Type of Surgery
Information
Last updated: 11/24/2009
Established surgical alternatives
The primary restrictive alternative to a VBG is implanting a Lap-Band, which is an adjustable band that the surgeon positions around the upper end of the stomach to form the small pouch instead of using...
staples. The Lap-Band was approved by the Food and Drug Administration (FDA) for use in the United States in 2001. It can be implanted with the laparoscopic technique. When the band is in place, it is inflated with saline solution. It can be tightened or loosened after the operation through a portal under the skin. Although the Lap-Band eliminates the risk of dehiscence, it produces such side effects as vomiting, heartburn, abdominal cramps, or enlargement of the stomach pouch due to the band's slipping out of place. In one American study, 25% of patients eventually had the band removed.
The other major type of obesity surgery combines restriction of the size of the stomach with a malabsorptive approach. The combination surgery that is considered the safest and performed most frequently in the United States is the Roux-en-Y gastric bypass. In this procedure, the surgeon forms a stomach pouch and then divides the small intestine, connecting one part of it to the new pouch and reconnecting the other portion to the intestines at some distance from the stomach. The food bypasses the section of the stomach and the small intestine, where most nutrients are absorbed. The procedure takes its name from Cesar Roux, a Swiss surgeon who first performed it, and the "Y" shape formed by the reconnected intestines.
Experimental procedures
A newer technique in obesity surgery is known as gastric pacing. In gastric pacing, the surgeon implants electrodes in the muscle of the stomach wall that deliver a mild electrical current. These electrical impulses regulate the pace of stomach contractions so that the patient feels full on smaller amounts of food. Preliminary results from a team of Italian researchers on patients followed since 1995 indicate that gastric pacing is both safe and effective.
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The animation describes gastric bypass surgery, gastric band surgery, and sleeve gastrectomy. As explained in the video, these procedures use either restrictive or malabsorptive approaches to weight loss, or both.
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Other Information
Vertical banded gastroplasty (VBG), also known as stomach stapling, is a restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch. In the bottom of the pouch is an approximately one-centimeter hole through which the pouch contents can flow into the remainder of the stomach and thence onto the remainder of the gastrointestinal tract.
Stomach stapling is a restrictive technique for managing obesity. The pouch limits the amount of food a patient can eat at one time and slows passage of the food. Stomach stapling is more effective when combined with a malabsorptive technique, in which part of the digestive tract is bypassed, reducing the absorption of calories and nutrients. Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine, bypassing the lower stomach, the duodenum, and the first portion of the jejunum.
This type of weight loss surgery is losing favor as more doctors begin using the adjustable gastric band. The newer adjustable band does not require cutting into the stomach and does not use any staple lines, thus making it a much safer alternative.
VBG is known in the medical community as a very serious and dangerous procedure. It has been classified by the AMA as a "severely dangerous" operation.
From http://en.wikipedia.org/wiki/Vertical_banded_gastroplasty_surgery
Other Information
Weight loss usually reaches a maximum between 18 and 24 months after Bariatric Surgery - 2004.
From: Bariatric-Surgery.info
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