Types of Bariatric Surgery Adjustable Gastric Banding: • Decreasing in prevalence, 3% of bariatric surgeries performed • Adjustable silicone band creates a 30-40ml gastric pouch • High rate of weight regain, complications (slippage of band, re-operation) Sleeve Gastrectomy: • Most common bariatric surgery performed worldwide • Longitudinal gastrectomy, 75-100ml gastric pouch intake, ↓ghrelin levels, ↑gastric emptying • Low complication rate, ↓risk of malnutrition • Common complications - staple line leak, mid-gastric stricture, GERD Roux-en Y Gastric Bypass - RYGB: • 2nd most common procedure performed • 15-30mL gastric pouch, 150cm alimentary limb bypassing excluded stomach + duodenum, biliopancreatic limb (200cm) • Restrictive (small gastric pouch), malabsorptive (bypassing small bowel i.e. reduced gastric acid, bypass of bile salts and pancreatic secretion causing malnutrition), Hormonal changes (GLP1, glucagon, GIP) • Common Complications — dumping syndrome, marginal ulcers, internal hernia, bowel obstruction & SIBO Mini (one anastomosis) Gastric Bypass - MGB: • 3rd most performed bariatric surgery • Long narrow gastric pouch and 1 anastomosis • Restrictive and malabsorptive • Technically easier than RYGB Less complications Biliopancreatic Diversion with Duodenal Switch (BPD-DS): • Relatively uncommon procedure • Combines sleeve gastrectomy and post pyloric RYGB • Pylorus preserved less dumping syndrome and marginal ulcers by Chuma G. Obineme, MD @TypicallySilent via Emory Gastroenterology and Hepatology @EmoryGastroHep #Bariatric #Surgery #types #gastric #bypass #gastroenterology
