Gastric bypass
is a surgical procedure to treat extreme obesity. Individuals at least 100 pounds overweight may be candidates for gastric bypass surgery. Others with specific medical conditions such as diabetes or high blood pressure who are not 100 pounds overweight may still be considered as candidates if no other viable options exist. Several procedures are available, depending on the physical and emotional needs of the patient.
Lap-Band
The Lap-Band is a restrictive procedure, limiting the amount of food consumed. An adjustable silicone band is placed around the stomach, dividing it into two sections; the smaller pouch at the top is used to eat. Food drains slowly through the remainder of the stomach and into the intestines using the normal pathways and allowing normal absorption of nutrients. Recovery is quick as the surgery is performed laparoscopically.
Roux-en-Y Gastric Bypass
The Roux-en-Y gastric bypass is the classic and most frequently performed procedure. This malabsorptive procedure divides the stomach into two sections, with the new pouch being connected directly the the intestines, bypassing the lower stomach and a portion of the small intestine. As a result, some nutrients are no longer absorbed from food--hence the term malabsorptive.
Laparoscopic Gastric Bypass
Laparoscopic gastric bypass is a less invasive procedure, performed through 5 to 6 small incisions. In addition to Lap-Band surgery, the traditional Roux-en-Y can also be performed laparoscopically. Using a lighted scope projected on closed circuit TV, the surgeon achieves a full view of the patient's organs without an open incision. Recovery time and mortality rates are both reduced by having these wounds heal quickly. Not all patients are candidates for laparoscopic surgery.
Silastic Ring Gastric Bypass
The silastic ring gastric bypass adds another level of reinforcement to the traditional Roux-en-Y procedure, whether performed open or laparoscopically. In this enhancement, a mesh ring is placed around the new outlet constructed from the pouch to the small intestine. The ring prevents the outlet from stretching over time, protecting the small diameter of the opening. Although not recommended for all patients, weight loss is generally enhanced with this addition.
Vertical Banded Gastroplasty
Vertical banded gastroplasty (VBG) is a restrictive procedure like the Lap-Band. It limits the amount of food the patient can eat. However, like the Roux-en-Y procedure, staples or sutures are used to physically separate the stomach into two sections, one of which is used to eat. Unlike the Roux-en-Y procedure, the pouch is created vertically instead of horizontally in order to take advantage of the existing outlet to the intestines.
