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Restrictive Procedures

The stomach size is reduced by applying staplers across it and thereby reducing the amount of food a person can eat at a given time.

Gastric Banding is the most popular restrictive procedure currently. A band is placed around the upper most part of the stomach. This band divides the stomach into two portions, one small and one larger portion. Because food is regulated, most patients feel full faster. Food digestion occurs through the normal digestive process. Other advantage is that it is EXTERNALLY adjustable ( the band can be tightened or loosened to regulate the amount of food passing ).

RISKS: Gastric perforation or tearing in the stomach wall may require additional operation, access port leakage or twisting may require additional operation, may not provide the necessary feeling of satisfaction that one has had enough to eat, nausea and vomiting, outlet obstruction, pouch dilatation, band migration/ slippage.

The vertical-banded gastroplsty is associated with a relatively low complication rate but is only moderately effective for significant weight loss hence has lost popularity. Prospective randomized studies that compared vertical-banded gastroplasty with gastric bypass demonstrated significantly less weight loss for patients undergoing vertical-banded gastroplasty.

Gastric bypass ( short limb ) is more effective in “sweets eaters” than vertical-banded gastroplasty because dumping symptoms curtail the high dietary intake of sweets. If the intestinal joint is made lower down, this procedure becomes a combined restrictive + malabsorbtive procedure.

The Gastric Sleeve Resection removes a great part of the stomach and leads to 'considerable' loss of weight. This is useful in those with a BMI between 35 and 40. Also, this procedure is being done in BMI over 60 to downgrade the obesity to a more manageable level of about 50, after which a gastric bypass / duodenal switch can be done.






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