Laparoscopic Adjustable Gastric Banding
Tube Gastrectomy :: Gastric Bypass
This is a relatively new approach. It is the first component
of the duodenal switch operation and
involves removing the lateral 2/3rds of the stomach with a stapling
device. It can be done
laparoscopically ( keyhole surgery) but is not reversible. It
basically leaves a stomach tube
instead of a stomach sack.
This is the first component of a BPD-DS where the stomach is
reduced in size by removing the lateral 2/3rds leaving the stomach
in the shape of a tube.
Sometimes it is offered to patients as part of a two stage Bypass
operation particularly if they are
super obese ( BMI>60) because it allows good weight loss until
the patient gets down to a safe
weight and the more radical bypass can then be offered laparoscopically
when they are at a safer
The residual stomach capacity is about 200mls
so a generous entree should be possible.
Issues with Tube gastrectomy
- Stomach tube may stretch up over time leading to late weight
regain. The extent of this is currently unknown
- The amount of weight reduction is in the region of 40-60% of
excess wt lost over the first 1-2 years.
- It is a good option for people living in remote areas because
it is a "set and forget"
operation which requires little post op follow up
or nutritional supplements
- There is no malabsorbtion to nutrients
- If weight is regained the second stage of the BPD the
intestinal bypass can be added... often laparoscopically as well