If she indeed had a lap band, the stomach is NOT made smaller. A band is placed around the opening to the stomach and is restricted by injecting saline into the band, likewise the restriction can be lessened by removing or suctioning out the saline from the band.
Many people I know (yes many) have had no good luck at all with the lap band because they weren't disciplined and their doctors allowed them to have adjustments whenever they wanted to 'feast' ie: go to a wedding or a banquet, they could eat till their hearts content and then restrict intake at a later time.
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The Gastric Bypass operation, also known as the Roux-en-Y gastric bypass, is one of the most commonly performed weight loss surgical procedures. It involves creating a very small 2-3 ounce gastric pouch and connecting it to a limb of small bowel. The reduction in the size of the stomach is the most significant of all weight loss surgical procedures. It is, however, important to note that the smaller stomach pouch does not function in the same manner as the original intact stomach. When you compare the stomach of the Sleeve Gastrectomy or the Duodenal Switch operation, their function and physiology is very similar to the normal anatomy. This is, however, not the case in the Gastric Bypass operation. The remnant stomach that connects to the small bowel does not, physiologically or mechanically, function the same as a normal intact stomach. This ultimately results in a number of complications that are unique to the gastric bypass operation. Complications include marginal ulcers, dumping syndrome, stricture at the site of the gastrojejunostomy anastomosis (where the stomach is attached to the small bowel), and nutritional deficiencies including iron and B12.
Even though the short-term results of the gastric bypass operation may be acceptable when measured by excess weight loss, the outcome of its long-term maintained weight loss, along with the associated complications of the surgery, make it a procedure that a lot of surgeons no longer recommend.
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The Biliopancreatic Diversion with a Duodenal Switch is a hybrid surgical procedure that has two aspects that reduce weight.
The smaller stomach size limits the amount of food that can be taken in to about 120-150cc (1/2-3/4 Cup).
The small bowel is reattached in such a fashion as to keep the biliopancreatic juices away from the food until the last portion of the small bowel, limiting the absorption of the food that is eaten. The stomach is decreased in size by doing a Sleeve Gastrectomy, which uses proportional amounts of the stomach areas that make important enzymes and chemicals. The hallmark of the Duodenal Switch operation is the preservation of the pyloric valve. The pyloric valve is at the last portion of the stomach and acts as a gateway to the small bowel. The food needs to be of the right chemical and mechanical consistency before the pyloric valve allows it to progress into the small bowel. The appendix and the gallbladder are also removed.
Duodenal switch provides the best remedy for failed gastric bypass.
When necessary, the revision or reversal of the Duodenal Switch operation is technically the safest and easiest of all revisional surgical procedures.
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