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    Aintree University Hospital
    Lower Lane
    Liverpool
    Merseyside
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    Liverpool
    Merseyside
    L23 3AD

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Weight reduction procedures

Adjustable Gastric Banding

A hollow silicone rubber band is placed around the stomach near the top end, leaving only a narrow passage into the rest of the stomach. This is inflated using a solution through a tube connected to an access port placed under the skin. This can be adjusted over time to change the size of the passage. The procedure is known as adjustable gastric banding surgery.

This is easier to perform and generally safer than malabsorptive operations, but weight loss tends to be smaller.Patients who maintain the necessary changes in eating habits after the operation can lose over 50-60 per cent of their excess weight in under two years.

Roux-En-Y Gastric Bypass (RGB)

This is easily the most common and successful combined procedure across the UK. The surgeon creates a small stomach pouch to restrict food intake then attaches the pouch to a Y shaped section of the small intestine so food by-passes the lower stomach, the duodenum and the first portion of the jejunum. This reduces the amount of calories and nutrients the body absorbs. Taking away the pyloric valve may cause a side effect of dumping syndrome.

 The Gastric Bypass mainly works through restriction of portion size amd malabsorption.

The portion of the small intestine connected to large intestine is attached to the short duodenal segment next to the stomach. The remaining segment of the duodenum connected to the pancreas and gallbladder is attached to this limb closer to the large intestine. Where contents from these two segments mix is called the common channel, which deposits into the large intestine.

First Stage for a Two Stage Procedure (Sleeve Gastrectomy)

Research has shown that for patients with a BMI of 60+ there is a significant decrease in operative mortality if the RGB or DS is carried out in two stages. This is particularly true for male patients and those with extensive co-morbidities. The sleeve gastrectomy does not involve a bypassing of the intestines. It is said to produce weight loss simply through the reduced volume of the stomach. 

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a new stomach which is roughly the size and shape of a banana. Since this operation does not involve any "rerouting" or reconnecting of the intestines, it is a simpler operation than the gastric bypass or the duodenal switch. Alternatively, the patient can be given a Gastric Band until sufficient weight loss has taken place for the second stage to be completed. This procedure is usually done laparoscopically.

Details

The Sefton Suite
Aintree University Hospital
Lower Lane
Liverpool
Merseyside
L9 7AL
Telephone: 0151 330 6551