Bariatric Surgery: Surgical Options

Bariatric surgery includes a spectrum of procedures from restrictive to malabsorptive to those combining the two. Restrictive procedures such as adjustable gastric banding reduce the size of the stomach, and malabsorptive and combined procedures, such as Roux-en-Y gastric bypass (RGB) and biliopancreatic diversion, reduce the body’s ability to absorb calories and nutrients from food.

Methods of Surgery

Traditional Open Surgery
Once the only method used for surgical procedures, traditional open surgery involves making a 10- to 12-inch incision to access the stomach and intestines.

Minimally Invasive (Laparoscopic) Surgery
In minimally invasive or laparoscopic surgery, the surgeon uses five or six small incisions (each 1/4 and 1/2 inch long) to gain access to the stomach and intestines. The laparoscope is a telescope attached to a video camera. The surgeon inserts the laparoscope through the incisions and gets a magnified view of the patient’s organs on a television monitor. The entire operation is performed inside the abdomen after gas has been inserted to expand the abdomen.

Minimally invasive surgery offers a faster and less painful recovery and a lower incidence of hernias and wound complications. However, not everyone qualifies for less-invasive surgery. Qualification depends on medical history, surgical difficulty, and body shape.