Comparing Weight Loss in Three Bariatric Procedures: Roux-en-Y Gastric Bypass, Vertical Banded Gastroplasty, and Gastric Banding

Weight loss is one of the most ubiquitously reported outcome measures after bariatric surgery. Indeed, this metric could be considered the center of focus of bariatric surgery. The potency of an intervention is generally judged by the magnitude of weight loss induced following surgery, and the longer lasting the weight loss, the more likely the intervention will gain publicity.Many reports have attempted to study weight loss over both the short and long term following surgery. Comparative and single-arm studies have been reported in large numbers. There are usually few studies included in meta-analyses addressing this issue. Currently, the majority of comparisons between the weight loss results following Roux-en-Y gastric bypass (RYGBP), vertical banded gastroplasty (VBG), and gastric banding (GB) indicate that the weight loss is consistent following RYGBP and could be higher than VBG or GB, in which the weight loss is either jeopardized by the necessity for conversion or inconsistent. It is noteworthy that VBG could be equally effective to RYGBP in well-selected patients. Weight loss after GB is greatly variable. In comparative studies of the three procedures, GB is the least effective.Weight regain is reported after all three procedures. Revisions usually have a positive influence on weight loss. Revision is frequently reported for RYGBP after primary or secondary weight loss failure following VBG or GB. However, revision after failed RYGBP is usually a refashioning of the pouch size, anastomosis, or the length of different limbs; other techniques have also been reported to be successful.