Types of Bariatric Surgery
Early surgical procedures focused on limiting nutrient/calorie absorption. Kreman et al. produced weight loss through bypassing a significant portion of the intestines . Other modifications eventually led to the Roux-en-Y gastroenterostomy with weight loss resulting from a small pouch partitioned from the stomach.
Roux-en-Y Gastric Bypass
- • Restricts food volume and alters nutrient absorption
- • Remission of type 2 diabetes mellitus (T2DM)
- • Rapid improvement of blood glucose and blood pressure
- • 50%-70% weight loss reported
- • Dumping syndrome, vitamin and mineral deficiencies, constipation, vomiting
- • Anemia, incisional hernia
- • Intolerance to dairy
The Roux-en-Y gastric bypass (RYGB) surgery dramatically reduces the size of the stomach by producing a small pouch that receives food from the esophagus. The small intestine is cut at a point below the stomach and connected to the pouch creating a bypass for food around most of the stomach and part of the small intestine. The unused upper part of the small intestine that is connected to the bypassed stomach section is looped around and connected further down the small intestine creating a “Y” shape allowing gastric juices to drain.
Weight loss occurs from a combination of restriction on amount of food that can be eaten and changes in the neuronal and hormonal pathways. Most of the gastric bypass studies report weight loss in excess of the other procedures. Many individuals who lose weight rapidly from this procedure run the risk of gallstones and may need gallbladder removal during surgery to avoid complications.
Guidry et al. reported no significant difference in survival rates at 30 days and 1 year between patients with obesity undergoing gastric bypass surgery and those who did not chose the procedure .
The single anastomosis gastric bypass, also known as omega loop gastric bypass or mini-gastric bypass, has been increasing throughout Europe and Asia. Studies have labeled it a rapid, safe, and effective bariatric operation with expected weight loss compared with the RYGB. More information on the procedure can be found at the International Federation Surgery of Obesity website: ifso.com.