Restrictive Gastroplasty & Bariatric
Gastric Banding Operations
Weight Loss Surgery 2.
Types of Gastrointestinal Weight Loss
Surgery
There are several types of restrictive
and malabsorptive operations. Each one carries its own benefits and risks.
Restrictive Weight Loss Surgical Operations
Restrictive operations serve only to restrict
food intake and do not interfere with the normal digestive process. To
perform the surgery, doctors create a small pouch at the top of the stomach
where food enters from the esophagus. Initially, the pouch holds about
1 ounce of food and later expands to 2-3 ounces. The lower outlet of the
pouch usually has a diameter of only about 3/4 inch. This small outlet
delays the emptying of food from the pouch and causes a feeling of fullness.
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As a result of this surgery, most
people lose the ability to eat large amounts of food at one time.
After an operation, the person usually can eat only 3/4-1 cup of
food without discomfort or nausea. Also, food has to be well chewed.
Restrictive operations for obesity
include adjustable gastric banding (AGB) and vertical banded gastroplasty
(VBG).
As a result of this surgery, most
people lose the ability to eat large amounts of food at one time.
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After an operation, the person usually
can eat only 3/4-1 cup of food without discomfort or nausea. Also, food
has to be well chewed.
Restrictive operations for obesity include
adjustable gastric banding (AGB) and vertical banded gastroplasty (VBG).
Adjustable Gastric Banding - LapBand®
In this procedure, a hollow band made of
special material is placed around the stomach near its upper end, creating
a small pouch and a narrow passage into the larger remainder of the stomach
(see figure 2).
Figure 2. Weight Loss Surgery - Adjustable
Gastric Banding (AGB) - LapBand®
In this procedure, commonly known as the
LapBand®, a silicone elastomer band is placed around the upper part
of the stomach to create a small stomach pouch which can hold only a small
amount of food. The lower, larger part of the stomach is below the band.
These two parts are connected by a small outlet created by the band. Food
will pass through the outlet (“stoma” in medical terms) from
the upper stomach pouch to the lower part more slowly, and one will feel
full longer. The diameter of the band outlet is adjustable to meet individual
needs, which can change as one loses weight.
Weight Loss Surgery - Adjustable Gastric
Banding
Advantages & Disadvantages
Advantages
- Simple and relatively safe
- Short recovery period
- Major complication rate is low
- No opening or removal of any part of
the stomach or intestines
- No altering of the natural anatomy
- Very short recovery periods
Disadvantages
About 5 percent failure rate because of:
- Balloon leakage
- Band erosion/migration
- Deep infection
- Identifying patients who will not "eat
through" the operation is difficult
Vertical Banded Gastroplasty (VBG)
VBG has been the most common restrictive
operation for weight control. As figure 3 illustrates, both a band and
staples are used to create a small stomach pouch.
Figure 3. Weight Loss Surgery - Vertical
Banded Gastroplasty (VBG)
This, along with the RNY, is one of the
two major types of operations recognized by the NIH for the treatment
of clinically severe obesity. It is a purely restrictive procedure with
no malabsorptive effect. The goal of this procedure is to severely restrict
the patient's capacity to eat certain foods.
Weight Loss Surgery - Vertical Banded
Gastroplasty
Advantages & Disadvantages
Advantages
- Completely reversible
- Body anatomy is left intact
- No dumping syndrome
- No nutritional deficiencies
Disadvantages
- Needs strict patient compliance to diet
- No malabsorption
- Vomiting if food is not properly chewed
or if food is eaten too quickly
Although restrictive operations lead to
weight loss in almost all patients, they are less successful than malabsorptive
operations in achieving substantial, long-term weight loss. About 30 percent
of those who undergo VBG achieve normal weight, and about 80 percent achieve
some degree of weight loss. Some patients regain weight. Others are unable
to adjust their eating habits and fail to lose the desired weight. Successful
results depend on the patient’s willingness to adopt a long-term
plan of healthy eating and regular physical activity.
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Additional Weight Loss Surgery Resources:
American Society for Bariatric Surgery
140 NW 75th Drive, Suite C
Gainesville, FL 32607
Phone: (352) 331-4900
Fax: (352) 331-4975
Website: www.asbs.org
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Sources include:
Weight-control Information Network (WIN).
ObesityHelp.com
Gastric
Bypass Surgery
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