Surgical Procedures
There are three main procedures performed at
the Hospital of the University of Pennsylvania:
the
Vertical Banded Gastroplasty (VBG), the Roux-en-Y
Gastric Bypass, and the Lap-Band system.
Vertical Banded Gastroplasty
Vertical banded gastroplasty is a procedure
that is performed to restrict food intake. This
procedure reduces a normal-sized stomach into
a small pouch by partitioning the stomach with
staples. At the lower end of the staple line,
a permanent band is placed at the bottom of the
pouch and restricts food intake. It is a purely
restrictive procedure. The band causes food to
be retained in the smaller stomach for a longer
period of time. Patients feel full for a longer
period of time and tend to eat less. After this
procedure, patients must chew their food well
and avoid high calorie liquids.
Roux-en-Y Gastric Bypass
 Like
the vertical banded gastroplasty, the roux-en-y
gastric bypass also partitions the stomach.
However, in this procedure the pouch that is
created is disconnected from the rest of the
stomach. The small intestine is then cut and
connected to the pouch. A hole is made in the
pouch, and the lower segment of the small intestine
is surgically connected to the pouch. Connection
of the pouch to the lower segment of the small
intestine reduces the amount of substances absorbed
from the food, and therefore induces malabsorption.
However, because nutrient absorption also takes
place in the upper segment of the small intestine
that is removed, patients must take vitamin
supplements to maintain adequate nutrition levels.
Following surgery, patients must chew food well
and avoid concentrated sugars. This procedure
induces a degree of malabsorption and achieves
restriction of the stomach capacity.
Lap-Band
The Lap-Band system is the least
invasive Bariatric surgical approach. It avoids
stomach stapling, cutting and gastrointestinal
bypass. The adjustable silicone elastomer band
is placed around a portion of the upper stomach.
This forms a small gastric pouch and stoma. The
band is connected to an access port under the skin.
The band can then be adjusted by accessing the
port, changing the size of the pouch. The band
causes food to be retained in the smaller stomache
for a longer period of time and tend to eat less.
After this procedure patients must chew their food
well and avoid high calorie liquids. The operation
assists in weight loss by limiting food intake.
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