The Medical University of South Carolina's weight loss surgery program performs two weight loss surgeries for the treatment of obesity. The program currently offers the Gastric Bypass Roux-en-Y and Laparoscopic Adjustable Gastric Band weight loss surgeries. Below is an overview of each of these procedures. If you have questions we encourage you to contact us directly.

Combined Restrictive/Malabsorptive Operations

Combined operations are the most common bariatric procedures and weight loss surgeries. They restrict both food intake and the amount of calories and nutrients the body absorbs.

Roux-en-Y gastric bypass (RGB). This operation, illustrated in fFgure 4, is the most common and successful combined procedure in the United States. The first step in a Roux-en-Y gastric bypass is to have the surgeon create a small stomach pouch to restrict food intake.  Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs. Rarely, a cholecystectomy (gall bladder removal) is performed to avoid the gallstones that may result from rapid weight loss. More commonly, Roux-en-Y gastric bypass patients take medication after the operation to dissolve gallstones.

 Detailed information on gastric bypass surgery 
 More on the Roux-en-Y bypass procedure
 Risks of this procedure
 Brief history and summary of bariatric surgery (ASMBS)

Restrictive Operations
Laparoscopic Adjustable Gastric Banding Procedure

Purely restrictive operations only limit food intake and do not interfere with the normal digestive process. To perform the operation, doctors create a small pouch at the top of the stomach where food enters from the esophagus. At first, the pouch holds about 1 ounce of food and later may stretch to 2-3 ounces. The lower outlet of the pouch is usually about ½ inch in diameter or smaller. This small outlet delays the emptying of food from the pouch into the larger part of the stomach and causes a feeling of fullness.
After the operation, patients can no longer eat large amounts of food at one time. Most patients can eat about ½ to 1 cup of food without discomfort or nausea, but the food has to be soft, moist, and well chewed. Patients who undergo restrictive procedures generally are not able to eat as much as those who have combined operations.

Here at MUSC we perform the laparoscopic adjustable gastric banding (LAGB) using the Realize™ band.

In this procedure, a hollow band made of silicone rubber is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the rest of the stomach (Figure 2). The band is then inflated with a salt solution through a tube that connects the band to an access port placed under the skin. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

 Detailed information on the Laparoscopic Adjustable Gastric Banding procedure
 Risks of this procedure