Bariatric Surgery: Procedure Options
There are two types of gastric bypass surgery procedures available at Geisinger: Roux-en-Y Gastric Bypass and Adjustable Gastric Band. Both procedures may be done laparoscopically or with open surgery. Upon initial evaluation, our team will thoroughly discuss the benefits of each option so we can help determine which procedure is right for you.
Roux-en-Y Gastric Bypass Surgery
Statistics
- More than 80% of Type 2 diabetes cases are resolved with Roux-en-Y gastric bypass surgery
- Gastric bypass surgery successfully resolves more cases of Type 2 diabetes than purely restrictive procedures
- Resolution of Type 2 diabetes often occurs within days of the surgery
- Almost 97% of hyperlipidemia cases are resolved
- Over 75% of hypertension cases are resolved; Nearly 90% are resolved or improved
- Substantial weight reduction occurs
- Over 60% of excess weight is lost
- In 2000, a study of 500 patients showed that over 95% of co-morbidities (the study looked specifically at back pain, sleep apnea, high blood pressure, Type 2 diabetes, and depression) were improved or resolved
- The average excess weight loss after a gastric bypass procedure is generally higher than with a purely restrictive procedure
Procedure
The operation involves creating a small gastric pouch using surgical stapling across the stomach. The gastric pouch is drained by a Roux-en-Y gastric bypass. The procedure combines the restrictive effect of a small pouch with malabsorption of food bypassing the duodenum. Deficiencies in iron, folic acid, and calcium can be controlled by vitamin and calcium supplements.
Adjustable Gastric Band Surgery
Statistics
- Nearly 50% of Type 2 diabetes cases are resolved with Adjustable Gastric Band Surgery
- Significant improvements in overall cholesterol occur, including a boost in HDL levels
- Over 70% of hypertension cases are resolved or improved
- Patients lose roughly 50% of their excess weight
- The amount of food that can be consumed at a meal is restricted
- Food passes through the digestive tract in the usual order, allowing it to be absorbed fully by the body
- In studies involving more than 3,000 patients, excess weight loss ranged from approximately 30 to 90%, with a minimum of two-year postoperative follow-up
- Band can be adjusted to increase or decrease restriction via an access port
- Surgery can be reversed
Procedure
A silicone elastomer band is placed around the upper part of the stomach to create a small stomach pouch, which can hold a minimal amount of food. The lower, larger part of the stomach is below the band. These two parts are connected by a small outlet created by the band. Food will pass through the outlet (“stoma” in medical terms) from the upper stomach pouch to the lower part more slowly, and one will feel full longer. The diameter of the band outlet is adjustable to meet individual needs, which can change as one loses weight.
SOURCE: Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery. A Systematic Review and Meta-Analysis. JAMA 2004.
For more information about Geisinger’s nationally recognized gastric bypass surgery program, please e-mail us today or call 1-800-275-6401 and ask for bariatric surgery.
