Bariatric Surgery or Weight Loss Surgery – Types, Complications and Results

Several types of weight loss surgeries (Bariatric surgeries) are available. Lap banding and gastric bypass are the most commonly used ones.

Roux-en-Y gastric bypass

Laparoscopic adjustable gastric banding (LAGB)

Biliopancreatic diversion (BPD)

Duodenal switch (DS)

Vertical banded gastroplasty (VBG)- abandoned

Weight loss surgeries (Bariatric surgeries) fall into two groups: restrictive and restrictive-malabsorptive. In a restrictive surgery, the amount of food the stomach can hold is limited and the rate of gastric emptying is slowed down.

Laparoscopic adjustable gastric banding (LAGB) is the most commonly performed restrictive operation. An adjustable band (the lap-band) is used around the opening of the stomach. The band is connected to a reservoir that is implanted under the skin. Injection or removal of saline into the reservoir constrains or loosens the band's internal diameter. The size of the gastric opening can thus be altered.

There are three restrictive-malabsorptive bypass procedures: Roux-en-Y gastric bypass (RYGB), Biliopancreatic diversion (BPD), and Biliopancreatic diversion with duodenal switch (BPDDS). They work by combining the elements of gastric restriction and selective malabsorption.

Roux-en-Y gastric bypass (RYGB) is the most commonly performed and accepted bypass procedure. A small pouch is created in the stomach and it is attached to the small intestine. The procedure can be performed as an open surgery (by making an incision on the abdomen) or laparoscopically (via smaller incisions, using smaller instruments). The surgery usually involves a 5-7 day hospital stay in case of open and 2-3 days in case of laparoscopic procedures. Most people may return to their normal activities within 3 to 5 weeks.

Patients who have an extremely high BMI and are high operative risks benefit from a two-stage duodenal switch (DS) procedure. This includes sleeve gastrectomy where the size of the stomach is reduced to a narrow tube. This procedure is however not as commonly done as the previously mentioned ones.