Weight Loss Guru


Surgery Types

The different types of weight loss surgery are:

1) RNY - Gastric Bypass:

     This surgery is a complex operation, which provides consistent and successful weight loss. A small upper pouch is completely separated from the stomach which is left in place. A segment of the bowel is attached to the pouch with a narrow opening. This delays the mixing of food and digestive juices from the actual stomach resulting in poorer absorption of calories and nutrients. This restricts appetite and food intake as well as interferes with absorption. However, this surgery has a higher risk of side effects and complications than other weight loss surgeries. 80% of patients lose at least half their weight.

2) Adjustable Lap Bands:

     The LAP-BAND is designed to induce weight loss by restricting food consumption. An adjustable elastic band is placed around the upper stomach to create a small pouch with a narrowed outlet. The outlet size can be adjusted by injecting saline into a small reservoir placed under the skin at the time of surgery, and connected to the band by an I.V. tubing. The pouch fills quickly with solid food and empties slowly to relieve hunger and produce a feeling of fullness. Overeating results in pain or vomiting to limit food intake.

     There are many advantages to this surgery including: no cutting or stapling of the stomach, the ability to adjust outlet size in the office by injecting saline into the band to loosen or tighten the opening, and the more easy reversibility of the operation with the restoration of a normal stomach after the band is removed.

     Some of the disadvantages of this surgery include: the risk of slippage of the band around the stomach to an abnormal position, the erosion of the band into the stomach, problems with the tubing, and the mechanical malfunction of the band. As well, this method, does not limit the intake of high caloric liquids.

3) VBG - Vertical Banded Gastroplasty- Stapling:

     This surgery limits food intake by creating a small pouch in the upper stomach with a narrow outlet, reinforced by a mesh band to prevent stretching. The pouch fills quickly and empties slowly with solid food - producing a feeling of fullness. Over eating will result in pain and vomiting. It restricts food intake and generally has lower complications and shorter hospital stays. The disadvantage of this is that this surgery usually results in less weight loss than the RNY. As well, it does not restrict in take of caloric liquids. 20% of people do not loose weight and only half the people who have this operation loose 50% of their excess weight.

4) DS/BPD duodenal switch

     This procedure has two components. A gastrectomy (see above) results in the reduction of oral intake. The second component of the operation is a RNY (see above) that reduces the absorption of nutrients and calories which helps to maintain weight loss over the long term. Recent results indicate 72% of excess body weight lost and maintained. The advantage of this surgery to the patient is that the person will still be able to eat large quantities of food and still achieve excellent long term weight loss results. Some disadvantages include loose stools, stomach ulcers, offensive body odour and foul smelling stools and flatus. The most serious potential complications include protein malnutrition which can result in hypoalbuminemia, anemia, edema, asthenia, and alopecia. To prevent this people are required to take vitamin supplements.

5) JIB and MGB

     This surgery bypasses all but 12-18 inches of the small bowel. It is relatively outdated and there are more successful and safer procedures being used now. It was designed to be reversible when the patient had lost all their weight. But many patients were intrigued by being able to eat a lot and not gaining as fast as they would have without the bypass so they did not have it reversed. Although many patients gained back a considerable amount of weight, most hesitated to have them reversed until the years of malabsorption began to cause damage to organs like the kidneys. For those who left the JIB intact, liver failure often resulting in death, was a common long term side effect.

6) Gastric Pacing

     Gastric pacing, also known as gastric electrical stimulation uses an implantable device designed to treat nausea and vomiting that occurs because of other gastrectomy procedures. The device may be referred to as a gastric pacemaker. Electrodes are implanted in the stomach.

7) Liposuction:

     Liposuction (also called lipoplasty, suction-assisted lipectomy, Tumescent Liposuction or Ultrasound liposuction) is a surgical procedure designed to improve body shape and proportion by removing fat deposits that are resistant to both diet and exercise. Liposuction can restore balance to bodies that are physically fit, but out of proportion in a few areas. It is most effective for patients who fall within the normal weight range for age and height. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don't respond to traditional weight-loss methods.

     Liposuction is a procedure in which localised deposits of fat are removed to re-contour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. The size of the liposuction cannula can influence the smoothness of the skin after liposuction. The use of large cannulas tend to create irregularities more commonly than microcannulas (outside diameter less than 3 millimetre's). Surgeons who do total-body liposuction tend to use larger cannulas.

     As with any major surgery there is always a risk that something may go wrong. If you are considering liposuction your surgeon should outline all the risks to you before you agree to undertake the surgery.

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