People who qualify for either procedure have a body mass index (BMI) of over 40, or have a BMI of 35 and have one or more severe co-morbid conditions: high blood pressure, diabetes, spinal or joint problems, venous thromboembolic disease, obstructive sleep apnea, and other related issues.
Gastric Bypass Surgery
Gastric bypass is the blanket term used for the permanent surgical re-arrangement of the stomach and small intestine. Basically, the stomach is divided into two areas: an upper (small) pouch, about 10% of the size of the entire stomach, and the remaining portion of the stomach. The small intestine is then reattached. The purpose of this procedure is to reduce the amount of food required before the patient feels full, which limits the number of calories consumed each day. Weight is lost fairly quickly, and most patients will lose an average of 65 to 80% of excess weight in the first three and a half years following surgery.
Risks and complications of gastric bypass surgery include (but are not limited to):
- adverse reaction to anaesthesia which causes death;
- complications of abdominal surgery such as bowel obstruction, venous thromboembolism, infection, hemorrhage and hernia;
- complications of gastric bypass such as dumping syndrome, anastomotic ulcer, anastomatic stricture, and anastomatic leakage; and
- nutritional deficiencies.
Gastric Band Procedure
The gastric band procedure involves the laparoscopic installation of an inflatable silicone band to the upper portion of the patient’s stomach. The gastric band divides the stomach into two areas, one small pouch and a large pouch which includes the rest of the stomach. The patient eats a small amount of food and fills the small pouch, which causes the patient to feel full on less food. The resulting change in eating habits causes the patient to lose weight – an average of 60% of the excess weight. The difference between the gastric band and the gastric bypass is that with the gastric band there is not a permanent division of the stomach, as this procedure is reversible. There is less risk associated with the gastric band than with gastric bypass surgery. Patients tend to lose weight more slowly with the gastric band procedure during the first three and half years compared to the gastric bypass, but over the course of five years, patients from both types of procedures will lose about the same amount.
Risks and complications of the gastric band procedure include (but are not limited to):
- adverse reaction to anesthesia which causes death;
- productive burping;
- improper position of the band;
- problems with the port or tube connecting to the band (used for inflation and deflation); and
Benefits of the gastric band compared to gastric bypass surgery include (but are not limited to):
- lower mortality rate;
- shorter recovery time;
- no malabsorption issues (which cause nutritional deficiencies).
It must be noted that gastric bypass surgeries and gastric band procedures are life-altering and are not to be undertaken without commitment and full understanding of the risks, complications, and requirements. Patients must follow strict eating guidelines if they are to achieve success. Overall, patients achieve weight loss of up to 60% of excess weight averaged over the course of five years following the procedure. Personal choice and medical recommendations will determine if gastric bypass or gastric band is the preferred procedure for weight loss.
Comments, questions and stories of experiences with gastric bypass and gastric band procedures are welcomed and encouraged. Reply below.