Bariatric Surgery

DEFINITION

• A frequently done, effective surgical intervention for obese individuals to reduce weight and improve obesity-related comorbidities such as diabetes. Results in weight loss by restriction of overall nutrient intake, malabsorption of nutrients, and/or a combination of restriction and malabsorption.
• Laparoscopic adjustable gastric band: restrictive procedure that inserts a band around the proximal stomach; the band is connected to a subcutaneous port used to adjust the amount of gastric restriction provided by the band.
• Laparoscopic sleeve gastrectomy: restrictive procedure that removes large portion of the greater curvature of the stomach leaving a stomach "sleeve" along the lesser curvature. Can be done as the first part of a duodenal switch or as a standalone procedure.
• Roux-en-Y gastric bypass: combination restrictive and malabsorptive procedure that creates a small gastric pouch by separating the proximal and distal stomach; the proximal gastric pouch is anastamosed to a loop of jejunum ("Roux limb"), while the bypassed distal stomach and proximal small bowel ("Y limb") is anastamosed distally to the jejunum.
• Biliopancreatic diversion (BPD) with or without duodenal switch: combination restrictive and malabsorptive procedure that creates a laparoscopic sleeve gastrectomy with remaining stomach either: 1) attached to lower portion of smaller intestine (BPD) or 2) attached to upper small intestine with creation of separate biliary loop, both of which connect to common channel of lower smaller intestine (duodenal switch).