Bariatric Surgery: Choice of Operative Procedure

  • Joseph Y. Chung
  • Jonathan A. Myers
  • Mohammad Jamal

Several options exist for minimal access bariatric surgery for morbid obesity. This chapter explores the specific choice between two procedures—the laparoscopic adjustable gastric band, and the laparoscopic Roux-en-Y gastric bypass. Details on both procedures and on laparoscopy in the morbidly obese are given in the SAGES manuals.


Bariatric Surgery Gastric Bypass Morbid Obesity Gastric Banding Laparoscopic Adjustable Gastric Banding 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg 2003;197(4):536-544.CrossRefPubMedGoogle Scholar
  2. DeMaria EJ, Sugerman HJ, Meador JG, et al. High failure rate after laparoscopic adjustable sili-cone gastric banding for treatment of morbid obesity. Ann Surg 2001;233(6):809-818.CrossRefPubMedGoogle Scholar
  3. Doherty C, Maher JW, Heitshusen DS. Long-term data indicate a progressive loss in effi-cacy of adjustable silicone gastric banding for the surgical treatment of morbid obesity. Surgery 2002;132(4):724-727.CrossRefPubMedGoogle Scholar
  4. Fernandez AZ Jr, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc 2004;18(2):193-197.CrossRefPubMedGoogle Scholar
  5. Griffin WO Jr, Young VL, Stevenson CC. A prospective comparison of gastric and jeju-noileal bypass procedures for morbid obesity. Ann Surg 1977;186(4):500-509.CrossRefGoogle Scholar
  6. Laws HL, Piantadosi S. Superior gastric reduction procedure for morbid obesity: a pro-spective, randomized trial. Ann Surg 1981;193(3):334-340.CrossRefPubMedGoogle Scholar
  7. Maggard MA, Sugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obes-ity. Ann Intern Med 2005;142:547-559.PubMedGoogle Scholar
  8. Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a rand-omized study of outcomes, quality of life, and costs. Ann Surg 2001;234(3):279-289.CrossRefPubMedGoogle Scholar
  9. Pories WJ, Flickinger EG, Meelheim D, Van Rij AM, Thomas FT. The effectiveness of gastric bypass over gastric partition in morbid obesity: consequence of distal gastric and duodenal exclusion. Ann Surg 1982;196(4):389-399.CrossRefPubMedGoogle Scholar
  10. Snow V, Barry P, Fitterman N, et al. Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2005;142:525-531.PubMedGoogle Scholar
  11. Sugerman HJ, Londrey GL, Kellum JM, et al. Weight loss with vertical banded gastro-plasty and Roux-en-Y gastric bypass for morbid obesity with selective versus random assignment. Am J Surg 1989;157(1):93-102.CrossRefPubMedGoogle Scholar

Suggested Readings

  1. Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326-351.CrossRefPubMedGoogle Scholar
  2. DeMaria EJ. Is gastric bypass superior for the surgical treatment of obesity compared with malabsorptive procedures? J Gastrointest Surg 2004;8(4):401-403.CrossRefPubMedGoogle Scholar
  3. Fisher BL. Comparison of recovery time after open and laparoscopic gastric bypass and laparoscopic adjustable banding. Obes Surg 2004;14:67-72.CrossRefPubMedGoogle Scholar
  4. Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-en-Y gastric bypass for mor-bid obesity: technique and preliminary results of our first 400 patients. Arch Surg 2000;135(9):1029-1033.CrossRefPubMedGoogle Scholar
  5. Jones DB, Provost DA, DeMaria EJ, Smith CD, Morgenstern L, Shirmer B. Optimal man-agement of the morbidly obese patient. Surg Endosc 2004;18:1029-1037.CrossRefPubMedGoogle Scholar
  6. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 1991;115(12):956-961.Google Scholar
  7. O’Brien PE, Dixon JB. Lap-Band®: Outcomes and results. J Laparoendosc Adv Surg Tech 2003;13:265-270.CrossRefGoogle Scholar
  8. O’Brien PE, Dixon JB, Brown W. Obesity is a surgical disease: Overview of obesity and bariatric surgery. ANZ J Surg 2004;74:200-204.CrossRefPubMedGoogle Scholar
  9. Ren CJ, Horgan S, Ponce J. US experience with the LAP-BAND system. Am J Surg 2002;184(6B):46S-50S.CrossRefPubMedGoogle Scholar
  10. Rubenstein RB. Laparoscopic adjustable gastric banding at a U.S. center with up to 3-year follow-up. Obes Surg 2002;12(3):380-384.CrossRefPubMedGoogle Scholar
  11. Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparo-scopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232(4):515-529.CrossRefPubMedGoogle Scholar
  12. Shen R, Dugay G, Rajaram K, Cabrera I, Siegel N, Ren CJ. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg 2004;14:514-519.CrossRefPubMedGoogle Scholar
  13. Steinbrook R. Surgery for severe obesity. N Engl J Med 2004;350(11):1075-1079.CrossRefPubMedGoogle Scholar
  14. Weber M, Muller MK, Bucher T, et al. Laparoscopic gastric bypass is superior to laparo-scopic gastric banding for treatment of morbid obesity. Ann Surg 2004;240:975-983.CrossRefPubMedGoogle Scholar
  15. Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux en-Y-500 patients: technique and results, with 3-60 month follow-up. Obes Surg 2000;10:233-239.CrossRefPubMedGoogle Scholar
  16. Zinzindohoue FC, Chevallier JM, Douard R, et al. Laparoscopic gastric banding: a mini-mal invasive surgical treatment for morbid obesity. A prospective study of 500 con-secutive patients. Ann Surg 2003;237:1-9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Joseph Y. Chung
    • 1
  • Jonathan A. Myers
    • 2
  • Mohammad Jamal
    • 3
  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Rush Medical CollegeRush University Medical CenterChicagoUSA
  3. 3.Department of Surgery, Division of Gasrointestinal, Minimally Invasive and Bariatric SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA

Personalised recommendations