Gastric Bypass and Gastric Banding
Choosing which type of weight-loss surgery to have is an important and serious decision. While the majority of patients who undergo these procedures are very successful, no procedure is perfect. Discuss the benefits and risks of each type of surgery in detail with your surgeon.
Bariatric surgeons at GW Hospital offer the following procedures:
- Roux-en-Y Procedure (Gastric Bypass). In this procedure, the surgeon staples across the top portion of the stomach to create a small stomach pouch and connects the new stomach pouch to the small intestine, bypassing some of the upper and more absorptive part of the small intestine. This reduces the amount of food that can be eaten and decreases absorption of the food and calories consumed. Results vary but the average patient usually can expect to lose 50 to 90 percent of excess weight in 12 to 18 months after surgery.
- Laparoscopic Gastric Bypass Surgery. In a conventional procedure, the surgeon operates through an abdominal incision, usually four to five inches for the majority of patients. Laparoscopic procedures involve small incisions in the abdomen. The surgeon operates through these incisions using a laparoscope (a fiber-optic tube and a small video camera which shows the abdominal organs on a TV monitor). The surgeon staples the stomach to create a pouch as is done in traditional gastric bypass surgeries.
- Laparoscopic Adjustable Gastric Band. Surgeons use a silicone band to create a small pouch using the top part of the existing stomach. Using thin surgical instruments and a small internal camera to monitor the operation, the surgeon places a laparoscopic adjustable gastric band around the top portion of the stomach creating a small pouch, without cutting or stapling. This pouch later limits the patient's food consumption without disrupting the normal progression of food through the digestive tract. In some cases, the gastric band is connected via a small tube to a small reservoir that contains saline. This reservoir is placed under the skin of the upper abdomen. After surgery, the surgeon will examine the patient to ensure that the band contains enough saline. It needs to be tight enough to allow for gradual weight loss while ensuring that the patient eats enough food for proper nutrition. Adjustments typically are made to the band one month after the procedure. Using a fine needle, the surgeon can add or remove saline to enlarge or shrink the band. This results in allowing more or less food to pass between the two parts of the stomach. The number of adjustments varies from person to person, but most patients usually need three to five before the band is at the ideal tightness. This procedure allows for pregnancy since the stomach outlet size can be opened to increase nutritional uptake. With the laaroscopic adjustable gastric band procedure, patients can experience weight loss of one to three pounds a week in the first year after surgery. The amount usually decreases after 12 to 18 months.
- Laparoscopic Sleeve Gastrectomy. Laparoscopic sleeve gastrectomy, an alternative to laparoscopic banding or Roux-en-Y, restricts the amount of food consumed by the stomach. During this procedure, the surgeon removes 85 percent or more of the stomach without bypassing the intestines. The stomach is not bypassed as in Roux-en-Y procedures. In addition to the reduced stomach volume, this procedure decreases Ghrelin blood levels (a hunger hormone) so patients may feel less hungry while they lose weight.
Podcast: Understanding Weight-Loss Surgery
Khashayar Vaziri, MD, discusses the two types of weight loss surgery offered by GW Hospital (laparoscopic gastric bypass and laparoscopic sleeve gastrectomy). Both procedures are minimally invasive and allow patients a quick and less painful recovery than past surgical techniques.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if bariatric surgery is right for you.