Bariatric surgery alters the digestive process. Most bariatric procedures work by two methods - a food intake restriction component and a malabsorptive component.
Restrictive Operations
A portion of the stomach may be removed or bypassed so as to restrict the amount of food the stomach can hold. Thus, only a limited amount of food can be eaten prior to getting full.
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Adjustable Gastric Banding (or Lap-Band®) - This is most recent procedure available. It is performed laparoscopically and involves placing an adjustable elastic band around the upper section of the stomach to create a small pouch which restricts the passage of food. |
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Vertical Banded Gastroplasty (VBG) - This procedure involves stapling and dividing the upper stomach to form a small pouch that shrinks the stomach and the amount of food it can hold. |
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Malabsorptive Operations
These procedures create a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients. This limits the amount of food that is completely digested or absorbed.
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Biliopancreatic Diversion (BPD) - This procedure involves removing about 75 percent of the stomach. This procedure also rearranges the small intestine, so that food is diverted and only absorbed in the last 75-100cm. The section of the intestines that carry the food from the small stomach does not join with the section carrying the digestive juices from the liver until very far downstream. |
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Duodenal Switch |
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Combined Restrictive & Malabsorptive Procedure
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Roux-en-Y Gastric Bypass - This is currently the most frequently performed procedure. It involves stapling the upper stomach to create a small pouch that is then attached to part of the small intestine. |
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