Archive Bariatric Surgery 2005

6 Bariatric Procedures: An Overview

What you need to know about the most common and the most investigational techniques.

Yasmine Iqbal, Contributing Editor

BIO

The American Society for Bariatric Surgery estimates that more than 140,000 people had weight-loss surgery in 2004. Bariatric procedures can either reduce stomach volume, limiting the patient's ability to consume food, or they can alter the digestive process, curbing the amount of calories that the patient can absorb. Here's a rundown of six bariatric procedures, from the most popular to the most experimental.

Roux-en-Y gastric bypass
Many bariatric surgery experts consider Roux-en-Y gastric bypass (RYGB) to be the premier weight loss surgery, claiming that it offers the most excess weight loss over time with an acceptable level of risk. Most of these procedures are now performed laparoscopically and require an inpatient stay of one or two days. At Baylor University Medical Center in Dallas, bariatric surgeon Todd McCarty, MD, leads a team of six surgeons who perform about 1,100 laparoscopic RYGB procedures every year. What's most remarkable about Baylor's cases is that 92 percent of these patients leave within 23 hours after surgery.

Laparoscopic RYGB requires four or five incisions and takes about one hour. Dr. McCarty performs the procedure as follows: First, he creates a proximal stomach pouch, which holds about 30ccs. He then divides the upper jejunum, brings it up in front of the colon (an antecolic approach) and connects it to the stomach pouch (this section of the intestine is called the Roux limb). He then connects the end of the jejunum to the side of the Roux limb. Food passes through the esophagus, into the upper pouch, through the anastamosis and into the Roux limb. Digestive juices from the stomach, the liver and the pancreas pass through the duodenum and the jejunum and mix with the food in the Roux limb where the parts of the small intestine are attached. The food and the digestive juices then pass through the rest of the intestine.

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