Surgical Procedures
There are two main procedures performed at Pennsylvania
Hospital: the Vertical Banded Gastroplasty
(VBG), and the Roux-en-Y Gastric Bypass.
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.
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