Roux-en-Y Gastric Bypass
The Gastric Bypass (GBP) has become the gold standard, not because it is the best operation, but because most long-term studies have about the gastric bypass.
This is a reversible operation; the stomach is made to be about the size of a walnut and most of the stomach and a short segment of intestines bypassed. This has powerful effects on hunger, appetite and diabetes. This is also the preferred operation for GERD, if present. Vitamin and mineral deficiencies are frequent, but preventable with proper supplementation.
A single multi-vitamin with iron, calcium and vitamin B12 is all that is necessary to prevent deficiencies in most patients. However, alcohol absorption is altered and there is a tendency toward alcoholism if consumed to excess. Also, some patients who take aspirin or ibuprofen type of anti-inflammatory agents or who smoke will develop ulcers. The gastric bypass appears to be more powerful than the VSG for absolute weight loss and diabetes prevention and treatment. It has also been shown to be safe for future pregnancies.