Patient Guide

Types of Bariatric Surgery

Gastric Banding
Gastric banding, usually done laparoscopically, is a less invasive and the only adjustable and reversible obesity surgery available. During this procedure, surgeons place an inflatable silicone band around the upper stomach to create a new, tiny pouch that limits the amount of food that can be consumed and slows its progression into the stomach and intestines. The patient feels full sooner and satisfied with smaller amounts of food, ultimately losing up to 40 to 60 percent of his or her excess weight over three years.

This procedure usually requires a one-day hospital stay, and normal activities can be resumed in one to two weeks. The band itself is adjustable by adding or removing fluid from the band’s interior through a small port that is placed beneath the patient’s skin.

Adjustments can be made as necessary in the surgeon’s office, where the surgeon can adjust the band via the port with minimal discomfort to the patient. If the band ever needs to be removed, the stomach will return to its original form and function.

Gastric Bypass (Roux-en-Y Gastric Bypass)
If a patient requires even greater weight loss than banding techniques produce, a gastric bypass operation is considered. Gastric bypass procedures reduce absorption of food, in addition to restricting food intake. Patients who have bypass operations generally lose 70 percent of their excess weight within one-and-a-half years.

In Roux-en-Y gastric bypass (RGB), the most common gastric bypass procedure, a small (30 ml) stomach pouch is created by stapling to separate it from the rest of the stomach. Then, a section of the small intestine is attached to the new pouch to allow food to bypass the first portion of the small intestine to reduce calorie and nutrient absorption. The limited quantity of food, combined with reduced absorption of calories, results in faster and perhaps more pronounced weight loss than is normally achieved by the gastric banding procedure. This procedure usually requires a two- to three-day hospital stay, and normal activities can be resumed in four to five weeks.

Laparoscopic Gastric Sleeve Resection
In some cases, a patient’s morbid obesity is so pronounced that the patient would benefit from a two-stage process in order to lose several hundred pounds.

Gastric sleeve resection is usually performed as the first stage. In this surgery approximately 70 percent of the stomach is removed to limit the volume of food intake at one time. After a few months of weight loss and improvements in various medical conditions, a second surgery is offered (gastric bypass or bilio-pancreatic duodenal switch) to reach the goal weight for that patient.

Bilio-Pancreatic Duodenal Switch Surgery
After the stomach is divided as described above for the gastric sleeve resection, this surgery is carried out, usually several months later as the second-stage operation.

During this surgery, the stomach and first part of the small intestine are surgically separated and reattached to the last portion of the small intestine.

In addition to the restriction of intake, food will be in contact with less surface area of intestine than would be the case with gastric bypass surgery, resulting in even fewer nutrients and calories being absorbed and a more significant weight loss. Bilio-pancreatic duodenal switch surgery is usually reserved for the most severely obese patients.

Before, During and After Surgery>>

More about bariatric surgery

Back