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