|
Modality of Weight Loss
|
Restrictive and Malabsorptive
(stomach and intestines)
|
Restrictive (stomach only)
|
| Type of Operation |
Gastric Bypass |
Gastric Sleeve |
Gastric Banding |
| Anatomy |
Small 1 ounce pouch (20-30cc) connected to the small intestine. Food and digestive juices are separated for 3-5 feet. |
Long narrow vertical pouch measuring 2-3 oz (60-100cc). Identical to the duodenal switch pouch but smaller. No intestinal bypass performed. |
An adjustable silicone ring (band) is placed around the top part of the stomach creating a small 1-2 ounce (15-30cc) pouch. |
| |
|
|
|
| Mechanism |
Significantly restricts the volume of food that can be consumed.
Mild malabsorption
"Dumping Syndrome" when sugar or fats are eaten
|
Significantly restricts the volume of food that can be consumed.
NO malabsorption
NO dumping
|
Moderately restricts the volume and type of foods able to be eaten.
Only procedure that is adjustable
Delays emptying of pouch
Creates sensation of fullness
|
Weight Loss
United States Average statistical loss at 10 years |
70% loss of excess weight
More failures (loss of <50% excess weight) than the DS
|
60%-70% excess weight loss at 2 years
Long term results not available at this time.
|
60% excess weight loss.
Requires the most effort of all procedures to be successful.
|
Long Term Dietary Modification
(Excessive carbohydrate/high calorie intake will defeat all procedures) |
Patients must consume less than 800 calories per day in the first 12-18 months; 1000-1200 thereafter?3 small high protein meals per day
Must avoid sugar and fats to prevent "Dumping Syndrome"
Vitamin deficiency/protein deficiency usually preventable with supplements
|
Must consume less than 600-800 calories per day for the first 24 months, 1000-1200 thereafter
No dumping, no diarrhea
Weight regain may be more likely than in other procedures if dietary modifications not adopted for life
|
Must consume less than 800 calories per day for 18-36 months, 1000-1200 thereafter.
Certain foods can get "stuck" if eaten (rice, bread, dense meats, nuts, popcorn) causing pain and vomiting.
No drinking with meals
|
| Nutritional Supplements Needed (Lifetime) |
Multivitamin
Vitamin B12
Calcium
Iron (menstruating women)
|
Multivitamin
Calcium
|
Multivitamin
Calcium
|
| Potential Problems |
Dumping syndrome
Stricture
Ulcers
Bowel obstruction
Anemia
Vitamin/mineral deficiencies (Iron, Vitamin B12, folate)
Leak
|
Nausea and vomiting
Heartburn
Inadequate weight loss
Weight regain
Additional procedure may be needed to obtain adequate weight loss
Leak
|
Slow weight loss
Slippage
Erosion
Infection
Port problems
Device malfunction
|
|
Average Hospital Stay |
1-3 days |
1-3 days |
Typically
outpatient or 1 night stay |
|
Average Time off Work |
2-3 weeks |
1-2 weeks |
1 week |
|
Average Operating Time |
1 to 2 hours |
1 to 2 hours |
30 to 90
minutes |
