Bariatric Surgery Techniques
There are many bariatric surgery techniques, but gastric bypass surgery, LAP-BAND® surgery and the gastric sleeve procedure are the three most widely practiced bariatric surgery techniques.
Each bariatric surgery technique is different and the bariatric surgery technique used on a patient depends on a number of factors that only a bariatric surgeon can determine.
Bariatric surgery is usually performed under general anesthesia and generally takes one to four or more hours, depending on the bariatric surgery technique that you are having. Each of bariatric surgery technique is performed differently. Some are open and some are laparoscopic.
There are several types of bariatric surgery techniques; LAP-BAND® and gastric bypass are only two. Each bariatric surgery technique provides different benefits, risks, and considerations.
Choosing A Bariatric Surgery Technique
Choosing to have bariatric surgery is an important decision. Like any other medical procedure, bariatric surgery provides different benefits, risks, and considerations. Making an informed decision and choosing the right bariatric surgery technique for you is a very important part of the process.
Choosing the bariatric surgery techniques that best suits your lifestyle will not only assure that you are getting all the benefits from this procedure, but it will also help you find the right bariatric surgeon for you; increase your chances of having a smooth recovery; obtaining the best results and achieving complete personal satisfaction after bariatric surgery.
During your bariatric surgery consultation, your surgeon will explain the different bariatric surgery techniques available for your case. Please ask any question that you may have regarding the different bariatric surgery techniques and how each one differs from the other. You will also be examined during your bariatric surgery consultation. You can take advantage of this time and talk to your bariatric surgeon about what is the best bariatric surgery technique for you and how it will be performed; what to expect, how long it takes, how long is the recovery process and if there are any special considerations about regarding your case. Make sure that all your questions are answered and that you are fully aware of all possible complications and have realistic expectations about the results that can be obtained with this bariatric surgery technique.
In some cases, a person might not be a good candidate for certain bariatric surgery techniques, the procedure may represent big risks for them or the results that can be achieved might not be significant. In this case you can explore with your bariatric doctor other surgery techniques that can give you similar results without any problems. Please keep in mind that every person is different and that each body can react differently to each bariatric surgery technique and procedure. That is why is so imperative that an expert and skilled bariatric surgery specialist evaluates your case and performs this procedure.
If you are unsure about what bariatric surgery technique to choose; you can continue your research, talk to friends or relatives that may have had this bariatric surgery technique performed. People who have had this bariatric surgery technique performed can tell you more about their experience, how they feel about the procedure and the bariatric doctor that performed. In some cases a second opinion from another physician can answer questions about the bariatric surgery technique; clear doubts and help you make a clearer decision.
Bariatric Surgery Techniques: Gastric Bypass
The gastric bypass procedure is a bariatric surgery technique intended to physically alter the size of the stomach in order to reduce food intake. There are several types of gastric bypass surgeries including Roux-en-Y, biliopancreatic diversion bypass, and duodenal switch.
Bariatric Surgery Techniques: Roux-en-Y Gastric Bypass
Roux-en-Y is the most common gastric bypass surgery technique.
The Roux-en-Y is a bariatric surgery technique consists of making the top half of the stomach into the shape of a pouch with the use of staples or sutures. The stomach pouch is closed and attached to a Y-shaped section of the small intestine. The connection bypasses the rest of the rest of the digestive tract including stomach, duodenum, and part of the small intestine. The remainder of the stomach is transferred through a connection from the top portion of the small intestines through the rest of the small intestine, or jejunum.
Bariatric Surgery Techniques: Biliopancreatic Diversion Bypass
Biliopancreatic diversion bypass (BPD) is less common than other gastric bypass bariatric surgery techniques and performed through traditional open surgery.
Biliopancreatic diversion changes the normal process of digestion by making the stomach smaller and directing the food to bypass part of the small intestine, thus fewer calories and nutrients from food are absorbed. Duodenal switch is one type of biliopancreatic diversion surgery.
In the Biliopancreatic diversion bypass bariatric surgery technique, the lower part of the stomach is removed and the bypass is attached to the lower (distal) part of the small intestine. Your bariatric surgeon makes one long incision in the abdomen, leaving a permanent scar. Gastric staples or sutures are used to create a pouch, which holds about six ounces. The remainder of the stomach is then connected to the last section of the small intestine (ileum).
Finally, part of the small intestine, the duodenum, is attached to the last part of the small intestines where all of the bile and pancreatic secretions meet with the digested food from the stomach pouch in the ileum. Most of the food will not be digested, therefore causing you to feel full and eat less.
Bariatric Surgery Techniques: Duodenal Switch
Duodenal Switch is a bariatric surgery technique that is similar to biliopancreatic diversion bypass, but instead of a small stomach pouch, a sleeve-shaped stomach is made.
The bariatric surgeon attaches the final section of the small intestine into the stomach sleeve. Duodenal switch has the same result as other stomach bypass surgery techniques: bypassing the rest of the small intestine resulting in less absorption of calories and nutrients, causing the feeling of being full.
