Weight Loss Surgery - Gastrointestinal Surgery

Weight loss surgery, gastrointestinal surgery helps in weight loss by closing off particular parts of a person's stomach, making it smaller and thus limiting their food intake.

Restrictive Gastrointestinal

Procedures that decrease the size of the stomach are called ‘restrictive operations’ because the stomach is restricted in the amount of food it can hold. Restrictive gastrointestinal procedures include:

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

Mal-absorptive Weight Loss Surgery

Specific gastrointestinal weight loss surgery merges the limitation of the stomach with a partial bypass of the small intestine. Operations such as these create a connection which is direct from the stomach to the lower small intestine.

This then bypasses particular portions of the digestive tract which absorbs the calories and nutrients. Surgical procedures such as these, known as Mal-absorptive surgical procedures include:

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

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 specific procedure are to strictly restrict a person's capacity to eat certain foods.

Advantages of Vertical Gastroplasty

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

Disadvantages of Vertical Gastroplasty

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

Adjustable Gastric Banding (LapBand) (AGB)

Adjustable gastric banding 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 parts of the stomach are then connected by a small opening which is created using the band which has been put in situ.

Then through the outlet the food passes 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 band’s 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

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

Disadvantages of the Adjustable Gastric Banding

• Approximately 5% failure rate due to:
1. band erosion/migration
2. balloon leakage
3. Difficulty in identifying those patients who will ‘eat through’ the operation.
4. deep infection

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