Roux-en-Y gastric bypass (RGB):
First, a small stomach pouch is created by stapling part of the stomach together or by vertical banding. This limits how much food you can eat. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum as well as the first portion of the jejunum. This causes reduced calorie and nutrient absorption.
Risks:
Leakage - The surgical connection between the stomach and the bowel or between two parts of the bowel is called an anastomosis. If the body doesn’t heal properly after gastric bypass surgery, fluid from within the gastrointestinal tract can leak into the abdominal cavity and cause an infection and abscess formation
Stricture - As the anastomosis heals, it forms scar tissue, which shrinks over time, making the opening smaller. The passage of food through an anastomosis keeps it stretched open. If the inflammation and healing process occurs faster than the stretching process, there is a risk that the scarring may make the opening so small that even liquids can no longer pass through it.
Ulcer- There is a risk of ulceration of the anastomosis. Possible causes of such ulcers are:
Dumping Syndrome - The release of food into the bowel is regulated by the pyloric valve at the lower end of the stomach. When the gastric bypass patient eats a sugary food, the sugar passes rapidly into the bowel. This leads to a physiological reaction called dumping syndrome, which causes for the patient to feel his/her heart beating rapidly, break into a cold sweat, and have a “sky is falling” type of anxiety.
Vertical Sleeve Gastrectomy (VSG):
Sleeve gastrectomy is a newer surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (often with surgical staples) to form a sleeve or tube with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.
Risks:
Leakage –. If the body doesn’t heal properly after surgery, fluid from within the gastrointestinal tract can leak into the abdominal cavity and cause an infection and abscess formation
Status – VSG is still considered investigational by many surgeons and insurance companies.