What are the different kinds of bariatric surgery?

The two most common bariatric operations in the United States are the laparoscopic vertical sleeve gastrectomy and Roux-en-Y gastric bypass. Duodenal switch with biliopancreatic diversion and adjustable gastric band are also performed, but less frequently. Your surgeon will generally select the best operation for you based on your specific medical conditions.

Dr. Keith A. Kreitz, MD
Bariatric Medicine (Obesity Medicine) Specialist

There are four procedures that we're currently doing.

The first is called sleeve gastrectomy. We basically take off the excess amount of stomach, leaving people with a skinnier, banana-shaped stomach. We call it a restrictive procedure because, since their stomach is smaller, they eat smaller meals and feel full faster. This makes them more inclined to eat less in general, which is very helpful.

The second is gastric bypass, where I divide the upper area of the stomach from the lower end of the stomach. This creates what we call a pouch. When people eat, it goes into the small, front area of the stomach, stretches it, and makes them feel full, similar to a sleeve gastrectomy.

I then divide the intestines at a point downstream, bring it up and attach it to the pouch. The stuff that you eat leaves the pouch, bypasses the rest of the stomach and a segment of the intestine and goes directly into the middle of the intestines. This creates less area for absorption, so you’ll absorb fewer calories.

Another surgery that's been popular since 2001, is lap band. It's a small band that goes around the front area of the stomach, creating a small pouch, like gastric bypass. The band can also be inflated to pinch the stomach tighter. It can narrow down the passageway from the front part of the stomach to the lower part of the stomach, and slow down the transit of food going through. This makes people feel full longer, and helps people eat smaller meals.

The fourth procedure is biliopancreatic duodenal switch (BPD), but it’s less common. It's similar to a gastric bypass, but it uses a sleeve gastrectomy built in, instead of a pouch.

Endoscopic procedures, such as the gastric balloon, are less invasive than open surgery. 

The main types of bariatric surgery are:

  • gastric sleeve, the most popular weight loss procedure in the United States
  • gastric bypass
  • gastric band

Other types of bariatric surgery include:

  • duodenal switch
  • biliopancreatic diversion

However, several new procedures are being introduced in the United States, including the vagus nerve stimulator and the aspirator.  

The different kinds of bariatric surgery include the following:
  • sleeve gastrectomy
  • gastric bypass
  • duodenal switch
  • gastric banding
  • gastric balloon

The different kinds of bariatric surgery are:

  • Lap band: A band is placed around the upper part of the stomach and the opening is adjusted through a port that is placed under the skin.
  • Gastric sleeve: The surgeon removes 80 percent of the stomach.
  • Gastric bypass: The surgeon divides the stomach to create a small pouch and reroutes the bowel, so all the food that you eat is not fully absorbed.
  • Duodenal switch: This is an advanced procedure where the stomach is divided like a sleeve and the bowel is rerouted. This allows you to lose more weight and also helps control very severe diabetes.
  • Revisional procedure: If you have not had enough weight loss with a previous procedure, it can be revised to a different procedure to help to lose more weight. The complication rates with this revisional procedure are a bit higher than if you were to the do the procedure the first time.
  • Stomach balloon: A balloon is placed in your stomach for six months. You will also need to make behavior and dietary changes. The surgeon removes the balloon after six months. It is a same day procedure and you are able to return home the same day.

There are four different kinds of bariatric surgery: gastric bypass, gastric sleeve, biliopancreatic diversion and lap band. Gastric sleeve surgery has the least amount of side effects and one of the best outcomes. Essentially, gastric sleeve surgery is removing part of the stomach and leaving the rest in a pouch shaped like a banana. This affects the hormones and leaves people with a smaller stomach so they cannot take in a lot of food. People do very well with this surgery.

There are basically four different kinds of bariatric surgery done in the United States:

  • sleeve gastrectomy
  • gastric bypass
  • adjustable gastric band
  • duodenal switch

By far the most popular operation currently is the sleeve gastrectomy, followed by the gastric bypass, adjustable gastric band and duodenal switch. Each of the operations works just a bit differently and carries different risks and results. Each of these operations, however, can provide excellent long-term improvement in health and quality of life. A surgeon will look at a person’s weight and medical conditions to help him or her decide which operation might be best.

A common type of bariatric surgery used to treat obesity in the United States is the biliopancreatic bypass, or Roux-en-Y gastric bypass. It creates a small stomach pouch, going around the upper part of the small intestine. This reduces the amount of food you can eat and limits the amount of fat and calories that can be absorbed.
Another procedure is the adjustable Lap-Band. The surgeon places a small band around the top of the stomach so you can't eat as much food.
The gastric sleeve (a gastrectomy) is also quite popular. During this type of bariatric surgery, the surgeon removes most of your stomach. Food enters a small sleeve, which reduces the amount of food that you can eat.
There are a few different types of bariatric surgery:
  • The laparoscopic adjustable gastric band (Lap-Band) procedure results in weight loss thanks to a band that is wrapped around the stomach’s entry to reduce the amount of food that can pass through it.
  • A sleeve gastrectomy involves reshaping the stomach to reduce the amount of food it can hold.
  • Roux-en-Y gastric bypass surgery changes the size of the stomach and small intestine, causing weight loss by restricting food intake and making the body unable to absorb as many calories from food.

Gastric bypass surgery is the most well-known, but there are other weight-loss surgical procedures to consider. In this video, bariatric surgeon James "Butch" Rosser Jr., M.D., discusses   alternatives to gastric bypass surgery.

Bariatric surgery is an umbrella term for many different types of weight loss procedures. The different tpes of bariatric surgery are:
  • Gastric bypass (also called Roux-en-Y gastric bypass): This involves creating a small pouch out of a person’s stomach and attaching the pouch directly to the small intestine.
  • Sleeve gastrectomy: A large part (up to 85%) of your stomach is removed.
  • Duodenal switch: A part of the stomach is removed and bypasses a large part of the small intestine.
  • Gastric banding: A band is wrapped around the stomach so you feel full with less food.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.