WHAT IS WLS?

Morbid obesity presents a major health threat to our society. 
Some estimate that more than 30%
of the US population is affected by some degree of obesity.  T
here are many medical illnesses associated with morbid obesity.
  Some include:
Hypertension
Diabetes
Heart Failure
Sleep Apnea
Degenerative Arthritis
Depression, etc.
The illnesses associated with morbid obesity
significantly increase the risk of premature death.

Weight loss surgery (WLS) is available for the treatment of morbid obesity. 
Beginning with stomach stapling,
the most common procedure done 5 years ago,
,has since shown to have a high failure rate.
This procedure only limits food intake.

There are a number of surgical procedures
that are available for the treatment of morbid obesity. 
The following are restriction surgeries.

Restriction Operations
Restriction operations are the surgeries most often used for producing weight loss. 
Food intake is restricted by creating a small pouch at the top of the stomach. 
In the beginning, the pouch holds about one ounce of food
and expands to two or three ounces with time. 
The pouch's lower outlet usually has a diameter of a quarter inch. 
After an operation, the person
usually can eat only a half to a whole cup of food without nausea. 
Restriction operations for obesity include gastric banding
and vertical banded gastroplasty. 
Both surgeries serve only to restrict food intake. 
They do not interfere with the normal digestive process.

AGB-Adjustable Gastric Band
In this procedure a silicone band is placed around the upper part of the stomach
to create a small pouch which can hold only a small amount of food. 
The lower, larger part of the stomach is below the band. 
These two parts are connected by a small outlet created by the band. 
Food will pass through the outlet from the upper stomach pouch
to the lower part more slowly, and one will feel fuller longer. 
The diameter of the band outlet is adjustable to meet individual needs,
which can change as one loses weight. 
The inner surface of the band can be inflated
with saline solution or deflated to modify the size of the outlet. 
This can be done in the surgeon's office.

VBG-Vertical Banded Gastroplasty
This operation emphasizes the volume restriction aspect of calorie control,
by creating a tiny stomach pouch that exits into the lower stomach
through a small fixed outlet that is reinforced
by a permanent band on the stomach outlet. 
The VBG was once the most frequently performed surgery
for morbid obesity in the United States. 
Its popularity is decreasing because long term studies
have shown that it doesn't maintain weight loss
as well as the RNY gastric bypass.

Bypass Operations
These operations combine creation of small stomach pouches
to restrict food intake and the construction of bypasses of the duodenum
and other segments of the small intestine to cause malabsorption.

Roux-en-Y (RNY) gastric bypass
This operation is the most common gastric bypass procedure. 
First, a small stomach pouch is created by stapling or by vertical banding. 
This causes restriction in food intake. 
Then a y-shaped section of the small intestine is attached to the pouch
to allow food to bypass the duodenum
(the first segment of the small intestine)
as well as the first part of the jejunum
( the second segment of the small intestine). 
This causes reduced calorie and nutrient absorption.

Fobi Pouch
Dr. Malcolm Fobi and others
have elected to place a firm ring of synthetic material
around the tiny stomach pouch. 
The idea is to provide a very strict lifelong restriction
to the amount and the physical density of food intake,
in distinction to the progressive increase in tolerance
to solids that patients experience after a gastric bypass
where the pouch is not reinforced.

Biliopancreatic Diversion (BPD)
This is a more complicated gastric bypass operation
in which portions of the stomach are removed. 
The small pouch that remains is connected directly
to the final segment of the small intestine,
completely bypassing both the duodenum and the jejunum. 
Although this procedure successfully promotes weight loss,
it is not widely used because of the high risk for nutritional deficiencies.

Gastric bypass operations that cause malabsorption and restrict food intake
produce more weight loss than restriction operations that only decrease food intake. 
Patients who have had bypass operations
generally lose two-thirds of their excess weight within 2 years. 
The risks for pouch stretching, band erosion,
breakdown of the staple lines,
and leakage of stomach contents into the abdomen
are about the same for gastric bypass as for with vertical banded gastroplasty. 
Because the gastric bypass operations cause the food to skip the duodenum,
where most iron and calcium are absorbed,
risks for nutritional deficiencies are higher in these procedures. 
Patients are required to take nutritional supplements
that usually prevent these deficiencies. 
Gastric bypass operations may cause "dumping syndrome,"
where the stomach contents move too fast thorough the small intestine. 
Symptoms include nausea, weakness, sweating, faintness, and,
on occasion, diarrhea after eating,
as well as the inability to eat sweets without becoming so weak and sweaty
that the patient must lie down until the symptoms pass.

Some people ask me why I have chosen the RNY procedure. 
Well, I didn't have much choice,
as the RNY procedure is what Dr. Marymor does. 
The more I read about the procedure, the pros and cons,
I feel more confident in having the RNY done. 
I am having the open RNY, and have a good feeling
that with my hard work and dedication
to the process that the surgery will be successful for me.










DISCLAIMER: I cannot and do not give medical advice
nor am I affiliated with any medical organization. 
The information on my pages comes from reliable web sources. 
In all matters of your health,
please contact a qualified, licensed practitioner.