Gastric Bypass 101: More Options

As the prevalence of obesity in the United States has grown, so has the demand for surgical solutions to weight problems. In fact, surgical weight-loss procedures were performed on nearly 200,000 Americans in 2005. Here, we continue our overview of options, risks, and success rates.


The Options for Surgical Slim Down Continued:

2. The LAP-BAND® System.
The only adjustable and reversible surgical weight loss procedure available, LAP-BAND® System surgery involves placing an inflatable "band" around the upper part of the stomach to restrict the amount of food that can be consumed in one bout and increases the time it takes for the stomach to empty. There's no stomach stapling, cutting or intestinal re-routing. "LAP-BAND® System is a good first approach because it has the lowest risk of complications," says Horgan. "And it's the only procedure I recommend for teens or women who want to become pregnant because it does not restrict the absorption of nutrients." Patients achieve sustained weight loss by limiting food intake, reducing appetite and slowing digestion. Weight loss is slower with the LAP-BAND® System -- five years compared to one with bypass -- but it's the least invasive surgical option and has the lowest mortality rate (0.05 percent). The drawback: the LAP-BAND® System can erode over time and may need adjustments to remain effective.

3. Biliopancreatic Diversion/Duodenal Switch
In this more complicated gastric bypass procedure, surgeons remove three-fourths of the stomach. The small pouch that remains is connected directly to the small intestine -- completely bypassing both the central and lower portions of the small intestine. The switch preserves a valve that controls the release of food into the intestines from the stomach. And results are astounding with 60 to 80 percent of excess pounds lost within a year. But with a 2.5 to 5 percent mortality rate, this procedure is the riskiest in terms of death and malnutrition, and according to Horgan, the increase in weight loss does not justify the increase in mortality.

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