The Roux-en-Y gastric bypass (RYGBP) is the most commonly performed bariatric surgery, combining restrictive and malabsorptive elements. The surgery can be performed via laparoscopy* or through an open incision.
The restrictive element is achieved by dividing the stomach into two sections. The top section becomes a small pouch that "restricts" or limits the amount of food you can eat. It also provides a feeling of fullness and satisfaction with smaller portions of food.
The new stomach or "pouch" will be about 5-10% the size of the original stomach. The lower section of the stomach no longer receives, stores and mixes food, but remains functional by continuing to secrete digestive juices.
The malabsorptive element is achieved by surgically dividing the small intestine. The lower part of the small intestine is connected to the small pouch or "new" stomach. The other end of the intestine is reconnected further down the small intestine. The shape of the intestine now somewhat resembles a "Y."
When food is eaten, it enters the "new" stomach traveling directly into the lower part of the small intestine, thereby "bypassing" the upper part of the small intestine. As a result, a limited amount of calories and nutrients are absorbed into the body.
Adjustable Gastric Banding (often called Lap-Band®) surgery involves attaching an inflatable band around the top portion of the stomach and tightening it like a belt to form a small pouch. The surgery can be performed via laparoscopy or through an open incision.
This creates a new, much smaller stomach. In gastric banding surgery, the entire gastrointestinal tract and digestive processes remain intact.
By adding or removing saline (salt water) from the band, adjustments can be made to "tighten" it to promote weight loss over a period of time.
*A laparoscopic procedure uses several small incisions for insertion of the instruments, including small video cameras to visualize the inside of the abdomen during the operation. Persons with a Body Mass Index (BMI) of 60 or more or those who have already had some type of abdominal surgery are usually not considered a candidate for this technique.
