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Modality of Weight Loss
Restrictive and Malabsorptive
(stomach and intestines)
Restrictive (stomach only)
Type of Operation Gastric Bypass Gastric Sleeve Gastric Banding
Anatomy Small 1 ounce pouch (20-30cc) connected to the small intestine. Food and digestive juices are separated for 3-5 feet. Long narrow vertical pouch measuring 2-3 oz (60-100cc). Identical to the duodenal switch pouch but smaller. No intestinal bypass performed. An adjustable silicone ring (band) is placed around the top part of the stomach creating a small 1-2 ounce (15-30cc) pouch.
 
Mechanism
  • Significantly restricts the volume of food that can be consumed.
  • Mild malabsorption
  • "Dumping Syndrome" when sugar or fats are eaten
  • Significantly restricts the volume of food that can be consumed.
  • NO malabsorption
  • NO dumping
  • Moderately restricts the volume and type of foods able to be eaten.
  • Only procedure that is adjustable
  • Delays emptying of pouch
  • Creates sensation of fullness
  • Weight Loss
    United States Average statistical loss at 10 years
  • 70% loss of excess weight
  • More failures (loss of <50% excess weight) than the DS
  • 60%-70% excess weight loss at 2 years
  • Long term results not available at this time.
  • 60% excess weight loss.
  • Requires the most effort of all procedures to be successful.
  • Long Term Dietary Modification
    (Excessive carbohydrate/high calorie intake will defeat all procedures)
  • Patients must consume less than 800 calories per day in the first 12-18 months; 1000-1200 thereafter?3 small high protein meals per day
  • Must avoid sugar and fats to prevent "Dumping Syndrome"
  • Vitamin deficiency/protein deficiency usually preventable with supplements
  • Must consume less than 600-800 calories per day for the first 24 months, 1000-1200 thereafter
  • No dumping, no diarrhea
  • Weight regain may be more likely than in other procedures if dietary modifications not adopted for life
  • Must consume less than 800 calories per day for 18-36 months, 1000-1200 thereafter.
  • Certain foods can get "stuck" if eaten (rice, bread, dense meats, nuts, popcorn) causing pain and vomiting.
  • No drinking with meals
  • Nutritional Supplements Needed (Lifetime)
  • Multivitamin
  • Vitamin B12
  • Calcium
  • Iron (menstruating women)
  • Multivitamin
  • Calcium
  • Multivitamin
  • Calcium
  • Potential Problems
  • Dumping syndrome
  • Stricture
  • Ulcers
  • Bowel obstruction
  • Anemia
  • Vitamin/mineral deficiencies (Iron, Vitamin B12, folate)
  • Leak
  • Nausea and vomiting
  • Heartburn
  • Inadequate weight loss
  • Weight regain
  • Additional procedure may be needed to obtain adequate weight loss
  • Leak
  • Slow weight loss
  • Slippage
  • Erosion
  • Infection
  • Port problems
  • Device malfunction
  • Average Hospital Stay 1-3 days 1-3 days Typically outpatient or 1 night stay
    Average Time off Work 2-3 weeks 1-2 weeks 1 week
    Average Operating Time 1 to 2 hours 1 to 2 hours 30 to 90 minutes

     

     

     

     

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