Gastric Bypass Surgeries

There are two procedures currently offered at OHSU. The selection of the procedure is determined by individual concerns and needs. 

Divided Roux-en -Y ("roo-en-y") Gastric Bypass

The stomach pouch is designed to hold 1-2 ounces (the size of an egg). Early distention of the pouch by solid food sends a stronger signal to the brain to turn off hunger and maintain a sense of fullness on less food. The bypass portion of small bowel (Alimentary limb on the diagram) is generally two feet long. Channeling the food away from its normal route to the duodenum and the first part of the small bowel, give additional signals of fullness. Finally, the typical slowdown in the body's metabolic rate is inhibited by various signals from the new intestinal food route. With this procedure, the common channel segment of bowel where food mixes with the fat-absorbing bile and pancreatic digestive enzymes is relatively long. With that, there is little limitation to calorie absorption of the food ingested but supplementation of daily vitamins, calcium, iron and B12 injections are required. Many patients are able to continue long-term weight loss averages of 60-70% of the excess body weight five to fifteen years after the surgery. This procedure can be done with an open incision or through a laparoscope. The risk of serious complication is about 5%, and the risk of death with either type of operation is about one-half of one percent or 1 in 200.

Laparoscopic gastric banding (the Lap-Band)

Gastric Banding usually does not require a major incision and avoids some of the major complication of gastric bypass. It uses an adjustable silicone band that is placed around the upper part of the stomach and restricts the amount of food a person can eat and gives the feeling of fullness. A small balloon-like reservoir attached to the band under the abdominal skin contains salt water that can be added or removed to tighten or loosen the band. No stomach or intestines are cut, removed, or bypassed. Because of this, no vitamin or mineral deficiencies are expected after lap banding. One 1999 study reported that after a year, patients had experienced significant weight loss and improved quality of life. At this time research studies are not available to support the claims that the Lap-Band is as good as gastric bypass over the long term (> 5 years). Long term studies are underway. Complications include bleeding, infection, and slippage or rupture of the band. Very serious complications or death are very rare (0.1-0.2%) but include blood clots, pneumonia, and perforation of the stomach. The band is removable, if necessary and studies so far indicate that the intestinal tract returns to normal. Gastric banding may be too technically difficult to do in individuals with very high BMIs.

OHSU is the premier bariatric surgery center for the treatment of obesity in Portland, Oregon. We look forward to serving you. Please contact us at 503-494-4373.

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