The following information regarding the types of surgery are provided Courtesy of  

Weight-control Information Network,  1 WIN Way, Bethesda , MD 20892-3665       

http://win.niddk.nih.gov/index.htm

There are four types of operations that are commonly offered in the United States:

• Adjustable gastric band (AGB)
• Roux-en-Y gastric bypass (RYGB)
• Gastric sleeve (GS)
• Giliopancreatic bypass with a duodenal switch (BPD).

Each has its own benefits and risks.

To select the option that is best for you, you and your physician will consider that operation’s benefits and risks along with many other factors, including BMI, eating behaviors, obesity-related health conditions, and previous operations. 

Adjustable Gastric Band        

AGB works primarily by decreasing food intake.

Food intake is limited by placing a small bracelet-like band around the top of the stomach to produce a small pouch about the size of a thumb.

The outlet size is controlled by a circular balloon inside the band that can be inflated or deflated with saline solution to meet the needs of the patient.  

Roux-en-Y Gastric Bypass   

RYGB works by restricting food intake and by decreasing the absorption of food. Food intake is limited by a small pouch that is similar in size to the adjustable gastric band. In addition, absorption of food in the digestive tract is reduced by excluding most of the stomach, duodenum, and upper intestine from contact with food by routing food directly from the pouch into the small intestine.  

Gastric Sleeve         

GS is usually performed as the first stage of biliopancreatic bypass with duodenal switch in patients who may be at high risk for complications from more extensive types of surgery.

These patients’ high risk levels are due to body weight or medical conditions.

A GS operation restricts food intake and does not lead to decreased absorption of food.

However, most of the stomach is removed, which may decrease production of a hormone called ghrelin. A decreased amount of ghrelin may reduce hunger more than other purely restrictive operations, such as gastric band. 

Biliopancreatic Bypass With a Duodenal Switch    

BPD, usually referred to as a “duodenal switch,” is a complex bariatric operation that includes removing the lower portion of the stomach and creating a gastric sleeve with the small pouch that remains.

That pouch is connected directly to the small intestine, completely bypassing the duodenum and upper small intestine from contact with food. BPD produces significant weight loss.

However, the mortality rate is higher than with other bariatric operations and there are more long-term complications because of decreased absorption of food, vitamins, and minerals. 

What are the complications of these operations?    

Early complications of these operations can include bleeding, infection, leaks from the site where the intestines are sewn together, and blood clots in the legs that can progress to the lungs and heart.

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