Bariatric Surgery

Each bariatric sugrical procedure is different to one another. The inforrmation below briefly descirbes what happens in each kind of procedure: 1. Sleeve gastrectomy: The Laparoscopic Sleeve Gastrectomy, often called the "sleeve", is performed by removing approximately 80% of the stomach. The remaining stomach is the size and shape of a banana. The new stomach holds less food and liquid helping reduce the amount of food (and calories) that are consumed. By removing the portion of the stomach that produces most of the “hunger hormone”, the surgery has an effect on the metabolism. It decreases hunger, increases fullness, and allows the body to reach and maintain a healthy weight as well as blood sugar control. The simple nature of the operation makes it very safe without the potential complications from surgery on the small intestine. 2. Roux-en-Y bypass: The Roux-en-Y Gastric Bypass, also known as a gastric bypass a has now been performed for more than 50 years. It is one of the most common operations and is very effective in treating obesity and obesity related diseases. The name is a French term meaning “in the form of a Y”. First, the stomach is divided into a smaller top portion (pouch) which is about the size of an egg. The larger part of the stomach is bypassed and no longer stores or digests food. The small intestine is also divided and connected to the new stomach pouch to allow food to pass. The small bowel segment which empties the bypassed or larger stomach is connected into the small bowel approximately 3-4 feet downstream, resulting in a bowel connection resembling the shape of the letter Y. Eventually the stomach acids and digestive enzymes from the bypassed stomach and first portion of the small intestine will mix with food that is eaten. The gastric bypass works in several ways. Like many bariatric procedures, the newly created stomach pouch is smaller and able to hold less food, which means fewer calories are ingested. Additionally, the food does not come into contact with the first portion of the small bowel and this results in decreased absorption. Most importantly, the modification of the food course through the gastrointestinal tract has a profound effect to decrease hunger, increase fullness, and allow the body to reach and maintain a healthy weight. 3. Gastric band: The Adjustable Gastric Band is a device made of silicone that is placed around the top part of the stomach to limit the amount of food a person can eat.The impact on obesity related diseases and long-term weight loss is less than with other procedures. Its use has therefore declined over the past decade. The gastric band is placed and secured around the top part of the stomach creating a small pouch above the band. The feeling of fullness depends upon the size of the opening between the pouch and the rest of the stomach. The opening size can be adjusted with fluid injections through a port underneath the skin. Food goes through the stomach normally but is limited by the smaller opening of the band. It is less successful against type 2 diabetes and has modest effects on the metabolism. 4. BIliopancreatic diversion with duodenal switch (BPD-DS): The Biliopancreatic Diversion with Duodenal Switch, begins with creation of a tube-shaped stomach pouch similar to the sleeve gastrectomy. It resembles the gastric bypass, where more of the small intestine is not used. Following creation of the sleeve-like stomach, the first portion of the small intestine is separated from the stomach. A part of the small intestine is then brought up and connected to the outlet of the newly created stomach, so that when the patient eats, the food goes through the sleeve pouch and into the latter part of the small intestine. The smaller stomach, shaped like a banana, allows patients to eat less food. The food stream bypasses roughly 75% of the small intestine, the most of any commonly performed approved procedures. This results in a significant decrease in the absorption of calories and nutrients. Patients must take vitamins and mineral supplements after surgery. Even more than gastric bypass and sleeve gastrectomy, the BPD-DS affects intestinal hormones in a manner that reduces hunger, increases fullness and improves blood sugar control. The BPD-DS is considered to be the most effective approved metabolic operation for the treatment of type 2 diabetes.