Question:
I am new to this. I am very confused about your acronyms.

Where can I find explanations as to exactly what each surgery is, and how it is done?    — John B. (posted on August 31, 1999)

August 31, 1999
Hi John, I was in the same position in the beginning. My PCP couldn't give me all the details but when I saw the surgeon he sent me to, he went over all the types of surgeries and which he preferred to do and why. He also gave me a booklet to read and set me up with a local support group. These groups are a wonderful addition for anyone thinking about having WLS. Hope you find a good surgeon who can answer all your questions. Janice
   — Janice M.

August 31, 1999
Try internet searches on the following and you should come up lots of information: Gastric Bypass, Vertical Banded Gastroplasty, Weight Loss Surgery, Morbid Obesity, Bariatric Surgeons. Also worth visiting are the websites for National Institute of Health-morbid obesity, and the American Association of Bariatric Surgeons where you can obtain a listing of bariatric surgeons in your State. Deciphering the acronyms: Bariatric Surgeons - surgeons who specialize in the treatment of obesity BMI - body mass index GB-Gastric Bypass VBG - Veritical banded gastroplasty RNY - Gastric Bypass Roux-en-Y Lap - surgery performed laparoscopically (5-6 small incisions of 1-2" in length) Open - surgery performed by an open incision of 3-12" from breastbone to belly button Proximal - this describes the amount of small intestine bypassed (usually 1-4 ft in a proximal). Distal-this procedure bypasses much more of the small intestine and is sometines called a malabsorptive procedure. Lastly most surgeons/clinics have websites. They are also more than willing to mail out information packets, questionaires and literature describing procedures and insurance. Some clinics also have monthly informational seminars you can attend for free - they also ususally have monthly support group meetings. Here's an excerpt from my doctors literature on the different procedures. My doc is in favor of the Proximal RNY Gastric Bypass so the information may be more heavily weighted in favor of that procedure. I would also stress that eating habits need to be evaluated in deciding a procedure. "Biliopancreatic Diversion: This operation consists of removing part of the stomach, leaving a 200-500cc pouch and shortening the small intestinal food conduit to 250cm leaving a 50cm common channel in which bile and pancreatic juices mix prior to entering the colon. Weight loss has been excellent, but malabsorptive complications have lead most surgeons in the US away from this approach. Distal Roux-en-Y Gastric Bypass: A horizontal gastroplasty is combined with a biliopancreatic diversion type bypass. The length of the common channel varies, but over 1/2 of the small intestine is bypassed. The stomach pouch will continue to enlarge over time. Being mostly malabsorptive, this is not an NIH approved procedure. Vertical Banded Gastroplasty: Described by most as the Gastric Stapling procedure. This procedure creates a small pouch (30-60cc) along the inner curve of the stomach and controls the size of the opening with a plastic or silastic band. This is the operation of choice of Ed Mason at the Univ. of Iowa. Weight loss is not as predictable as with the Roux en Y Gastric Bypass. Roux en Y Gastric Bypass (proximal): This is my clinic's operation of choice. A small pouch (30cc) is created along the inner curve of the stomach by a quadruple row of heavy-duty staples. A limb of bowel is attached to the pouch - the 'Roux' limb.' It is very important to use this part of the stomach as it will not continue to enlarge over time. Food therefore bypasses most of the stomach and duodenum. The number of calories you ingest is limited by the size of the stomach pouch. A small amount of food will give you the feeling of fullness. Drinking is not affected as liquids pass through the pouch very quickly. This is the operation of choice for most Bariatric Centers. The major long term nutritional consequences appears to be mostly due to decreased iron and calcium absorption and can be overcome with oral supplementation. Iron and Calcium are absorbed mostly in the duodenum and first part of the small intestine and therefore it is important to keep this limb as short as possible. " End of excerpt. Note: In the procedure my doc performs approximately 1-2 ft of the small intestine in bypassed. Many surgeons have modified the above procedures or combined various aspects of those procedures. It is very important to understand the difference in the procedures and to understand the benefits and side effects of each. I visited three different clinics in researching WLS and found each one had a slightly different twist to their procedures and follow up care. Lastly, there is a book you can order called "Living a Lighter Lifestyle" A guide to successful weight loss following gastric bypass or gastroplasty. It can only be ordered from the publisher by sending a check or money order to (24.95 + 3.50 S&H - CA residents add 2.06 sales tax ) to Wheat Field Publications, 490 Sierra Keys Dr., Sierra Madre, CA 91024. Or you can order the book by calling Dr.Gaye Andrews at (626) 355-7025....for Dr.Gaye Andrews Hope this informations helps you - there's lots to learn to make an informed choice about WLS!!
   — Jennifer L.