Bariatric Surgery Techniques: Biliopancreatic Diversion With Duodenal Switch
The duodenal switch, or BPD-DS, is a complex bariatric surgery technique and is considered a bigger operation than simple gastric bypass. A large amount of the lower stomach, about half, is permanently and irreversibly removed. The remaining top portion of the stomach is stapled or sutured and formed into the shape and size of a banana.
Much of the small intestine is rerouted, forming two separate pathways and one common channel. The shorter pathway routes food from the stomach to the common channel. The longer pathway carries bile to the common channel. In the common channel, the contents from the stomach mix with the bile before traveling to the large intestine. The purpose of this bariatric surgery technique is to reduce the absorption of fat and limit the time the body has to draw calories from food.
Bariatric Surgery Techniques: Adjustable Gastric Banding
Gastric banding is a bariatric surgery technique that uses an adjustable band that fits around the upper part of the stomach.
In this bariatric surgery technique, the band divides the upper portion of the stomach into a small pouch, separating it from the lower larger portion of the stomach. The banding limits food intake by causing you to feel full faster after eating. There is no stapling or removal of the stomach, nor are the intestines redirected. Adjustable banding surgery is also referred to as laparoscopic adjustable gastric banding and gastric banding.
Two types of adjustable gastric bands are REALIZE™ Band and LAP-BAND®.
The restrictive adjustable gastric band surgery involves placing a silicone band with an inflatable inner collar around the upper part of the stomach. The pouch created by the band forms a narrow passage to the lower part of the stomach. The band is connected to a small port that is placed inside the abdominal wall. The band is adjusted by injections of saline through the port known as a fill and can be adjusted over time. The band can be tightened or loosened to change the size of the passage, thus making it possible to tailor a weight loss program for each patient.
Bariatric Surgery Techniques: Lap Band
LAP-BAND® is a bariatric surgery technique that is similar to gastric bypass because it physically changes the size of the stomach, but instead of staples or sutures, the bariatric surgeon uses an adjustable gastric band to reduce food intake.
What makes the Lap Band bariatric surgery technique so unique is its adjustability. There are no staples, sutures, or parts of the digestive tract moved or removed.
This bariatric surgery technique is performed in the following way: small incisions are made in the abdomen laparoscopically. The LAP-BAND® is placed around the top part of the stomach and held in place with sutures. A port attached to the LAP-BAND® is placed around the top half of the stomach inside the abdominal wall. The port's function is to inflate over time in order to speed up weight loss. This bariatric surgery technique takes about an hour, sometimes with an overnight stay in the hospital, depending on recovery.
Bariatric Surgery Techniques: Realize Band
The REALIZE™ Adjustable Gastric Band bariatric surgery technique is a reversible procedure that requires no cutting or stapling of the stomach.
The REALIZE™ Band is a silicone device that fits around the stomach. The band creates a small pouch that mimics a smaller stomach, therefore gives you feeling of feeling full and eating less.
The REALIZE™ Band is made of strong and flexible silicone. Saline in the balloon controls the tightness around the stomach. The soft balloon fits around the stomach. In this bariatric surgery technique, the tighter the balloon, the smaller the stomach, and the fuller you will feel because the tightness affects how much food you are able to eat. The band's tubing is connected to the REALIZE™ port. It is sutured during the gastric bypass surgery on the left or right side of the body below the rib cage.
Bariatric Surgery Techniques: Gastric Sleeve
Gastric sleeve is a bariatric surgery technique that is a relatively new procedure and is also known as gastric sleeve resection, vertical sleeve gastrectomy (VSG), tube gastrectomy, and laparoscopic sleeve gastrectomy.
Gastric sleeve is used for patients who are not eligible for the gastric banding bariatric surgery technique and have a very high BMI (>60). The gastric sleeve procedure is meant for the morbidly obese or high risk patients and with the intention of performing another bariatric surgery technique at a later time: gastric bypass or duodenal switch.
The gastric sleeve technique is performed laparoscopically. About 60 - 80% of the rounded, larger part of the stomach is removed so that the remaining part of the stomach takes the shape of a tube or sleeve. The tube-shaped stomach is sealed closed with staples or sutures. The remaining portion of the stomach holds about 15% as much food as the original stomach.
Unlike gastric bypass or duodenal switch bariatric surgery techniques, the gastric sleeve bariatric surgery technique leaves the stomach openings intact and unchanged, therefore malabsorption and dumping syndrome (a condition in which the stomach contents empty into the small intestine too quickly, causing nausea or discomfort) should not be a problem. However, because the stomach is permanently removed, the procedure is irreversible.
Surgery with this bariatric surgery technique takes about one to two hours, with a hospital stay of about one to two days for recovery. Full recovery from this bariatric surgery technique takes about three weeks. On average, patients lose approximately 30 - 50% of their excess body weight over six months to one year.