Gastroplasty

The gastroplasty (or gastric banding) is a surgical procedure regularly carried out in France since 1996. It quickly proved its effectiveness for people having much weight to lose, for several reasons : It carries a fast feeling of satiety. It makes possible to avoid modes, difficult to follow a long time (with a gastroplasty, you can eat what you like in reasonable quantity, under dietetic control). It is carried out by coelioscopy. Lastly, and especially, it avoids the most dangerous side effect of the modes : The resumption of weight after the stop of a reducing diet. This resumption of weight is behavioral (you tend to eat more), and especially metabolic (the modes, especially the diet protein modes, carry modifications of food absorption). The experiment showed that gastroplasty is very effective to obtain weight loss lower than 50 kgs (what is already considerable) but 2 problems were not solved : It is often difficult to obtain weight loss higher than 50 kgs (patients of more than 150 kgs are regularly operated). There are failures, especially patients who eat sweetened (junk food), all the day (and even the night…) and who did not succeed in being released from these bad habits.

Gastric Bypass

Gastric bypass is now proposed for the people having a food profile which can make fear a partial failure of gastroplasty. Gastric bypass is the procedure most frequently carried out in USA. It is carried out by coelioscopy. Sleeve gastrectomy This procedure is recent (2001) It was developed initially like the “first possible time” of a gastric bypass : At the very obese subjects (more than 150 kgs), the bypass is sometimes dangerous for engineering problems. Sleeve is carried out, which makes it possible to make lose forty kilos in one year. If it proves to be insufficient to obtain a more important weight loss, it can be then transformed into bypass under good conditions of safety. Currently, some  teams prefer Sleeve than gastroplasty for the following reasons:             - It involves a fast feeling of satiety, like the gastroplasty.             - It does not require the installation of a foreign body (gastric band).             - The vomiting is less frequent than with the gastroplasty.             - It decreases the rate of ghrelin, and thus the feeling of hunger, as in the bypass. Its main issue is represented by the ignorance of the long-term results.             - At 5 years old, the results seem intermediate between gastroplasty and bypass. I.e. - on average - a weight loss of about 60% of the weight excess.             - Then, they should be maintained, but it no current study to show it there.

Other surgical procedures are proposed in weight loss surgery :

The Mason procedure is carried out by several teams. The duodenal switch, the Scopinaro procedure are not current practices.     The intra gastric baloon is very effective in moderate overweight.