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Although other procedures appear to result in greater weight loss than adjustable gastric banding in the short term, results from the study by Maggard suggest that this difference decreases significantly over time. [19] Gastric banding patients lose an average of 47.5% of their excess weight, according to a meta analysis by Buchwald. [5]
Gastric band malpositioning can be devastating, leading to gastric prolapse, overdistention, and resultingly, gastric ischemia and necrosis. [27] Erosion and migration of the band may also occur post-operatively, in which case, if over 50% of the circumference of the band migrates, then surgical repositioning is necessary.
Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine , bypassing the lower stomach, the duodenum , and the first portion of the jejunum .
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The gastric bypass reduces the size of the stomach by well over 90%. [4] A normal stomach can stretch, sometimes to over 1000 mL, while the pouch of the gastric bypass may be 15 mL in size. The gastric bypass pouch is usually formed from the part of the stomach that is least susceptible to stretching.
Sleeve gastrectomy or vertical sleeve gastrectomy, is a surgical weight-loss procedure, typically performed laparoscopically, in which approximately 75 - 85% of the stomach is removed, [1] [2] along the greater curvature, [3] which leaves a cylindrical, or "sleeve"-shaped stomach the size of a banana.
Banding may also be used to restrict the function of an organ without killing it. In gastric banding to treat obesity, [3] the size of the stomach is reduced so that digestion is slowed and the patient feels full more quickly. Banding as a medical procedure is commonly used in livestock for male castration of sheep [4] and cattle. [5]
The development of the adjustable gastric band in the mid-1980s was a watershed in the treatment of obesity. The father of the gastric band is generally agreed to have been Lubomyr Kuzmak (1929–2006), a Ukrainian born surgeon who had emigrated to the US in 1965. In 1986, Kuzmak reported on the clinical use of the “adjustable silicone ...