February 1, 2009 -- Question: What are the different types of bariatric procedures, and is one better than the others?
Answer: There's none that's better than the others. There are several different types. The most common is a Roux-en-Y gastric bypass. It involves making a small pouch in the stomach and bypassing part of the small intestine so that the food takes a slightly different pathway on the way from the mouth to the intestine. That's probably the most effective procedure that's used currently. There's some more aggressive procedures, but they don't really add too much to it
The other major procedure that's done in the United States is a gastric banding procedure, formerly called a laparoscopic adjustable gastric band, and that creates a crimp in the stomach -- puts a band around the stomach -- which slows the passage of food from the beginning of the stomach to the end of the stomach, and that seems to cause weight loss as well.
There's a newer procedure that's gaining some popularity which is called the sleeve gastrectomy. And that has the advantage of the band in that it's easier to do and has the advantage of the bypass in that it's a little bit more effective.
The bypass typically causes more weight loss, has a greater impact on diabetes, but it also has a greater risk associated with it, and so as a result, for people who need less of an operation, they need a less severe operation and a less effective operation, then the band is the way to go.
For people who need more of an operation, the bypass is the way to go, and maybe the sleeve gastrectomy is something in between.