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Comparison Between Minimally Invasive Weight-Loss Surgery Options

Discussion in 'Gastroenterology' started by Egyptian Doctor, Sep 21, 2013.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Gastric Sleeve

    Rapid and long-term weight loss without implants or rerouting intestinal tract
    In gastric sleeve surgery, about 60 percent of the stomach is removed laparoscopically, leaving behind a sleeve of the stomach. This smaller stomach restricts the amount of food a patient can eat and leads to significant weight loss.

    In some gastric sleeve patients, this procedure is performed instead of gastric banding or gastric bypass surgery. In others, especially those at higher surgical risk, it is offered as the first part of a two-stage surgical plan. As weight is lost following the gastric sleeve procedure and patients become healthier, they can safely be offered a second operation, either gastric bypass or gastric banding, for additional weight loss.

    Gastric Banding

    Minimally invasive procedure with risk of few complications

    Gastric banding involves placing a silicone gastric band with an inflatable inner collar around the upper stomach to restrict food intake. This creates a small pouch and a narrow passage to the lower stomach. This small passage delays the emptying of food from the pouch and causes a feeling of fullness. The silicone gastric band can be tightened or loosened over time to change the size of the passage.

    Gastric banding is usually performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large one. It is usually done on an outpatient basis.

    Currently, two types of gastric bands are approved by the U.S. Food and Drug Administration: the Lap-Band System and the newer Realize Band.

    Gastric Bypass

    Rapid and long-term weight loss

    The most common type of bariatric weight-loss surgery, gastric bypass, works by laparoscopically reducing the volume of the stomach. The intestines are rerouted and a small stomach pouch is created by stapling off the main body of the stomach. Food flows through this pouch, bypassing the main portion of the stomach and emptying slowly into the small intestine where it is absorbed. Gastric bypass surgery restricts food intake and reduces hunger to promote healthy weight loss.

    Gastric bypass patients can expect to lose one-half to two-thirds of their excess weight within two years and they should be able to maintain their weight loss for five years and beyond.

    Revisional Bypass

    For those regaining weight following gastric bypass

    Over years following gastric bypass surgery, some patients will regain weight. This may be caused by an enlarged pouch, which can be repaired through a variety of options. Surgeons at UC San Diego Health System are exploring endoscopic options involving inserting instruments through the mouth to reduce the size of the stomach pouch and the opening to the small intestine. This has the effect of reducing the stomach to the size that was achieved by the original gastric bypass surgery and promotes additional weight loss.

    Gastric Plication

    The new minimally invasive weight-loss surgery

    Gastric plication is a newer minimally invasive weight-loss surgery technique that reduces the size of the stomach capacity to approximately three ounces. The procedure does not involve the use of an implant (such as gastric banding). Also, unlike the gastric sleeve procedure, gastric plication may be reversible because a portion of the stomach is not removed. In addition, unlike gastric bypass, the gastric plication procedure does not involve rerouting and reconnecting the intestines.

    It is a restrictive weight-loss surgery, meaning that it restricts the amount of food the stomach can hold. You will feel full sooner so you won’t want to eat as much.

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