Describe the process of each of the four types of bariatric surgery, and list an advantage and a disadvantage of each.

Question

What will be an ideal response?

Answer 1

In laparoscopic adjustable gastric banding (LAGB), an inflatable silicone ring is secured around the upper part of the stomach to create a small pouch with a narrow opening at the bottom. The pouch restricts the amount of food that can be consumed at one time. LAGB is the simplest and least invasive because it does not require any stapling of the stomach, but those receiving LAGB lose weight at a slower rate. In laparoscopic vertical sleeve gastrectomy, (LVSG), up to 85% of the stomach is surgically removed, leaving a narrow, tubular, banana-shaped portion of the stomach between the esophagus and the duodenum. Because the detached section of the stomach is primarily responsible for the production of the hormone ghrelin, weight loss is further enhanced by the markedly lower serum levels of ghrelin seen in patients who have had LVSG. The Roux-en-Y gastric bypass procedure creates a small pouch at the top of the stomach, restricting food intake and quickly inducing satiety. The jejunum is cut and the distal end ("roux limb") is surgically connected to the pouch. The Roux-en-Y gastric bypass is the most common bariatric surgery and is highly effective and long lasting. The duodenal switch with biliopancreatic diversion (DS-BPD) is the most complicated and the least frequently performed, but also results in the greatest amount of weight loss. The first part of the procedure is a laparoscopically performed vertical sleeve gastrectomy; the second stage reroutes food from the stomach past most of the small intestine.