Types of Weight Loss Surgery: There are different kinds. Some, like the gastric “sleeve” and gastric banding, shrink your stomach’s size. They are restrictive surgeries. Other operations, such as the duodenal switch, only bypass part of the intestine, so you absorb less food. Doctors call these malabsorptive surgeries.
You need to have a lot of extra pounds to be a candidate for weight loss surgery:
Body mass index (BMI) of 40 or more (more than100 pounds overweight).
BMI of 35-40 (about 80 pounds overweight) and you have diabetes or metabolic syndrome, asthma, heart disease, diabetes, or obstructive sleep apnea. (Your doctor will have the full list.)
BMI of 30-35 and you have a certain kind of diabetes or a combination of other serious health conditions called the metabolic syndrome.
Your surgeon will use either the open or the laparoscopic surgical method. Laparoscopy leaves smaller scars and tends to have fewer complications and quicker recovery time. For this procedure, the doctor only needs to make several small, “keyhole” cuts. She’ll use a thin, lighted tool, called a laparoscope, that will show what’s going on inside on a monitor in the operating room. For open surgery, you’ll get an 8- to 10-inch cut on your belly.
Creating the Stomach Bypass
Next, your surgeon will cut your small intestine beyond the stomach. She will attach one end of it to the small stomach pouch and the other end lower down on the small intestine, making a “Y” shape. That’s the bypass part of the procedure. The rest of your stomach is still there. It delivers chemicals from the pancreas to help digest food that comes from the small pouch. Doctors use the laparoscopic method for most gastric bypasses.
In this operation, your surgeon will take out most of your stomach (75%) and create a tube-shaped stomach, or a gastric sleeve, that is still attached to your small intestine. After the surgery, your stomach will only be able to hold about 2-3 ounces. You’ll feel fuller sooner because your stomach is smaller. You also won’t be as hungry because most of the tissue that makes the “hunger hormone,” called ghrelin, will be gone. This is not a reversible procedure.
Adjustable Gastric Banding (AGB or Lap-Band)
Your surgeon will wrap an inflatable ring around the top of your stomach. She will inflate the band, squeezing a part of the stomach to create a small pouch with a narrow opening into the rest of the organ. She may use a laparoscope to do this. When you eat, food pushes the wall of the stomach and sends signals to the brain to curb your appetite. You can get the band re-adjusted or removed at any time.
Vertical Gastric Banding (VGB, or “stomach stapling”)
Doctors don’t use this method as often as they once did, as there are newer, better techniques now. It worked like this: A surgeon cut a hole in the upper part of the stomach and put surgical staples in the stomach toward the top of it, making a small pouch. After that, the surgeon put a plastic band through the hole, wrapping it around the bottom end of the pouch to prevent stretching. Food moved from the pouch through a small opening to the rest of the stomach.
Roux-en-Y Gastric Bypass
During this procedure, your surgeon will use surgical staples to create a small pouch to serve as your new stomach. This pouch will hold about 1 cup of food. The rest of your stomach will still be there, but food won’t go to it.
This is a malabsorptive procedure, which means it cuts way down on the calories and nutrients you absorb from food. First, your surgeon will make a small pouch from your stomach. The pouch will only hold about 4-8 ounces, so you’ll need to eat a lot less. Then the surgeon will make a bypass that skips the rest of your stomach and most of your small intestine.
Doctors typically save this operation for people with the most weight to lose, because you miss out on a lot of nutrients