Weight loss surgery has been practiced for more than 40 years, as an answer to severe obesity, which is a chronic condition that is very difficult to treat. Physicians have long sought out methods to improve the health of their obese patients. The concept of gastric surgery to control obesity grew out of results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine which resulted in overall weight loss from the surgery.

Because patients undergoing these procedures tended to lose weight after surgery, some physicians began to use such operations to treat severe obesity. The first weight loss operation that was widely used for severe obesity was the intestinal bypass.

This weight loss operation, first used 40 years ago, produces weight loss by causing malabsorption. The idea was that patients could eat large amounts of food, which would be poorly digested or passed along too fast for the body to absorb many calories. The problem with this surgery was that it caused a loss of essential nutrients and its side effects were unpredictable and sometimes fatal.

The original form of the intestinal bypass operation is no longer used. The “Gold Standard Roux-en-Y” surgeons now use includes techniques that produce weight loss by limiting how much the stomach can hold combined with modified gastric-bypass procedures that somewhat limit calorie and nutrient absorption and may lead to altered food choices.

Although the “Gold Standard Roux-en-Y” combines a restrictive operation with a malabsorptive operation, there are procedures available that do not combine, or combine the two procedures in a different balance, for instance much less restrictive but much more malabsorptive.

RESTRICTIVE WEIGHT LOSS OPERATIONS:

With restrictive weight loss operations food intake is restricted by creating a small pouch at the top of the stomach where the food enters from the esophagus. The pouch initially holds about one ounce of food and expands to 2—3 ounces with time. The pouch’s lower outlet usually has a diameter of about ¼ inch. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness.

Restrictive operations for obesity include gastric banding and vertical banded gastroplasty. Both operations serve only to restrict food intake. They do not interfere with the normal digestive process.

Gastric Banding Weight Loss:

In this procedure, a 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 reminder of the stomach.

Vertical Banded Gastroplasty (VBG):
This weight loss procedure is the most frequently used restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch.

Some patients who undergo a restrictive only procedure are
unable to adjust their eating habits and fail to lose the
desired weight. In all weight loss operations, successful results depend on your motivation and behaviors.

A common risk of restrictive operations is vomiting caused by the small stomach being overly stretched by food particles that have not been chewed well. Other risks of VBG include erosion of the band, breakdown of the staple line, and, in a small number of cases, leakage of stomach juices into the abdomen.

EXTENSIVE GASTRIC-BYPASS OPERATION
(Biliopancreatic Diversion):

In this gastric-bypass operation portions of the stomach are
removed and the remaining stomach pouch is connected
directly to the final segment of the small intestine. This procedure completely bypasses both the duodenum and the jejunum portion of the small intestine. Although this procedure successfully promotes weight loss, it is not widely used because of the high risk for nutritional deficiencies.

The more extensive the bypass operation, the greater is the risk of complications and nutritional deficiencies. Patients with extensive bypasses of the normal digestive process require not only close monitoring, but also life-long use of special foods and medications.

Significant enhancements have been made to weight loss surgery in general, including the advent of minimally invasive surgery by laparoscopic techniques.

Follow the link to the next page to review information about CURRENT WEIGHT LOSS TECHNOLOGY and the Roux-en-Y Gastric-Bypass procedure for weight loss.