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Bariatric Surgery: Comparing the Gastric Bypass and the Lap Band System

Many patients who are overweight or obese are especially interested in two specific types of bariatric surgery: the gastric bypass and the LAP BAND® surgery. Ultimately, it’s up to the bariatric surgeon to determine which type of surgical procedure will be the safest and most effective for each individual patient.

It isn’t easy for every patient to decide which type of procedure will work out best for them. It is necessary for every patient to do research on the procedures and to take the time needed to make the right choice. For people who need further assistance in making this decision, there are a number of helpful options, such as attending support group meetings, talking about the procedures with people who have had them, and discussing the procedures with a dietician or bariatric surgeon.

In some cases, patients do not have any say in the type of procedure they can have, for example, when insurance companies deny full coverage for the procedure, or when the patient has certain medical conditions that are contraindicated with some procedures.

There are other important questions you must ask yourself if you are considering having bariatric surgery:

  • Do you like to snack or do you have a sweet tooth? If so, the LAP BAND® procedure may not be best for you.
  • Does the idea of the gastric bypass scare you? If so, the LAP BAND® may be a better choice.
  • Do you live far away from your surgeon, and will this cause problems if you need help?

You can compare the advantages and disadvantages of the gastric bypass and the LAP-BAND procedure with the following :

Roux-en-Y Gastric Bypass
  • Considered the gold standard of bariatric procedures
  • Is a complex surgical procedure, involving multiple areas of the abdomen
  • In the first 3-6 months, weight loss is rapid; final weight settles at 10-16 months following surgery
  • Possible development of mineral deficiencies
  • Patient may develop inability to digest sugars and certain carbohydrates, known as “dumping syndrome”
  • Procedure cannot be reversed
LAP-BAND® Surgery
  • Uses new technology
  • Procedure is simpler, fewer risks associated with surgery
  • Weight loss is slow, steady
  • To some degree, can be reversed
  • Plastic material will be inserted in body and never removed
  • The LAP-BAND® procedure requires regular adjustments

In general, patients report more success with gastric bypass procedures than other types of surgery that are more restrictive. However, there are risks associated with both types of surgery.

The gastric bypass can cause nutritional deficiencies in iron, calcium and vitamin B12. And it can lead to the “dumping syndrome,” which occurs when food passes through the small intestine too rapidly. This condition can produce weakness, nausea, sweating, and diarrhea.

Other features of bariatric surgery to compare are whether the procedure will be open or laparoscopic – terms that refer to the way in which the abdominal cavity is opened. In an open surgery, a single incision is made by the surgeon in the patient’s abdomen. In general, the incision is about 4 ½ to 6 inches for women, and 5 ½ to 7 inches for men.

In a laparoscopic procedure, several small incisions are made in the abdominal wall, through which a small video camera and surgical instruments are inserted. This allows the surgeon to view the surgery on a video monitor as he is performing it. Many surgeons prefer the laparoscopic procedure, as it allows them to see more clearly into the abdomen.


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