What types of gastric bypass surgeries are available?
All of the surgeons on our team have an interest is laparoscopic surgery. There are basically three types of laparoscopic operations currently being performed in the treatment of morbid obesity.
The first type involves a gastric band. The gastric band has been in many centers in Europe. Of the three types of operations, laparoscopic banding is technically the easiest. The operation involves placing a band around the upper part of the stomach, and thereby limits the size of the stomach. The disadvantage of gastric banding is in it’s long term results and erosion rates. Studies show that 25% of patients with the band need to have the band removed and that weight loss is slower and less predictable. It is our opinion that most patients would do better with a gastric bypass than with a gastric band.
The second type of surgery uses both a band, and surgical staples. The combination of a band and staples (vertical banded gastroplasty) has been used to treat obesity for the past 15 years. The size of the stomach is reduced by about 90%. This type of procedure has fair long term results. Studies show that all patients have lost weight at one and a half years after surgery. Although this operation is being offered in some treatment centers, we will not be offering this type of surgical approach. The short term results are quite good, and the operation is fairly easy to perform laparoscopically, but the long term weight loss is discouraging.
The third type of surgery involves staples and a gastric bypass and has the best long term success. (Please note that this is not the same as the troubled intestinal bypass of 30 years ago). This operation is a bit more difficult laparoscopically, but nonetheless, we feel that the gastric bypass offers the best chance of long term weight control. It has a high chance of success, has a low chance of complications, and it will be technically feasible in a high percent of patients using the laparoscopic technique. The success of laparoscopic gastric bypass is that our approximate weight loss at 1 year is 110 pounds.