Gastrointestinal Surgery for Weightloss

Gastrointestinal surgery helps assist in weight loss by closing off specific parts of a person’s stomach, making it smaller and thus restricting their food intake.
Procedures that reduce the size of the stomach are called ‘restrictive operations because the stomach is limited in the amount of food it can hold. Restrictive gastrointestinal procedures include:

    • Adjustable gastric Banding (LapBand®) (AGB)
    • Vertical Banded Gastroplasty (VBG)

Particular gastrointestinal weight loss surgery combines the restriction of the stomach with a partial bypass of the small intestine. In operations such as these, a connection is created which is direct from the stomach to the lower small intestine. This then bypasses specific part of the digestive tract which absorbs the calories and nutrients. Surgical procedures such as these, known as mal-absorptive surgical procedures include:

    • Biliopancreatic Diverion Duidenal Switch
    • Biliopancreatic Diversion
    • Roux-en-Y Gastric bypass

Adjustable gastric Banding (LapBand) (AGB)

This procedure is commonly known as the LapBand. It consists of a silicone band placed around the upper section of the stomach, which creates a small pouch that can only hold a small amount of food. The lower section of the stomach remains below the band. The two portions of the stomach are then linked by a small opening which is created using the band which has been put in situ.

Food then passes through the outlet from the pouch in the upper stomach to the lower section much slower thus making the patient feel fuller for longer periods of time. The bands diameter can be adjusted to meet the needs of the person and can be changed as they lose weight.

Like most radical surgical procedures, there are advantages and disadvantages to AGB

Advantages of the Adjustable Gastric Banding

    • Short recovery period
    • Simple and relatively safe
    • No opening or removal of any part of the intestines or the stomach
    • Major complication rate is low
    • Very short recovery periods
    • No altering of the natural anatomy

Disadvantages of the Adjustable Gastric Banding

    • Approximately 5% failure rate due to:
    i) balloon leakage
    ii) band erosion/migration
    iii) deep infection
    iv) Difficulty in identifying those patients who will ‘eat through the operation.

Successful results depend on the person’s motivation and their ability to adopt a lifestyle plan that is long term and involves healthy eating and regular physical activity.

Vertical Banded Gastroplasty (VBG)

Vertical Banded Gastroplasty is a common restrictive surgery for controlling weight. A small pouch in the stomach is formed using a band and staples. It is a restrictive procedure without a mal-absorptive effect. The goals of this particular procedure are to severely restrict a person’s capacity to eat certain foods.

Advantages of Vertical Gastroplasty

    • Body anatomy is left intact
    • Completely reversible
    • No nutritional deficiencies
    • No dumping syndrome

Disadvantages of Vertical Gastroplasty

    • No mal-absorption
    • Needs strict patient compliance to diet
    • Vomiting food if it is not properly chewed or eaten too quickly.

See Also:

Restrictive versus Malabsorptive Weightloss Surgery

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