The Most Common Bariatric Procedures
Normal Anatomy In the normal human anatomy, ingested food travels from the esophagus to the stomach where it mixes with acid and enzymes that help to break the food down. The process of absorbing the food also begins here in the stomach. The food will then travel slowly into the small intestine where additional enzymes from the pancreas as well as bile from the liver continue to act on the food, further breaking it down and contributing to the absorption of the components throughout the length of the small intestine.
Sleeve gastrectomy is a restrictive bariatric surgery. During this procedure, the surgeon creates a small, sleeve-shaped stomach. It is larger than the stomach pouch created during Roux-en-Y bypass—and is about the size of a banana. The sleeve gastrectomy was originally intended to be the first procedure in a two part treatment for the duodenal switch. It was typically considered as a treatment option for bariatric surgery patients with a BMI of 60 or higher to help patients lose a significant amount of excess weight prior to the second procedure. Success was noticed with the sleeve gastrectomy alone and it has now gained popularity as a single bariatric surgical procedure.
Health Benefits of Sleeve Gastrectomy: Studies show sleeve gastrectomy patients experienced resolution rates for type 2 diabetes, high blood pressure, high cholesterol, and obstructive sleep apnea that were similar to resolution rates for other restrictive procedures such as gastric banding.
Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption. During the procedure, the surgeon creates a smaller stomach pouch. The small intestine is then transected past the duodenum, and brought up to the pouch so that food bypasses the lower stomach and a portion of the small bowel. This allows food to bypass a large portion of the small intestine, which absorbs calories and nutrients. Having the smaller stomach pouch causes patients to feel full sooner and therefore eat less food. Bypassing a portion of the small intestine means the patient’s body absorbs fewer calories.
Health Benefits of Gastric Bypass: Studies suggest gastric bypass patients experience resolution of type 2 diabetes often within days of surgery. They also have resolution of high blood pressure, high cholesterol, and obstructive sleep apnea.