What is weight loss surgery?
Weight loss surgery includes a wide array of procedures performed on those who are severely overweight. Generally speaking, weight loss is achieved by reducing the size and volume of the stomach.
Different types of bariatric procedures
While there are many different procedures and variations of procedures, there are three weight loss procedures that are most commonly performed in the United States. These procedures are sometimes labeled as restrictive, malabsorptive or both. During restrictive procedures, the surgeon creates a small stomach pouch, that limits the amount of food patients can eat. The smaller stomach pouch fills quickly, which helps patients feel satisfied with less food. During malabsorptive procedures, the surgeon reroutes the small intestine so that food skips a portion of it. The small intestine absorbs calories and nutrients from food, and avoiding part of it means that many calories and nutrients are not absorbed The most commonly performed procedures are Adjustable Gastric Banding, Roux-en-y Gastric Bypass, and Vertical Sleeve Gastrectomy. Certain procedures use both restriction and malabsorption.
Adjustable Gastric Banding
Gastric Band Surgery makes you feel full sooner which results in less food consumed at one time and makes it easier for you to participate in healthy eating and lifestyle habits. With Gastric Band Surgery, your stomach is divided into two parts: a small upper pouch and a lower stomach. The upper pouch can only hold about 4 ounces (1/2 cup) of food. For this reason, you will feel full sooner and longer than usual. Lap Band surgery does not change the functions of your digestive system. Food consumed passes through the digestive tract in the normal route.
Approximately four to six weeks after gastric band surgery, you will visit your surgeon and begin a series of periodic procedures to adjust your band. These gastric band adjustments may be necessary as long as you have your band in place. Your surgeon may tighten the Gastric Band by injecting saline into the injection port. As the saline is introduced to the injection port, it travels through the tube to the Gastric Band. The addition of saline to the band creates a smaller opening between the stomach and the upper stomach pouch. This smaller opening pouch restricts the amount of food you can eat before feeling full.
Roux-en-Y Gastric Bypass Surgery
Gastric bypass surgery makes the stomach smaller and causes food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size. This reduces the amount of food you can eat at one time. Bypassing part of the intestine reduces how much food and nutrients are absorbed. This leads to weight loss. In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted. In a Roux-en-Y gastric bypass, only a small part of the stomach is used to create a new stomach pouch, roughly the size of an egg. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum). This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach). A small pouch is created along the inner curve of the stomach and a segment of the small intestine is attached to the pouch to allow food to bypass a portion of the intestine. This results in reduced calorie and nutrition absorption. It is a restrictive and malabsorptive procedure.
Vertical Sleeve Gastrectomy
During this procedure a bariatric surgeon removes about 85 percent of the stomach so that it takes the shape of a tube or sleeve.
This operation is performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large incision. He or she inserts a viewing tube with a small camera (laparoscope) and other tiny instruments into these small incisions to remove part of the stomach.
The tube-shaped stomach that is left is sealed closed with staples. In some cases, gastric sleeve surgery may be followed by a gastric bypass surgery or duodenal switch surgery after a person has lost a significant amount of weight. Called a "staged" approach to weight loss surgery, this makes the second procedure less risky than it would have been had it been the first and only procedure.
The timing of the second surgery varies according to the degree of weight loss. It usually occurs within six to 18 months after the initial surgery.
More information on Weight Loss Surgery
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