Bariatric
Surgery
:: Laparoscopic Adjustable Gastric Banding
:: Tube Gastrectomy
:: Open Gastric Bypass
:: Laparoscopic Roux-en -Y Gastric Bypass
:: Abdominoplasty
:: Brachioplasty
Tube Gastrectomy or Gastroplasty.
This is a relatively new approach. It is the first component
of the duodenal switch operation and involves removing the
lateral 2/3rds of the stomach with a stapling device. It can
be done laparoscopically ( keyhole surgery) but is not reversible.
It basically leaves a stomach tube instead of a stomach sack.

This is the first component of a BPD-DS where the stomach
is reduced in size by removing the lateral 2/3rds leaving
the stomach in the shape of a tube.
Sometimes it is offered to patients as part of a two stage
Bypass operation particularly if they are super obese ( BMI>60)
because it allows good weight loss until the patient gets
down to a safe weight and the more radical bypass can then
be offered laparoscopically when they are at a safer weight.
The residual stomach capacity is about
80-100 cc
so a generous entree should be possible.
Issues with Tube gastrectomy
1. Stomach tube may stretch up over time leading to late
weight regain. The extent of this is currently unknown
2. The amount of weight reduction is in the region of 40-60%
of excess wt lost over the first 1-2 years.
3. It is a good option for people living in remote areas
because it is a "set and forget" operation which
requires little post op follow up or nutritional supplements
4. There is no malabsorption to nutrients
5. If weight is regained the second stage of the BPD the
intestinal bypass can be added... often laparoscopically as
well.

|