There are four different types of stomach reduction surgeries that are typically performed in the United States. These include: the adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG).
AGB surgery involves placing a small band around the top part of the stomach, reducing the size of the stomach. The amount of food that can be taken is limited due to the small thumb-sized stomach. The opening to the stomach is controlled by a balloon inside the band that is inflated or deflated with saline solution to customize it to the size the patient needs.
RYGB reduces the size of the stomach and restricts the amount of food that can be taken and absorbed. A smaller stomach is made similar to the gastric-band technique while also excluding the majority of the stomach, duodenum and upper intestine so that food is routed directly from the pouch to the small intestine.
BPD-DS, better known as the “duodenal switch,” is a more complicated stomach-reduction surgery than the AGB or RYGB. It involves the removal of a large part of the stomach, rerouting the food from the small intestine to prevent absorption, and rerouting of the digestive juices. BPD-DS surgery can result in a great amount of weight loss. There are complications, however, due to malabsorption of food nutrients.
During the BPD-DS, where a large portion of the stomach is removed, a “gastric sleeve” or vertical sleeve can be created and stays connected to a segment of the duodenum, which is then connected to a part of the small intestine. This procedure allows a portion of the duodenum to remain available for absorption of food, vitamins and minerals. The complications with this procedure occur when most of the food bypasses the duodenum. Because the distance between the stomach and colon are also made shorter, malabsorption can result.
Each one of these procedures has its pluses and minuses. Ask your doctor to discuss and describe each option to you and help you to select the surgery that is best for your particular situation. When recommending the surgery that is right for you, your doctor will take into consideration the procedure’s risk and benefits and factors such as your body-mass index (BMI), your eating habits, any weight-related health conditions you may have and your previous medical history, including operations you may have undergone.