Laparoscopic Roux Y Gastric
This is one of the two operations supported by the 1991
"NIH Consensus Conference on Surgery for Obesity". Laparoscopic
Roux Y Gastric Bypass has proven, over multiple studies,
to achieve significantly greater and more sustained weight
loss. It is a combination of two procedures in which a
restriction, or a small stomach, is created, as well as
a malabsorbtion, through which not all of the small intestine
"sees" the food. With this procedure, an average weight
loss of excess body weight is 70 - 80% possible.
The techniques of laparoscopic (minimally invasive) surgery
initially became available in 1990 for the removal of
gallbladders. This type of surgery has extended to hernia
surgery, removal of colon, appendix, and correction of
Laparoscopic Roux Y Gastric Bypass is only available to
a select group of patients. In addition to cosmetic advantages
(reduced scarring) studies have shown that Lap has decreased
hospital stays, pain, hernias, lung problems; and has
increased the ability to return to work.
Gastroplasty (Vertical Banded Gastroplasty, Gastric
The second procedure approved by the NIH Consensus Panel
was Vertical Banded Gastroplasty. It is a simple restrictive
procedure in which a small "stomach" pouch is created
with a stapler, with the pouch outlet restricted by a
The disadvantages of this procedure include the technical
considerations involved and the fact that weight loss
is difficult for "sweet eaters". Also, the possibility
of sustained weight loss is only up to approximately 40
- 50% of excess body weight.
For these reasons, and since a better alternative is available
at the same risk, this procedure has not been defined
as the "gold standard" by the American Society of Bariatric
Laparoscopic Adjustable Gastric
Banding (Lap-Band Surgery)
Lap band was approved by the FDA in 2001. It has a long
history in Europe and so America. Similar to the Vertical
Banded Gastroplasty (VBG) it only restricts the amount
of food and does not control quality or type of food.
The expandable band is connected to a port and needs to
be adjusted every month in order to have continued success.
The results are similar to the VBG with 40 -50% excess
body weight. It has some failures especially in sweet
eaters and with technical malfunctions.
Gastric Sleeve Resection is the 1st step of a 2-step operation.
It was created in an emergency situation when a patient
had to have a more complex bariatric procedure abandoned
during surgery. The patient had the sleeve performed and
lost a fair amount of weight. The patient subsequently
returned to surgery to have his bariatric procedure completed.
The sleeve has only restrictive properties and has only
a 1-2 year history.
The American Society for Metabolic & Bariatric Surgery
(ASMBS) has a formulated statement that recommends this
procedure as a staged procedure for weight loss in high
risk patients. Those patients need to understand that
they should proceed with a second operation.
See the ASBS position statement at www.asbs.org.
following information provides instructions and information
for before and after weight loss surgery.
Always consult you doctor (surgeon) and/or registered
nurse dietician before making any changes to your diet.
Support Group is open to anyone that has had surgery
for obesity and would like support. Info
Sessions are for anyone interested in learning more
about surgical treatment for obesity.