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Weight-Loss Surgery Options
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There are options available for weight–loss surgery. Talk with your surgeon about which one is right for you.
Gastric Bypass Surgery |
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The Roux–en–Y gastric bypass (RGB) is the most common weight-loss surgery procedure and combines two approaches. First, a small pouch is created by stapling the stomach, reducing the amount of food it can hold. Next, a Y–shaped section of the small intestine is surgically attached to the pouch in order to allow food to bypass the upper and lower sections of the small intestine. This reduces how much the digestive track can absorb of the food and nutrients that have been consumed.
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Gastric bypass operations that restrict food intake and cause malabsorption result in more weight–loss than those operations that only restrict food intake. Patients who have bypass operations generally lose two–thirds (80%) of their excess weight within two years.
Potential complications associated with these procedures may include a response called “dumping syndrome” — nausea, cold sweats, rapid heart beat, dizziness and possible diarrhea — which can be brought about by certain foods such as those that are high in fat or refined sugar; enlargement of the pouch caused by consistent overeating, resulting in inadequate weight loss or regaining some weight; nutritional deficiencies caused by bypassing the duodenum, where most iron and calcium are absorbed, requiring lifetime vitamin supplements; anemia brought about by malabsorption of Vitamin B12 and iron in menstruating women, and decreased absorption of calcium may induce osteoporosis and metabolic bone disease. The more extensive the bypass operation, the greater the risk for complications and nutritional deficiencies.
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Lap-Band System® |
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The Lap–Band is an inflatable and adjustable gastric band designed to induce weight–loss, without stapling or cutting of the stomach or intestines. The band is placed laparoscopically around the upper portion of the stomach to create a small pouch, with the rest of the stomach below the band. By tightening or loosening the band with saline (via a reservoir placed beneath the skin), the size of the opening can be adjusted to control the rate at which food passes to the lower stomach, and from there to the intestines. The new small pouch and narrowed outlet limit stomach capacity and increase the feeling of fullness. This reduction in food intake results in weight loss.
Most adjustments to the band can be made in the doctor’s office. Prior to and after each adjustment, a UGI (radiological examination) may be required. A fine needle is passed through the skin into the reservoir and only takes a few minutes. If the reservoir is not easily felt, the adjustment will need to take place under fluoroscopy.
Weight loss following the Lap–Band procedure often occurs more slowly than with gastric bypass. However, the procedure has fewer risks than gastric bypass and the weight loss achieved by most people meets the clinical objective — the loss of 50 to 60 percent of the excess pounds. Complications of the Lap–Band procedure can include mechanical failure or breakage of the band, port and or tubing resulting in the need for replacement or removal of the band; infection of the port; difficulty in accessing port, requiring additional radiological examinations; reaction to the implantable device, slipping and/or erosion of the band; perforation of the stomach/esophagus, resulting in leaks leading to peritonitis.
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