Question:
Helping pre-ops with all the diffrent surgery types..

Some information I gathered about all the different kinds Gastric Bypass Surgeries, Gastric Banding and Stomach Stapling .. this information is on my webpage along with PROS & CONS Section: http://www.angelfire.com/ok3/vbowen/insex.html Open Roux en Y (Rny) The Stomach is separated into two parts. The small Stomach pouch (A) receives food. The lower part of the stomach (B) received most of the gastric juices coming from the liver and other organs. The small intestine is carefully measured and cut.One end (C) is connected to the small stomach pouch. The other end (D) is reconnected to the small intestine, forming a "Y". ================================================= Laparoscopic Roux-en-Y same as open Roux-en-Y except instead of opening you with a long incision on your stomach, Surgeons use a pencil thin optical telescope, to project a picture to a TV monitor. Having surgery this way, smaller scars, usually 3 to 4 small incisions. Quicker recovery time and less pain. ================================================= Distal Gastric Bypass The Gastric Bypass operation can be modified, to alter absorption of food, be moving the Y-connection downstream ("distally"), effectively shortening the bowel available for absorption of food. The weight loss effect is then a combination of the very small stomach, which limits intake of food, with malabsorption of the nutrients which are eaten, reducing caloric intake even further. Patients have increased frequency of bowel movements and increased fat in their stools (bowel movements). The odor of bowel gas is very strong, which can cause social problems or embarrassment. Calcium absorption may be impaired, as well as absorption of vitamins, particularly those which are soluble in fat (Vitamins A, D, and E). Vitamin supplements must be used daily, and failure to follow the prescribed diet and supplement regimen can lead to serious nutritional problems in a small percentage of patients. We. and others, have noted an increased incidence of ulcers postoperatively, in patients having this procedure. ================================================= Biliopancreatic Diversion (BPG) This very powerful operation involves removal of approximately 2/3 of the stomach, and rearrangement of the intestinal tract so that the digestive enzymes are diverted away from the food stream, until very late in its passage through the intestine. The effect is to selectively reduce absorption of fats and starches, while allowing near-normal absorption of protein, and of sugars. Calorie intake is much reduced, even while normal-sized food portions are eaten. Although this operation is very powerful, patients are subject to increased risk of nutritional deficiencies of protein, vitamins and minerals. Vitamin supplementation recommendations must be carefully followed, and dietary intake of protein must be maintained, while intake of fat must be limited. Patients are annoyed by frequent large bowel movements, which have a strong odor. Excess fat intake leads to irritable bowel symptoms, and may lead to rectal problems. ================================================== Adjustable Gastric Band (AGB) Gastric Banding is a variation on the gastroplasty, in which the stomach is neither opened nor stapled -- a band is placed around the outside of the upper stomach, to create an hourglass-shaped stomach, and to produce a small pouch with a narrow outlet. The special device used to accomplish this is made of implantable silicone rubber, and contains an adjustable balloon, which allows us to adjust the function of the band, without re-operation. This device enjoys considerable advantage over the standard gastroplasty: It can be inserted laparoscopically, without the usual large incision. It does not require any opening in the gastrointestinal tract, so infection risk is reduced. There is no staple line to come apart. It is adjustable. ==================================================== Loop Gastric Bypass This form of Gastric Bypass was developed years ago, and has generally been abandoned by most bariatric surgeons as unsafe. Although easier to perform than the Roux en-Y, it creates a severe hazard in the event of any leakage after surgery, and seriously increases the risk of ulcer formation, and irritation of the stomach pouch by bile. Most bariatric surgeons agree that this operation is obsolete, and should remain defunct. This operation has been resurrected, in order to make the laparoscopic procedure easier to perform. A fundamental principle of laparoscopic surgery is that the operation should not be compromised or degraded, in order to accomplish it using limited access techniques. The loop bypass does not meet this standard ================================================= Gastroplasty Gastroplasty, or Stomach Stapling (Gastric Partitioning) is widely performed in the United States and elsewhere. It is a technically simple operation, accomplished by stapling the upper stomach, to create a small pouch, about the size of your thumb, into which food flows after it is swallowed. The outlet of this pouch is restricted by a band of synthetic mesh, which slows its emptying, so that the person having it feels full after only a few bites (one thumbful) of food. Characteristically, this feeling of fullness is not associated with a feeling of satisfaction-the feeling one has had enough to eat. Patients who have this procedure, because they seldom experience any satisfaction from eating, tend to seek ways to get around the operation. Trying to eat more causes vomiting, which can tear out the staple line and destroy the operation. Some people discover that eating junk food, or eating all day long by "grazing" helps them to feel more sense of satisfaction and fulfillment -- but weight loss is defeated. In a sense, the operation tends to encourage behavior which defeats its objective. Overall, about 40% of persons who have this operation never achieve loss of more than half of their excess body weight. In the long run, five or more years after surgery, only about 30% of patients have maintained a successful weight loss. Many patients must undergo another, revision operation, to obtain the results they seek. I have heard PROS & CONS on all.. Everyone has an opinion.. do your research and select the best for you..    — Victoria B. (posted on February 4, 2000)

February 4, 2000
Is the Doudenal Switch not the same thing as the Biliopancreatic Diversion (BPG) ???
   — Lori W.