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Vertically
Banded Gastric Bypass Surgery
Vertically banded gastric bypass consists of using a small remnant
of stomach - restricting how much the patient can eat - and a re-routing
of the usual passage of food through the intestine, altering the
way the body handles the calories and nutrients that are taken in.
Gastric bypass employs a large degree of restriction with a lesser
degree of malabsoprtion. When people go on a low calorie diet, their
body undergoes a compensatory drop in metabolic rate - a "starvation
mode" - making it more difficult to lose weight after a short
period of time. Gastric bypass largely overrides this effect to
augment weight loss long term, and to keep it off as long as patients
continue to eat small amounts of food. Many variations of gastric
bypass exist, but, keeping an eye to long term results, we prefer
the vertically banded gastric bypass as it functions to prevent
some of the more common causes of surgical failure. By addressing
the issues of pouch stretching, outlet stretching, pouch to stomach
re-growth and gastro-gastric fistula, the vertically banded procedure
is engineered to result in improved long term results when compared
to the conventional gastric bypass. As a picture is worth a thousand
words, lets look at the components of the vertically banded gastric
bypass below.
Patients undergoing the
vertically banded gastric bypass procedure need to accept the concept
of never eating large amounts of food again. Patients must resist
the temptation to try and "eat around" the restrictive
component of their operation. The gastric bypass surgery causes
high concentrated sugar-rich foods to dump into the small intestine,
causing "dumping syndrome". This side effect causes an
uncomfortable, shaky, weak feeling which can be strong enough to
cause the patient to lie down until the symptoms pass. Therefore,
the negative consequence causes most patients to pass up those sugary
foods.
| A |
A vertically
oriented (and therefore less prone to stretching) pouch, approximately
one ounce in size |
| B |
A silastic
band to keep the outlet from the pouch to the small intestine
from enlarging, thereby decreasing the risk of weight regain. |
| C |
Small
bowel imbrication around the cut edge of the pouch to maintain
sealing during healing |
| D |
Approximately
one-fourth of the small intestine is used to carry food without
digestive enzymes, resulting in alteration in calorie absorption
and insulin levels. |
| E |
A Roux-en-Y
connection between the alimentary limb (carrying food) and the
biliopancreatic limb (carrying the digestive juices). Essentially
normal digestion occurs downstream from this using the majority
of the small intestine. |
| F |
A gastrostomy
tube with a silastic site marker. The tube allows for temporary
decompression and feeding after surgery, where the site maker
provides a way to access the bypassed stomach in the future
should the need arise. |
To view an animation of this procedure click
here.
(This will require the use of Macromedia Flash Player. You can download
it here.)
You will need to carry an emergency wallet card at all times, describing
your surgery in the event you are in need of medical attention.
You can download
this card here.
For
a comparison of the procedures our surgeons offer click
here. Please note VERGITO and Vertical/Sleeve Gastrectomy will
be added to chart soon.
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