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Surgeries & Procedures

Gastric Bypass

What is a Gastric Bypass?

Gastric Bypass – A type of operation that combines the creation of a small stomach pouch to restrict food intake and the construction of bypasses of the duodenum and other segments of the small intestine to cause malabsorption (decreased absorption of nutrients.

Laparoscopic (Minimally Invasive) Gastric Bypass

Recently, surgeons have performed several anti-obesity operations including gastric bypass using minimally invasive techniques. This approach uses five or six tiny incisions instead of one large incision to perform the operation. These operations require two skilled, well-trained surgeons, skilled assistants and many new specialized instruments.

During the procedure, a laparoscope is inserted into the abdomen. This provides the surgeons with a magnified view on a TV monitor. The result is better visualization throughout the procedure, allowing for more precise work.

By eliminating the large abdominal incisions, bowel manipulation and extensive dissection, patients are assured a faster recovery. Further advantages of the laparoscopic approach include less pain following the surgery, less scarring, and likely an earlier discharge.

Digital Gastric Bypass

This modification of the standard gastric bypass is available for patients who are “super obese,” — more than 200 pounds overweight. This operation adds malabsorption to restriction of intake. The stomach stapling component of the distal modification is the same as in the standard procedure; the only difference is the location of the distal connection of the intestine which is reconnected much closer to the colon. Adding malabsorption increases the risk of several nutritional (metabolic) complications.

Biliopancreatic Diversion (BPD)

Biliopancreatic bypass (BPB) combines a modest amount of eating restriction with lack of complete digestion or absorption of food. This procedure and similar operations including the distal Roux-en-Y technique and duodenal switch are becoming increasingly popular. However, all of the BPB type operations have the potential for developing nutritional deficiencies. In a BPB, about one half of the intestine is excluded (bypassed) before it is rejoined to the ileum (near the end of the small intestine) at a point between 2 and 4 feet above the colon (large intestine), forming the so called common channel (see Figure 2). Some surgeons have modified the standard BPB operation to further reduce stomach capacity in the heaviest patients (BMI ? 50). Surgeons have also lengthened the common channel in less obese patients (BMI 40-50) to reduce the incidence of malabsorption-related complications. The duodenal switch operation is so named because the functional portion of the duodenum (the upper small intestine) is bypassed from digestive continuity in a reversal or “switch” technique.

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