Obesity Surgery

OBESITY SURGERY

What is Obesity Surgery

Weight-loss surgery, also known as bariatric surgery, is an operation that makes changes to the digestive system. It is intended for people who are obese and need to lose weight but have not been able to do so through other means.

What are the surgical options?

There are three types of operations most often:

*laparoscopic adjustable gastric band

*gastric sleeve surgery, also called sleeve gastrectomy

*gastric bypass

Surgeons use a fourth operation, biliopancreatic diversion with duodenal switch, less often.

Laparoscopic Adjustable Gastric Band

In this type of surgery, the surgeon places a ring with an inner inflatable band around the top of your stomach to create a small pouch. This makes you feel full after eating a small amount of food. The band has a circular balloon inside that is filled with salt solution. The surgeon can adjust the size of the opening from the pouch to the rest of your stomach by injecting or removing the solution through a small device called a port placed under your skin.

After surgery, you will need several follow-up visits to adjust the size of the band opening. If the band causes problems or is not helping you lose enough weight, the surgeon may remove it.

Pros

Can be adjusted and reversed.

Short hospital stay and low risk of surgery-related problems.

No changes to intestines.

Lowest chance of vitamin shortage.

Cons

Less weight loss than other types of bariatric surgery.

Frequent follow-up visits to adjust band; some people may not adapt to band.

Possible future surgery to remove or replace a part or all of the band system.

Gastric Sleeve

In gastric sleeve surgery, also called vertical sleeve gastrectomy, a surgeon removes most of your stomach, leaving only a banana-shaped section that is closed with staples. Like gastric band surgery, this surgery reduces the amount of food that can fit in your stomach, making you feel full sooner. Taking out part of your stomach may also affect gut hormones or other factors such as gut bacteria that may affect appetite and metabolism. This type of surgery cannot be reversed because some of the stomach is permanently removed.

Surgeon removes about 80 percent of stomach, creating a long, banana-shaped pouch

Pros

*Greater weight loss than gastric band.

*No changes to intestines.

*No objects placed in body.

*Short hospital stay.

Cons

*Cannot be reversed.

*Chance of vitamin shortage.

*Higher chance of surgery-related problems than gastric band.

*Chance of acid reflux.

Gastric Bypass

Gastric bypass surgery, also called Roux-en-Y gastric bypass, has two parts. First, the surgeon staples your stomach, creating a small pouch in the upper section. The staples make your stomach much smaller, so you eat less and feel full sooner.

Next, the surgeon cuts your small intestine and attaches the lower part of it directly to the small stomach pouch. Food then bypasses most of the stomach and the upper part of your small intestine so your body absorbs fewer calories. The surgeon connects the bypassed section farther down to the lower part of the small intestine. This bypassed section is still attached to the main part of your stomach, so digestive juices can move from your stomach and the first part of your small intestine into the lower part of your small intestine. The bypass also changes gut hormones, gut bacteria, and other factors that may affect appetite and metabolism. Gastric bypass is difficult to reverse, although a surgeon may do it if medically necessary.

Surgeon staples top part of stomach, creating a small pouch and attaching it to middle part of small intestine.

Pros

Greater weight loss than gastric band.

No objects placed in body.

Cons

Difficult to reverse.

Higher chance of vitamin shortage than gastric band or gastric sleeve.

Higher chance of surgery-related problems than gastric band.

May increase risk of alcohol use disorder.