Types of bariatric surgery

Gastric banding
Gastric banding involves the placement of a ring around the upper part of the stomach. This ring helps form a small pouch that can only hold about a half a cup of food, making you consume less because you feel full, faster.

The ring is adjustable and creates a small opening that slows the passage of food from the small upper pouch to the rest of the stomach and intestines, making you also feel full, longer.

There are two types of bands available—LAP-BAND^® System and the Realize^® Band. Ask your doctor about which type is best for you. For information about the new lowered FDA approved BMI standards for gastric banding, click here.

Advantages of gastric banding:

• Least invasive surgical approach
• Lowest rate of complications
• Lowest mortality rate
• Adjustable and reversible
• Allows individuals to return to work within one week

Disadvantages of gastric banding:

• Slower initial weight loss—usually 1–2 pounds per week
• Regular follow-ups are critical to success—monthly for the first year
• Requires an implanted medical device

Gastric bypass
In the Roux-en-Y gastric bypass, an egg-sized portion of the stomach is surgically divided from the rest. This new, smaller stomach severely restricts the amount of food you can take in. And while the larger, lower portion of the stomach never holds food again, it does continue to help with digestion.

A Y-shaped segment of your small bowel is attached to the new small stomach. The other branch of the bowel remains attached to the larger, lower stomach. This delays the mixing of food with digestive juices, resulting in reduced absorption of calories, and ultimately, weight loss.

Advantages of gastric bypass:

• Rapid weight loss
• Higher total weight loss than band or sleeve methods
• No device and no adjustments
• 80–90 percent remission of type 2 diabetes usually in the first few days

Disadvantages of gastric bypass:

• GI tract stapling required
• Decreased absorption of nutrients occurs
• Higher complication rates
• Difficult to reverse

Gastric sleeve resection
Sleeve gastrectomy is a surgery that involves only the stomach. It does not involve surgery on the intestine. A large, rounded portion of the stomach is removed, leaving a slender section of stomach that looks like a sleeve.

Unlike gastric bypass, which changes the stomach openings, sleeve gastrectomy leaves the openings intact, so digestion can continue as normal. This procedure is also helpful for patients who want to lose weight but have health conditions that make more aggressive procedures less safe. This procedure is irreversible, but it can be converted to other weight loss procedures in the future if necessary.

Advantages of gastric sleeve:

• No disconnecting or rerouting of small intestine
• Weight loss similar to gastric bypass
• No implanted device and no adjustments
• Safer than gastric bypass

Disadvantages of gastric sleeve:

• Long-term results not known conclusively
• Severely obese patients may need a second operation with a conversion to bypass
• Not covered by most insurance (Aetna and United Healthcare now cover this operation)

Every potential cure has complications
Bariatric surgery can change a person’s life for the better, but, as with any major surgery, there are also some risks. The most common complications associated with bariatric surgery are:

• Blood clots
• Bowel obstruction
• Hemorrhage
• Hernia
• Infections
• Nausea and vomiting
• Nutritional deficiencies
• Pneumonia
• Surgical site leakage

For more information, please call our Program Manager Debra Proulx, RN, at 678-312-6836, or complete the online form, and someone will contact you.