Types of Bariatric Surgery
The type of surgery that may help an adult or youth depends on a number of factors. Patients should discuss with their health care providers what kind of surgery is suitable for them.
What is the difference between open and laparoscopic surgery?
Bariatric surgery may be performed through "open" approaches, which involve cutting the stomach in the standard manner, or by laparoscopy. With the latter approach, surgeons insert complex instruments through 1/2-inch cuts and guide a small camera that sends images to a monitor. Most bariatric surgery today is laparoscopic because it requires a smaller cut, creates less tissue damage, leads to earlier hospital discharges, and has fewer problems, especially hernias occurring after surgery.
However, not all patients are suitable for laparoscopy. Patients who are considered extremely obese, who have had previous stomach surgery, or who have complex medical problems may require the open approach. Complex medical problems may include having severe heart and lung disease or weighing more than 350 pounds.
What are the surgical options?
There are four types of operations that are commonly offered in the United States: AGB, Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG). (
See Figure 1.) Each surgery has its own benefits and risks. The patient and provider should work together to select the best option by considering the benefits and risks of each type of surgery. Other factors to consider include the patient's BMI, eating habits, health conditions related to obesity, and previous stomach surgeries.