, Salem, MA


March 25, 2011

How bariatric procedures work

Salem Hospital performs three types of bariatric surgery, which are outlined here. Each of these procedures is performed laparoscopically, using instruments inserted through small incisions in the body along with a video camera that permits the surgeon to see inside.

Roux-en-Y gastric bypass surgery seals off a small pouch from the stomach with staples, and attaches it to a section of lower intestine that bypasses the stomach and the section of small intestine food normally passes through. The pouch is two ounces in volume, compared to one gallon for a typical stomach. The procedure takes about two hours and fifteen minutes.

The stomach and bypassed portion of intestine still contribute gastric juices to the digestive process, but the restricted pouch forces patients to eat less, and doesn't allow for absorption of as many calories and nutrients. Patients compensate for loss of the latter by taking vitamins.


Laparoscopic adjustable gastric band surgery fits an inflatable band around the top of the stomach that can later be inflated, through an access port positioned under the skin. Inflating the band eventually restricts the stomach to a volume of around two ounces, while allowing a small opening for digestion. The lap band procedure takes about an hour and fifteen minutes. The results are designed to be permanent, but can be reversed.


Sleeve gastrectomy is a procedure in which approximately 85 percent of the stomach is stapled off to leave a vertical sleeve-shaped section, as if the stomach had been changed into a further section of intestine. Food intake is restricted, but greater absorption of calories and nutrients is allowed for than with gastric bypass. The procedure takes two hours. Dr. Frederick Buckley said Salem Hospital has performed 18 sleeve gastrectomies, which he recommends for people who have had "a lot of prior surgery."

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