Restrictive Obesity Surgery 

There are two types of obesity surgery: 1) restrictive and 2) combined restrictive and malabsorptive.  Different ways of performing each surgery, called operative procedures, have been developed.  Each type of surgery and operative procedure has its own risks and side-effects.  Your doctor can help you decide which is best for you.

What Is Restrictive Surgery?

Restrictive Surgery - uses bands or staples to create food intake restriction. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch.  A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch.  Since the outlet is small, food stays in the pouch longer and you also feel full for a longer time.

• Vertical Banded Gastroplasty (VBG) - is a “pure” restrictive surgery since it only involves surgically creating a stomach pouch.  VBG uses bands and staples and is the most frequently performed procedure for obesity surgery.³
  
  
• Gastric Banding – involves the use of a band to create the stomach pouch. 
  
  
• Laparoscopic Gastric Banding (Lap-Band), approved by the FDA in June 2001, is a less invasive procedure in which smaller incisions are made to apply the band.  The band is inflatable and can be adjusted over time. ^7,8,9

Benefits and Risks

Success rate:  About 80% of patients lose some weight and 30% reach normal weight category with VBG.⁸ The long-term weight loss success rate with VBG is 40 to 63% of excess body weight over a three year period¹ and 50 to 60% after five years.³  A three year study with Lap-Band resulted in 62% of patients who lost at least 25% of their excess weight; 52% lost at least 33%; 22% lost at least 50% and 10% lost at least 75%.⁹

• Side-effects:  The stomach pouch holds about a half of a cup to one cup of food.  Eating too much at once or not chewing enough to break down food can cause nausea, stomach discomfort and vomiting.^3,8  Protein and vitamin deficiency have been reported in few cases, due to continual vomiting. Other side effects are heartburn and abdominal pain. ⁹
  
  
• Complications: Possible complications include leaking of stomach juices into the abdomen, injury to the spleen, band slippage, erosion of the band, breakdown of the staple line, and stomach pouch stretching from overeating.  Infection or death has been reported in less than 1 percent of patients. ^7,8

After Surgery

• Lifestyle Adjustments:  Patients must learn to eat smaller amounts of food at one time,⁸ to chew their food well and to eat slowly.³   Failure to adjust eating habits may inhibit weight loss.⁸
  
  
• Surgical Follow-up:  Follow-up, especially in the first three months after surgery, is necessary to maintain the proper intake of protein, calories, minerals and vitamins. With proper follow-up care and patient compliance, protein deficiency which typically occurs in the first three months after surgery, can be corrected within 18 months after surgery.³

Learn More About Combined Restrictive and Malabsorptive Surgery