An Overview of Gastric Bypass Surgery and other Bariatric Procedures

The General Information

• The Info
• The Aftermath
• The Purpose
• The Success
• The Failure

Gastric bypass surgery is becoming a common method in helping morbidly obese people lose weight as a last resort. Gastric bypass surgery makes the stomach smaller and bypasses part of the small intestine which in turn limits the amount of food patients eat and absorb. Patients feel full more quickly and have less room in their stomach, which results in weight loss.

The most common gastric bypass surgery is a Roux-en Y gastric bypass, where the stomach is made smaller by creating a small pouch at the top. Surgical staples or a plastic band are used. This smaller stomach is then connected directly to the middle portion of the small intestine (jejunum) thus bypassing the larger portion of the stomach and upper half of the small intestine. This is where gastric bypass surgery gets its name. The procedure can be with a large incision in the abdomen or by using small instruments and cameras to guide the surgeon in a much smaller incision, in a procedure known as laparoscopic surgery.

The Two Types of Bariatric Surgery

Restrictive only:

The Lap Band (Adjustrable Gastric Banding): An adjustable band is implanted in the upper portion of the stomach, thus causing a small pouch to materialize above the rest of the stomach. This leaves a narrow passage to the rest of the stomach from the small lap band stomach, restricting the amount of food a patient can eat. As an added benefit, the band can be tightened or loosened by adjusting the level of saline fill solution in the band.

Vertical Band Gastroplasty: This procedure is similar to lap band and is more common. It uses staples in addition to a band to form a smaller stomach. Unfortunately, this procedure is not adjustable and is prone to failure due to staples coming loose.

Restrictive & Malabsorptive

Roux-en-Y Gastric Bypass: Currently the most common bariatric procedure that is a combination of shrinking the stomach and bypassing part of the digestive tract. The small pouch of the stomach is meant to hold one ounce, but can grow to about three ounces. In addition, the middle of the small intestine is attached to the new pouch, bypassing the upper portion of the small intestine. The combination of the two components of this surgery restricts the amount of food intake as well as restricts the amount of calories that are absorbed in digestion.

Distal Gastric Bypass In this procedure, a portion of the stomach is removed all together. What is left of the stomach is attached to the last part of the small intestine, bypassing significantly more of the digestive tract that Roux-en-Y gastric bypass.