Gastric bypass

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Adjustable gastric banding	Biliopancreatic diversion (BPD)	Biliopancreatic diversion with duodenal switch	Dumping syndrome
Roux-en-Y stomach surgery for weight loss	Vertical banded gastroplasty

This "y-connection" allows food to mix with pancreatic fluid and bile, aiding the absorption of important vitamins and minerals. You still may experience poor absorption of certain nutrients.

The risk of malabsorption is of greater concern in gastric surgeries that skip over a larger portion of the small intestines. These are performed much less commonly than the Roux-en-Y gastric bypass as described.

LAPAROSCOPY

Gastric bypass can be performed using a laparoscope. This less-invasive technique allows the surgeon to make smaller incisions, which lowers the risk of large scars and hernias after the procedure.

First, small incisions are made in your abdomen. The surgeon passes slender surgical instruments through these narrow openings. The surgeon also passes a camera (laparoscope) through one of these small openings and watches through a lens and video monitor to do the surgery.

TYPES OF WEIGHT LOSS SURGERIES

Weight loss surgery can be divided into three types:

• Restrictive procedures reduce the size of your stomach.
• Malabsorptive procedures alter the flow from your stomach to your intestine, causing poor absorption of calories, vitamins, and minerals in the intestine.
• Combination procedures involve characteristics of both restrictive and malabsorptive procedures.

Gastric bypass surgeries are combination procedures that use both restriction and malabsorption to achieve weight loss.

Because it is a combination approach, it tends to be more successful for weight loss than purely restrictive surgeries. However, your body may not absorb vitamins and minerals properly.

Restrictive-only procedures are not as successful. It is easy to "cheat" and eat too much food, over-stretching the newly created stomach pouch.

A newer procedure, called the Lap-Band, uses a band around the upper part of the stomach, creating a small pouch to hold food. The band limits the amount of food you can eat, and increases the time it takes the intestines to digest the food. Your doctor can later adjust the band to allow food to pass more slowly or quickly through your digestive system. Possible complications include nausea, vomiting and gastroesophageal reflux.