Restrictive and Malabsorptive
(Stomach and Intestines)

Restrictive (Stomach Only)

Roux-en-Y Gastric Bypass (RNY, RGB)

Sleeve Gastrectomy

Lap-Band® (LAGB)

Small 1 ounce pouch (20-30 cc) connected to the small intestine. Food and digestive juices are separated for 3-5 ft.

Long narrow vertical pouch measuring 2-3 ounce (60-100 cc), No intestinal bypass performed.

An adjustable silicone ring (band) is placed around the top part of the stomach creating a small 1-2 ounce (15-30 cc) pouch

• Significantly restricts the volume of food that can be consumed.
• Mild malabsorption
• "Dumping Syndrome" when sugar or fats are eaten

• Significantly restricts the volume of food that can be consumer.
• NO malabsorption
• NO dumping

• Moderately restricts the volume of food that can be consumer.
• Only procedure that is adjustable
• Delays emptying of pouch
• Creates sensation of fullness

• 70% loss of excess weight
• More failures (loss of < 50% excess weight) than some other surgeries

• 60%-70% excess weight loss at 2 years
• Long term results not available at this time

• 60% excess weight loss
• Requires the most effort of all procedures to be successful

• Patients must consume less than 800 calories per day in first 12-18 months; 1000-1200 thereafter; 3 small high protein meals per day
• Must avoid sugar and fats to prevent "dumping syndrome"
• Vitamin deficiency/protein - deficiency usually preventable with supplements

• Patients must consume less than 600 -800 calories per day in first 24 months; 1000-1200 thereafter
• No dumping; no diarrhea
• Weight regain may be more likely than in other procedures if dietary modifications not adopted for life

• Must consume less than 800 calories per day for 18-36 months; 1000-1200 thereafter
• Certain foods can get "stuck" if eaten (rice, bread, dense meats, nuts, popcorn) causing pain and vomiting
• No drinking with meals

• Multivitamin
• Vitamin B12
• Calcium
• Iron (menstruating women)

• Multivitamin
• Calcium

• Multivitamin
• Calcium

• Dumping Syndrome
• Stricture
• Ulcers
• Bowel Obstruction s Dumping
• Anemia
• Vitamin/Mineral deficiencies (Iron, Vitamin B12, folate)
• Leak

• Nausea and vomiting
• Heartburn
• Inadequate weight loss
• Weight regain
• Additional procedure may be needed to obtain adequate weight loss
• Leak

• Slow weight loss
• Slippage
• Erosion
• Infection
• Port problems
• Device malfunction