Classical Roux en Y Operation (RNY)

Roux en Y (RNY) or gastric bypass is a restrictive procedure that staples off an approximate ½-1 ounce stomach pouch at the upper portion of the stomach. A section of small bowel is then attached to the pouch via a small opening, which is to simulate the pyloric valve. . Narrowing and or blockages can take place at this small opening. Ulceration can also happen at the area where the small bowel and the stomach tissue are attached. The pyloric valve is bypassed in this procedure. Because of the small pouch size vomiting can take place if food is not properly chewed or food is eaten too fast or too large a volume. Dumping syndrome is also takes place when consuming high sugar containing food.

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Vertical Banded Gastroplasty: (VBG)

VBG) is another restrictive procedure that only limits the amount of food. The stomach is portioned off with staples and then a stilastic ring is put into the gastric tissue to simulate the pyloric valve and to restrict the amount of food eaten at a given time. This procedure has had a high failure rate with regaining of weight and staple line disruption.

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Fobi Pouch

Fobi Pouch is a restrictive procedure that is a variation on the VGB and RNY. The procedure has the same pouch construction as the Roux en Y procedure but incorporates a silastic ring around distal end of the pouch to simulate the pyloric valve and prevent stretching of the opening between the pouch and the section of small bowel. Vomiting can take place if too large of a bite of food is taken. Dumping syndrome can also occur with this procedure.

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Lap Band

Lap Band, the most recent device that has won the FDA approval, has been in use in Europe and Australia for many years. The FDA postponed the approval of this device for release in US citing inadequate data, as well as poor outcome when compared to the European and Australian studies. The Lap band, is a restrictive procedure, that limits the amount of food intake. The amount of restriction can be controlled by the means of a implantable port under the skin which can be used to inflate or deflate (increase and decrease ) the restriction.

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