Download Bariatric Surgical Procedures

Bariatric Surgical Procedures
Adapted from
Poirier et al. Bariatric surgery and cardiovascular risk factors:
a scientific statement from the American Heart Association.
Circulation. 2011:
published online before print March 14, 2011,
10.1161/CIR.0b013e3182149099.
Reproduced with permission.
0
Gastric Banding (Restrictive procedure)
Figure 1
The uppermost area of the
stomach is encircled by a
band which prevents
expansion circumferentially
– this section is then
injected with saline on a
routine basis and results in
adjustment of the band
until patient achieves
optimum appetite control
and satiety.
© 2011 American Heart Association, Inc. All rights reserved.
Adapted from Poirier et al and reproduced with permission.
Roux-en-Y Gastric bypass
Figure 2
(Hybrid procedure – restriction and malabsorption)
1
2
3
Alimentary
Biliopancreatic
Common
1
2
The first section
of the small
intestine is
bypassed by all
ingested food
resulting in some
reduction in food
and nutrient
absorption.
© 2011 American Heart Association, Inc. All rights reserved.
3
Reducing the size of the
stomach by cutting off the
uppermost portion and
connecting 3 it to the
small intestine. 2
The stomach remains viable but is
bypassed by all ingested food and the
new stomach has a dramatically smaller
capacity.
Adapted from Poirier et al and reproduced with permission.
Biliopancreatic Diversion (BPD)
1
2
3
Alimentary
Biliopancreatic
Common
1
2
3
© 2011 American Heart Association, Inc. All rights reserved.
Figure 3A
Resection of the lower 2/3 of
the stomach, reducing its
capacity associated with the
small intestinal bypass, where
at least ½ of the jejunum
(middle section of the small
intestine) and ileum (end
section of the small intestine)
are disconnected from the
alimentary tract and
reconnected near the terminal
ileum.
Adapted from Poirier et al and reproduced with permission.
Biliopancreatic Diversion
Duodenal Switch
1
2
3
Alimentary
Biliopancreatic
Common
1
2
Figure 3B
A modified version
of BPD: Stomach
resection consists
of a sleeve
gastrectomy with
less drastic
intestinal bypass.
3
© 2011 American Heart Association, Inc. All rights reserved.
Adapted from Poirier et al and reproduced with permission.