Weight Loss Surgery

by Trudy Despain
(last updated March 13, 2012)

There are five kinds of surgical procedures available that make alterations to the digestive system. The four main categories are:

  • Gastric Bypass
  • Gastric Banding
  • Gastric Sleeve
  • Duodenal Switch

There are two techniques available within the gastric bypass category of weight loss surgeries: Roux-en-Y-Gastric Bypass and Biliopancreatic Diversion Bypass. Both surgeries leave permanent incision scarring but in a place that clothing would normally cover.

In both methods of gastric bypass, a surgeon reduces the size of the stomach by cutting across the top of it, sealing it off from the rest of the stomach. The result is a pouch the size of a walnut. A full size stomach can usually hold about 3 pints of food but a post-gastric bypass stomach only holds about one ounce. More changes are made as the surgeon cuts the small intestine and sews part of it directly onto the pouch. This done to allow food to bypass most of the stomach and first section of the small intestine. This reduces the amount of nutrients that can be absorbed from each meal making it more difficult for the body use and store calories.

The most common of the bypass surgeries is called Roux-en-Y-Gastric Bypass. This technique is considered to be less complicated than the biliopancreatic diversion bypass since this option does not remove portions of the stomach. It can also be done laparoscopically using multiple smaller incisions instead of one long incision. This smaller, less invasive surgery produces less scarring and allows for shorter recovery times than traditional Roux-en-Y-gastric bypass.

The second bypass method, biliopancreatic diversion bypass, leaves one long incision scar. This surgery is more invasive and risky because portions of the stomach are removed and the bypass is attached to the third and terminal portion of the intestine. This procedure is less common due to greater risk of nutritional deficiencies.

Gastric banding is aweight loss surgery procedure where a surgeon places a silicone band with an inflatable inner portion around the upper stomach to restrict food intake. This band makes the stomach seem smaller by creating a small pouch area and a smaller passageway for food to enter the lower stomach. Because it takes longer for food to move from the upper to the lower stomach, patients experience the feeling of fullness longer. Conveniently, the silicone band can be tightened or loosened as needed to accommodate the needs of the patient.

Gastric Sleeve is a procedure wherethe surgeon surgically removes about 80% of the stomach, making it appear more like a tube or sleeve than a pouch. The smaller stomach reduces a patient's ability to overeat.

Duodenal switch surgery is similar to the gastric sleeve procedure because the surgeon first surgically removes about 80% of the stomach. The next portion of the procedure is similar to biliopancreatic diversion but the pyloric valve of the stomach is left intact as well as the duodenum portion of the small intestine. The small intestines are rearranged in order to separate the flow of food from the flow of bile and pancreatic juices. There is less area for the food to interact with the digestive juices; therefore there is less chance for nutrients to be absorbed by the body. The result is fewer calories consumed and even fewer calories absorbed by the body that can be stored as fat.

With a surgery involving something as invasive as reducing the size of the stomach, education and informative decision making is key. Question your doctor in depth about the different procedures available and the risks and benefits associated with each in order to receive the best outcomes.

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