There are two basic types of bariatric surgeries for weight
loss: restriction procedures and malabsorption procedures.
Restriction procedures reduce the size of the stomach through
the use of a gastric band, staples, or both, and do not
interfere with the normal digestion process. Malabsorption
procedures, on the other hand, reduce the size of the stomach
and bypass duodenum, the first segment of the small intestine,
and sometimes the whole of the jejunum (the mid-section of the
intestines). Some bariatric procedures combine the two.
The Roux-en-Y gastric bypass surgery is widely accepted as the
most effective surgical weight loss treatment available. During
this procedure, the stomach is divided into two sections,
reducing the size of the new pouch 90 percent, from
approximately two quarts to one or two ounces. This drastic
reduction limits the new stomach pouch’s ability to hold food,
causing the patient to feel full after eating only a small
amount of food. This also causes the food to bypass part of the
digestive system, reducing the amount of calories the body
absorbs.
A more extensive gastric bypass procedure calls for the removal
of portions of the stomach. A small pouch remains, which is then
is connected directly to the final segment of the small
intestine, completely bypassing the duodenum and jejunum.
Although this surgery can result in substantial weight loss, it
is seldom used due to the high risk of nutritional deficiencies.
Other options include adjustable gastric banding, where the
stomach is encircled with an inflatable band allows only a small
portion of the stomach to be used for holding food. Patients
typically achieve less weight loss with this procedure because
no intestine is bypassed and there is no malabsorption, but the
absence of stapling makes it the least invasive and lowers the
risks involved.
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