I found this online tonight and wanted to post it. I figured that it would help those who are still researching which choice is right for them.

I hope it helps.

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The Sapala-Wood Micropouch®

Roux-en-Y Gastric Bypass Operation

<TABLE cellPadding=10 width="99%"><TBODY><TR><TD align=middle width="29%"></TD><TD width="71%">In the Sapala-Wood Micropouch® operation the very top of the stomach is completely divided. It is not stapled. This division results in the creation of a small "micropouch" completely separate from the lower part of the stomach. This Sapala-Wood Micropouch® is about the size of a grape (1-2 cc).

The small intestine is divided into two ends. One end travels upward to be connected to the Sapala-Wood Micropouch®. The other end is attached downward to the side of the distal small intestine to complete the circuit. food travels down the esophagus, through the Sapala-Wood Micropouch®, to the intestine. It bypasses the stomach. The bottom of the stomach no longer receives any food or liquids. But the stomach will still function because its nerve and blood supply are intact.

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ADVANTAGES

• <LI class=v9>greatly controls food intake <LI class=v9>dumping syndrome - dumping conditions to control intake of sweets <LI class=v9>less susceptible to ulcers
  
• limits the total number of calories that can be absorbed by the gastrointestinal or GI tract
  

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DISADVANTAGES

• <LI class=v9>narrowing/blockage of the stoma
  
• vomiting if food is not properly chewed or if food is eaten too quickly
  

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Fluid by injection through the subcutaneous (just under the skin) port. It is thus possible to vary the opening in the stomach after surgery. This can be done in the surgeon's office.

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ADVANTAGES

• <LI class=v9>Simple and relatively safe <LI class=v9>Short recovery period <LI class=v9>Major complication rate is low <LI class=v9>No opening or removal of any part of the stomach or intestines
  
• No altering of the natural anatomy
  

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DISADVANTAGES

• <LI class=v9>About 5% failure rate because of:
  
  • <LI class=v9>Balloon leakage <LI class=v9>band erosion/migration
    
  • deep infection
    

[*]Identifying patients who will not "eat through" the operation is difficult

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Vitamins and Calcium

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Iron and Vitamin B<SUB class=v7>12</SUB> <LI class=v9>better eating quality when compared to other WLS procedures <LI class=v9>eliminates or greatly minimizes most negative side effects of the original BPD

essentially eliminates stomal ulcer and dumping syndrome

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DISADVANTAGES

• <LI class=v9>greater chance of chronic diarrhea <LI class=v9>significant malabsorptive component
  
• more foul smelling stools and flatus, but less than with the BPD alone
  

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Top

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It is important to remember that there is risk with any surgery.

There are some specific risks associated with bariatric surgery.

• <LI class=v9>10-20% of patients who have weight-loss operations require follow-up operations to correct complications. Abdominal hernias are the most common complications requiring follow-up surgery. Less common complications include breakdown of the staple line and stretched stomach outlets. <LI class=v9>More than one-third of obese patients who have gastric bypass surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones is increased. Gallstones can be prevented with supplemental bile salts taken for the first 6 months after surgery. Many surgeons are opting to remove the gallbladder during the initial weight loss surgery. <LI class=v9>Nearly 30% of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis, and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained.
  
• Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus. Women of childbearing potential should have a pregnancy test before having weight-loss surgery.
  

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Have you heard about this new proceedure where tey inflate a balloon in the stomach via the esphagus and then can deflat it after total weight loss is achieved. Not cutting and no general anastesia

Have you heard about this new proceedure where tey inflate a balloon in the stomach via the esphagus and then can deflat it after total weight loss is achieved. Not cutting and no general anastesia

I read about this on a MX website, Monterrey, I think but I don't recall the Dr. It's called "Gastric Balooning" I think, and it's meant for very quick weight loss and can only be left in for a few months. Say if someone had to lose 80lbs fast or they couldn't have a life-saving surgery, this might be appropriate for them. I thought it was very interesting!

Thanks Kelly. That was very informative and succinct...all procedures right in a row. I always get them mixed up so this is helpful.

Good job!

I know Dr Kuri does them. He said u lose about 30-40 pounds. The balloon stays in for 6 months and cost somewhere around 3 grand. The down fall is once its out, it is really easy to regain the weight. It is also used on people who are too high in their BMI to be safe for the Lap Band. It helps them get to a safe weight. So it is ideal for either very low BMI or very high BMI. There is no surgery and yes it is done under "twilight sedation". I looked into it a lot a few months ago and could not find one support site to see what the side effects were. The only one they really talk about from the doctors office is vomiting. I dont know how long that lasts or if it goes away. It isnt that new of a procedure, just not as popular. I would do it if it if I didnt think I would gain it back.

hmmm, it is just me, or does anyone else think that malabsorption is a bad thing? Why would anyone think this was a good idea?

hmmm, it is just me, or does anyone else think that malabsorption is a bad thing? Why would anyone think this was a good idea?

I agree Crystal!

Thanks Kelly, it's nice to see it all together like this.

I agree. Why would malabsorption be considered a good thing?

Is that what happens with the other surgeries? I dont know I have never even considered anything other than the lalpband. I know other surgeries have like high death rates because Ive been to a few other boards and they need to have specail sections to remember their friends who died with complications. Its so sad. A whole section just for all of the deaths.

I agree. Why would malabsorption be considered a good thing?

Well, some would say that malabsorption is desirable because it is what guarantees weight loss for RNY patients. Along with dumping to provide negative behavioral reinforcement, malabsorption can seem like the holy grail to someone who just feels so completely out of control they need something to take over for them. RNY patients lose weight so fast because much of what they DO eat is simply not absorbed by their bodies.

Of course WE see that as a bad thing, but presented in a certain light I can see why some would find it attractive. It is, however, temporary. After a couple of years the body adjusts to the new protocol and the malabsorption of calories ceases. The malabsorption of nutrients, however, never ends.

Weird how anyone would consider this a good thing. I just don't get it.

Thanks for the article Kelly. Alex thanks for the malabsorption explanation, makes sense.

I agree with what you said Alex, about it being desireable in the sort run, but I guess I am just a long term thinker.

I guess I have to go back to my husband's experience. I have no idea what tiny percentage of the population are as fat as he was when he was banded. Heck, I don't know what percentage of folks are as fat as he currently is.

I wish there was greater awareness of the band. I know that people are emotionally generally invested in the WLS they chose. I know that I'm no different in that I think my choice is the best one for everyone. I mean, that isn't true, but it is human nature.