Invasive Technologies

There are two ways in which bariatric surgery promotes long-term weight loss.

Bariatric procedures are either restrictive, mal-absorptive, or a combination of the two.

The leading forms of weight loss surgery use at least one of these two methods.

Mal-absorptive procedures enhance weight loss by altering the structure of the digestive tract, allowing food to bypass portions of the small intestine. Mal-absorptive procedures generally incorporate restrictive methods by also reducing or limiting the capacity of the stomach for enhanced weight loss.

Restrictive procedures promote weight loss by making changes to stomach capacity. This form of weight loss surgery is considered restrictive because the amount of food that you can eat at one time is greatly reduced.

The most commonly used bariatric surgery techniques are:

• Laparoscopic Adjustable Gastric Band (Restrictive)
• Sleeve Gastrectomy (Restrictive)
• Laparoscopic Gastric Bypass (Mal-absorptive)

Current guidelines recommend evaluation of bariatric surgery for individuals with a body mass index >40 or >35 with serious comorbidities related to obesity except Laparoscopic Gastric band as it is recommended for individuals with BMI >30 with serious comorbidities related to obesity.

Laparoscopic Gastric banding:

A laparoscopic adjustable gastric band, commonly called a lap-band, a band, or LAGB, is an inflatable silicone device placed around the top portion of the stomach to treat obesity, intended to slow consumption of food and thus reduce the amount of food consumed.

Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 35 or greater — or between 30 and 35 in cases of patients with certain comorbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, hypertension (high blood pressure), or metabolic syndrome, among others.

In February 2011, the United States Food and Drug Administration (FDA) expanded approval of adjustable gastric bands to patients with a BMI between 30 and 40 and one weight-related medical condition, such as diabetes or high blood pressure. However, an adjustable gastric band may be used only after other methods such as diet and exercise have been tried.