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Gastrointestinal Weight Loss Surgery
Adjustable Gastric Banding (Lap Band) and Vertical Banded Gastroplasty
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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.

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.

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®

Adjustable Gastric Banding image

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)

Vertical band gastroplasty image


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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