Gastric Surgery

How It Works

Gastric surgeries are performed to specifically aid in weight loss and work in the following ways:

• Restrictive Surgeries: Reduces the size of your stomach to prevent you from being able to eat larger portions. When eating you will feel full sooner and eat less.
• Malabsorptive Surgeries: During surgery, part of your digestive system is rearranged and/or removed. Surgery can be performed to make the food you eat bypass part of your intestine so fewer calories and nutrients are absorbed.
• Some types of gastric surgery use a combination of these methods.

Is It Right For You?

If you are currently severely obese with a body mass index (BMI) above 40 – or you are 100 lbs. or more over your ideal body weight – you may be a candidate for surgery. Those who have a lower BMI of 35 and above also qualify with the presence of an obesity-related serious health condition such as diabetes, heart disease, high cholesterol, high blood pressure, sleep apnea, etc.

Other criteria that must be met include:

• You are healthy enough for surgery
• You understand the surgery and its risks
• You do not engage in drug or alcohol abuse
• You have no uncontrolled psychological conditions
• You have had previous failed attempts at weight loss

Surgical Methods Used

Weight loss surgeries can be performed via open surgery or laparoscopically. Laparoscopic surgery is trending in popularity, however, the more traditional open surgery may be necessary in certain cases such as the buildup of scar tissue from previous surgeries.

• Open Surgeries: Performed by making a relatively large incision in your abdomen. These surgeries carry a greater risk of infection and adhesions and require a longer recovery time. A typical hospital stay is five days or more.
• Laparoscopic Surgeries: Performed by making five or six small incisions, which are just big enough to allow passage of surgical instruments. Healing time is less with this method and you can usually be discharged home in two days or less.

Types of Gastric Surgery

No one procedure works the same for everyone. When considering surgery types, take into account many factors such as what your weight loss goal is, what health problem you want to improve, the associated risks and cost.

Roux-en-Y Gastric Bypass

This type is considered to be the ‘golden standard’ of weight loss surgery. The Roux-en-Y results in decreased calorie consumption related to a reduced stomach size and changes in the digestive process. More importantly, the rerouting of your food stream causes the previously mentioned hormonal changes that suppress hunger and promote satiety, reversing a primary mechanism that can induce type 2 diabetes.

During this procedure, a small pouch is created at the top of the stomach, which will be the only part receiving food. This greatly limits the amount of food eaten.

Next, the small intestine is cut below the main stomach and connected to the new small pouch. The remaining portion of the small intestine that is attached to the main stomach is reconnected farther down. This process causes a portion of the small intestine to be bypassed during digestion resulting in the decreased absorption of calories and nutrients.

Adjustable Gastric Band

The adjustable gastric band is the second most popular weight loss surgery method. This is a laparoscopic procedure in which an adjustable band containing an inflatable balloon is strategically placed around the upper portion of the stomach. Just above the band, a small stomach pouch with a narrow opening to the remaining portion of the stomach is created.

Next is the placement of a port just beneath the skin of the abdomen, which is connected to the band by a tube. The port is accessed to inflate or deflate the balloon – which adjusts the size of the band – by injecting or removing a saline solution.

As the amount of food that can be held in the stomach is restricted by the band, you will feel full more quickly. The adjustable band does not affect the absorption of nutrients or calories.

Sleeve Gastrectomy

During this surgical procedure, a portion of the stomach is completely removed. The section of the stomach that remains is formed into a tube-like shape, similar to a banana, and does not affect the absorption of calories and nutrients.

As the stomach is smaller, less food needs to be eaten to feel satisfied. The desire to eat may also be decreased as less of the appetite-regulating hormone is produced.

Duodenal Switch

This procedure is somewhat similar to the gastric bypass and begins by removing a large portion of the stomach while leaving the valve that releases food to the small intestine (duodenum). The middle portion of the small intestine is closed off and the last part of the small intestine is attached directly to the duodenum. Rather than removing the separated portion of the small intestine, it is reattached to the end of the intestine to allow for the flow of digestive juices.

This is a combination procedure as the size of the stomach is reduced and digestion only occurs in a small portion of the small intestine. Therefore; recipients eat less, feel full sooner, and the absorption of nutrients and calories is decreased.

What Results Can You Expect?

Gastric surgery for weight loss has been shown to produce a greater degree of weight loss in those who are obese when compared to other weight loss methods. The amount of weight loss varies per person and per procedure. Other benefits of gastric surgery include:

• Possible reversal or greatly improved control of Type 2 diabetes
• Studies have shown that severely obese people who have weight-loss surgery have a lessened risk of heart attacks, stroke, liver disease and some forms of cancer, making them likely to live longer.
• Also shown in studies, high blood pressure is less likely to develop in people who have undergone weight loss surgery when compared to those who used conventional weight loss treatments.