Surgical options for weight Loss

various surgical options for weight Loss

  • I. Restrictive
  • II. Malabsorptive
  • III. Combination restrictive/Malabsorptive
  • IV. Other

Options for restrictive surgery

  • • Vertical-banded gastroplasty (historical): A stapling device is used to divide the stomach vertically along the lesser curve to create a small (20 mL) pouch. A prosthetic device is then wrapped around the outlet of the pouch to prevent it from dilating over time. This operation is no longer performed because of poor long-term success, obstructive symptoms, and reflux.
  • • Gastric banding: This procedure is performed laparoscopically and involves placement of an adjustable band around the proximal stomach to create a small (15-mL) pouch. The band is connected to a reservoir placed in the subcutaneous tissue that enables band adjustment. Concerns about long-term complications and variable weight loss success have led to a substantial decline in popularity.
  • • Sleeve gastrectomy: This procedure is gaining in popularity and has now surpassed the gastric bypass as the most common operation done for weight loss. It involves stapling and removing a majority of the gastric body and fundus, leaving the lesser curvature and a small amount of antrum. This amounts to approximately 80% to 85% of the stomach being excised and removed. The pylorus remains intact and the small intestine is unaltered. The short-term complications are essentially the same as for gastric bypass, but the long-term risks and side effects are considerably less than for gastric bypass and biliopancreatic diversion. It is, however, less effective than these operations with regard to weight loss and resolution of diabetes and other comorbidities

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