of the stomach. The major plus is that the lap band can be adjusted to allow the channel to be enlarged (if the patient finds that the amount of food he can tolerate is too little) or the lap band can be removed (for example, if a women subsequently becomes pregnant). It's considered a simpler approach to bariatric surgery, however it showcases slower, less stellar numbers in terms of weight loss. It may not be a good option for someone with Crohn's disease, large hiatal hernia or a history of gastric ulcers.
Vertical banded gastroplasty is also called stomach stapling and it mechanically divides the stomach into two parts, which limits the amount of food you can eat. There's no bypass involved, just the use of a surgical stapler that divides your stomach now into two separate sections. The upper section receives food first (obviously far less food because of the limited room) and then it empties into the lower pouch. Success rate for long term substantial weight loss is limited.
Sleeve gastrectomy is considered an alternative to gastric bypass, and it is typically offered to morbidly obese patients who have a BMI over 50. From a surgical perspective it's sort of part one of the billopancreatic diversion with gastric switch surgery mentioned above. The surgery reshapes your stomach into a tube-like shape, restricting the amount of calories that your body can absorb from food consumed. Sometimes this is done as a phase one surgery to allow an extremely obese person to lose some weight. Then part two of the surgery is performed later on, creating the billopancreatic diversion, which helps to nudge additional weight loss (which may have slowed a bit). The two phase surgery may minimize some of the risks that a morbidly obese person faces undergoing any kind of surgery.
Published On: February 01, 2011