Restrictive procedures reduce the size of the stomach, limiting the volume of food that can be consumed at one time. Restrictive procedures include adjustable gastric banding (AGB) and Roux-en-Y gastric bypass (RYGB) – although gastric bypass is also malabsorptive as well.
Malabsorptive procedures reduce your body's ability to store calories by diverting food away from the parts of your digestive system that absorb calories. Largely malabsorptive procedures include biliopancreatic diversion (BPD) and biliopancreatic diversion with duodenal switch (BPD-DS).
All these procedures are commonly used and have been proven effective for reversing or minimizing weight-related health problems.
Gastric bypass is the most common bariatric surgery performed in the United States.1 It offers a combination of both restrictive and malabsorptive procedures, which appears to be a very effective recipe for weight loss. Moreover, it is considered the gold standard surgical treatment. 1
While gastric bypass has become fairly common, this elective surgery has serious risks. For example, potential early complications after gastric bypass can include bleeding, infection, leaks from the site where the intestines are sewn together, and blood clots in the legs that can progress to the lungs and heart.2 Surgeons must have excellent visualization, dexterity and control to complete this technically challenging operation successfully.
Bariatric surgery may be performed through “open” approaches, which make large abdominal incisions in the traditional manner, by conventional laparoscopy or laparoscopically with robotic-assistance ( da Vinci ® Surgery). With the laparoscopic approach, long-shafted instruments are inserted through tiny incisions and guided by a small camera that sends images to a television monitor. Most bariatric surgery today is performed laparoscopically because it requires a smaller cut, creates less tissue damage, leads to earlier discharges from the hospital, and has fewer complications, especially postoperative hernias. 4
While conventional laparoscopy is the most widely used approach for gastric bypass today, not all patients are considered candidates for traditional laparoscopy. Surgeons may determine that patients who are extremely obese, who have had previous abdominal surgery, or have complicating medical problems require a traditional open approach. 3 The da Vinci® System has been proven to help surgeons overcome these challenges with improved ergonomics, instrumentation and visualization.4, 5
Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, especially if they have an obesity-related disease. Surgery to produce weight loss is a serious undertaking. Anyone thinking about undergoing this type of operation should understand what it involves. Answers to the following questions may help you decide whether weight-loss surgery is right for you.
Remember: There are no guarantees for any method, including surgery, to produce and maintain weight loss. Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up—and you must maintain this cooperation and commitment for the rest of your life.
If your doctor recommends surgery to reduce your weight, you may be a candidate for da Vinci Gastric® Bypass, potentially the most effective, and least invasive surgery for weight loss.
* The multiplier 704.5 is used by the National Institutes of Health (NIH). Other organizations may use a slightly different multiplier; for example, the American Dietetic Association suggests multiplying by 700. The variation in outcome (a few tenths) is insignificant. 7
1. American Society for Metabolic and Bariatric Surgery. Metabolic & Bariatric Surgery
Fact Sheet. http://www.asbs.org/Newsite07/media/fact-sheet1_bariatric-surgery.pdf
2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “ Open and Laparoscopic Bariatric Surgery.” Bariatric Surgery for Severe Obesity. http://win.niddk.nih.gov/publications/gastric.htm#complications
3. National Institute of Diabetes and Digestive and Kidney Diseases. Longitudinal Assessment of Bariatric Surgery (LABS). http://win.niddk.nih.gov/publications/labs.htm#whydid
4. Snyder BE, Wilson T, Scarborough T, Yu S, Wilson EB. Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass.J Robotic Surg. 2008.
5. Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech A. 2003 Aug;13(4):279-83.
6. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Is Surgery for You?” Bariatric Surgery for Severe Obesity. http://win.niddk.nih.gov/publications/gastric.htm#issurgfor
While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.
Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com
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