The »restrictive effect is the underlying principle of this procedure. A silicon ring is placed around the upper part of the stomach and can be adjusted via a small access port placed under the skin. The band slows the passage of food from the created stomach pouch to the lower part of the stomach and only smaller portions can be eaten.

Unfortunately, the last 20 years have shown that on a longterm only a small number of patients achieve an effective weight loss with a gastric band (approx. 20% of our patients). Weight regain or overexpansion of the esophagus occur very often. Vomiting and intolerance to some aliments like fruits and meat are a side effect of this procedure.

After 14 years experience with the gastric band we recommend this procedure only in a few selected cases. Especially, indicated for gastric banding are patients that will have to loose only 10-20 kg.

When performing a gastric sleeve resection a great portion of the stomach is transected and removed from the body. Hereby, the size of a meal is significantly reduced. 

Beneath this pure mechanic »restriction effect, the sleeve gastrectomy also has hormonal effects. Ghrelin (a hunger promoting hormone) is produced in the stomach and after its removal the level in the blood is strongly reduced. This may lead to decreased feelings of hunger.

However, it is important to note, that so far there are no long-term results and experiences with this surgical treatment. Therefore, this procedure is performed only in specific indications as internationally recommended.

Currently, the proximal gastric bypass is the gold standard for bariatric surgery worldwide. Hereby, a great portion of the stomach and duodenum are bypassed. Additionally, as in other »restrictive procedures, the size of the meals is significantly reduced. 

Due to a change in the secretion of hormones responsible for hunger (grehlin) and satiety (GLP-1, PYY) in the gastrointestinal tract a reduced sense of hunger occurs. These metabolic changes are responsible for an improvement or even resolution of diabetes after a gastric bypass. In this context the term metabolic surgery or diabetes surgery is often mentioned. 

The disadvantage of all gastric bypass procedure is the malabsorption of some vitamins and minerals from the aliments. Therefore, these micronutrients have to be added to the diet with tablets or injections to avoid alimentary deficiencies.

The most common procedures are the Scopinaro BPD and the duodenal switch (DS). To avoid protein and micronutrients deficiencies the same precautions as for gastric bypass procedures have to be considered.

The »BPD procedure is the most extreme one. In our centre, this surgical treatment is therefore, only performed in case of failure of the gastric bypass procedures.