subject: Weight Loss Surgery Options - Gastric Band Versus Gastric Bypass [print this page] There are several different bariatric (obesity surgery) operations available. The two most common are the Roux en Y (RNY) gastric bypass and the laparoscopic adjustable gastric band (LAGB). Both surgeries can be life changing for patients and each have their own merits.
The question for many people considering bariatric surgery is how I choose the right procedure for me. For most people this is influenced by several things, the most important being suitability. For many patients they will discuss what procedure is most suitable for them with their bariatric surgeon and together they will come to a decision that will be of greatest benefit to the patients.
Weight-loss surgery operations fall into two main categories, restrictive and malabsorptive. An example of restrictive surgery is a gastric band and malabsorptive surgery is a gastric bypass.
What is a gastric band?
The band is a purely restrictive operation. It involves placing a silicone, hollow LapBand* around the stomach which forms a small stomach pouch. This is done via laparoscopy or keyhole surgery. It limits and slows down the amount of food eaten and, when well managed, results in the patient feeling satisfied on smaller portions of food. It can be made tighter to further restrict the volume and speed of the food. This is done by a "band fill", when a needle is injected into a port under the skin. Fluid is injected which expands the band, making it tighter and further restricting food intake.
The gastric band is an extremely safe procedure and patients can expect to lose around 50% of their excess weight, this can be increased if they commit to changing their diet and don"t eat too many sweets, crisps or chocolate. The gastric band works best for volume eaters rather than those who snack because it cannot restrict high calorie liquids, chocolate and ice cream, . It costs from 6850 and has a tiny mortality rate of 0.05% (1:2000)
What is a gastric bypass?
The Roux en Y (RNY) gastric bypass is both restrictive and malabsorptive. It involves reducing the food space and forming a small pouch by cutting and stapling the stomach. This greatly restricts the volume of food tolerated. In addition the small intestine is shortened as the duodenum is bypassed. This results in malabsorption, a reduction in the number of nutrients and calories absorbed from the foods. It works extremely well and is considered, by many surgeons, to be the gold standard for bariatric operations. It is usually performed laparoscopically (minimal access surgery) although it sometimes requires a 4-6" incision. This is usually hyper-obese patients or those with adhesions/scarring form previous surgeries.
It costs from 9500 and usually results in a loss of 60% off excess weight (often more). It is a more complicated operation with a higher mortality rate of 0.33% (1:300) although, in the hands of experienced bariatric surgeons can be considerably lower.
Sometime obese patients will chose an operation based on the cost, what is available locally, anxiety about surgery or celebrity experiences. The most important thing for anyone considering weight loss surgery is that they make the right decision for them. Weight loss surgery is life changing but is also a lifelong commitment. Before people go ahead they must be fully committed to working with the surgery that they have and ensuring that it is right for them.
*Lapband is a registered trademark of Allergan inc
