What are the different types of bypass surgery?
There are two main types of gastric bypass procedures, both of which reduce the size of the stomach pouch and reduce the amount of food absorbed. 1. Roux-en-Y Gastric Bypass (RGB): In this procedure, a small stomach pouch is created by stapling part of the stomach together, or by vertical banding. This limits the amount of food that can be eaten. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum as well as the first portion of the jejunum. This is demonstrated below: 2. Biliopancreatic Diversion Gastric Bypass (BPD): This is a more complicated procedure, in which portions of the stomach are removed and the small pouch that remains is connected directly to the final segment of the small intestine. Most of the small intestine (duodenum and jejumum) us bypassed resulting in significant reductions in calorie and nutrient absorption.
On-pump: After an incision is made in the chest, the surgeon saws through the breastbone and opens the rib cage to expose the heart. The heart is temporarily stopped and a heart-lung machine takes over. One end of a healthy blood vessel—or graft—is attached just above the blocked vein and the other end below. Blood can then flow in a detour around the bad artery. An electrical shock starts the heart pumping again after the graft has been attached. This classic approach is used in about 70 percent of cases. Off-pump: The same bypass of blockages is accomplished but without stopping the heart or using the heart-lung machine. The area of the heart being worked on is stabilized as the graft is attached. Working on a moving muscle requires a skillful surgeon, says Paul Corso, M.D., section director of Cardiac Surgery at Washington Hospital Center in Washington, D.C. But without the heart-lung machine there are fewer complications, such as stroke, because you don’t have to connect tubes thro
