Doctor's Search

Weight Loss surgery options & types of Bariatric surgery

May 11, 2018

Obesity is one of the modern-day scourges that now affect almost everyone. Changing lifestyle patterns, work-life balance, eating habits and stress levels has made obesity a global epidemic. Obesity results in various other health complications and therefore it is imperative to fight obesity right at the beginning.

Weight-loss (bariatric) surgery helps you lose weight and lowers your risk of medical problems associated with obesity. Bariatric surgery contributes to weight loss in two main ways:

  • Restriction. Surgery is used to physically limit the amount of food the stomach can hold, which limits the number of calories you can eat.
  • Malabsorption. Surgery is used to shorten or bypass part of the small intestine, which reduces the number of calories and nutrients the body absorbs.


Type of Bariatric Surgery

Gastric Banding – Credited to be the safest weight loss surgery, gastric banding reduces weight using an adjustable silicone band. A surgeon used laparoscopy to insert the band around the upper part of the stomach. This causes the stomach to be able to hold only about an ounce of food. Adjustable gastric banding results in 40% weight loss post-surgery. However, the results differ with the patient. Vertical banded gastroplasty is another variant of gastric banding. In this technique, the part of the stomach above the silicone band is stapled to form a smaller pouch.

Gastric Sleeve Surgery – Gastric sleeve surgery is a newer type of weight-loss surgery. The laparoscopic procedure is typically used to kick-start weight loss for the extremely obese—people who are too overweight to withstand more invasive surgeries. During a gastric sleeve operation, a surgeon removes more than half of the patient’s stomach. What’s left takes a sleeve- or tube-like shape, and it is sealed with staples. When the patient has lost enough weight, he or she may then undergo gastric bypass or another type of weight-loss surgery.

Gastric bypass surgery – This is one of the most popular bariatric techniques. It entails dividing the stomach into a small (upper) pouch and a larger pouch below. The lower part does not receive any food but continues to secrete the digestive juices. The small intestine is re-routed and joined to the small pouch which receives food. Since the food now bypasses a section of the small intestine, fewer calories are now absorbed.

Duodenal switch surgery – This procedure is a type of biliopancreatic diversion comprising of a malabsorptive and restrictive component. Almost 70% of the stomach is removed. The small intestine is divided into two paths connected by a channel. One section, the digestive loop, carries food and the other, the biliopancreatic loop, carries bile.

Gastroplasty – It is also known as “stomach stapling,” was once a popular type of weight-loss surgery. The original gastroplasty debuted in the 1970s. It involved stapling the stomach into a smaller section, so only a small opening was left for food. Surgeons eventually began performing Vertical Banded Gastroplasty (VBG). In this type of surgery, both staples and a band are used to reshape the patient’s stomach into a small pouch. Like regular gastroplasty, only a small hole is left for food to travel into the rest of the stomach. Today, gastroplasty is not performed as often, as studies indicate many patients regain weight.

Sleeve Gastrectomy – This procedure reduces the stomach by 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible. It is usually performed on extremely obese patients, with a body mass index of 40 or more, where the risk of performing a gastric bypass or duodenal switch procedure may be too large.

Roux-en-Y Gastric Bypass – is currently the most commonly performed bariatric operation with roughly 7 out of 10 bariatric surgeons use it as their primary weight loss procedure. An easier gastric bypass operation than either Biliopancreatic Diversion Stomach Bypass, or Duodenal Switch Stomach Bypass, Roux-en-Y has been practiced for more than 30 years, during which it has demonstrated a high long-term success rate with relatively low rates of mortality (less than one percent) and post-operative health complications. Roux-en-Y patients typically lose 50-75 percent of their initial excess weight, which is a sufficient weight reduction to cure or significantly reduce most of the life-threatening medical conditions associated with severe clinical obesity.

Gastric Balloon – It is becoming a popular alternative to ‘going under the knife’. It is a non-invasive procedure which means no general anesthetic or overnight stay and can be done quickly and painlessly. It can take as little as 10 minutes and you can return home after an hour. You are looking for just a day spent at home recovering although you will experience some nausea in the first week following this procedure. Your suitability for this procedure will be discussed with your surgeon. This is exactly the same as for any other obesity procedure. He/she may recommend this if you do not want surgery; if you do not fulfill the criteria for obesity surgery or as a means of achieving weight loss before undergoing a surgical procedure.

To summarize…

There is no “one size fits all” procedure. You and your bariatric surgeon can together determine which ones best fit your goals. It is important to remember that obesity surgery is not a quick fix. It’s an ongoing journey toward weight loss through lifestyle changes. After surgery, the difference in your body makes it physically easier to adjust your eating and lifestyle habits. Fortunately, you will not have to go through the process alone. A team of professionals will be there to support your efforts. Positive changes in your body, your weight, and your health will occur, but you will need to be patient through the recovery process.

Posted in Gastro Care