BARIATRIC SURGERY
Purely Restrictive Technique
This technique is based tin the reduction of the capacity of the stomach through the creation of a small bag or gastric reservoir smaller that 30ml, with a small orifice or stoma for an exit of food of 10mm in diameter. This provokes, by feeling full with a small amount of food, the stimulus of nerves that transmit signals to the centre of fullness, creating a response of self-limitation of eating and early satiation.
They are techniques with a low percentage of post-operative complications (less than 10%) and a low level of mortality (equal or less than 1%). However, in spite of a loss in weight in the first year of nearly 50% of their initial weight, many patients recuperate a significant amount in the following 3-5 years.
Restrictive techniques require important changes in eating habits and can be associated with persistent vomiting and/or intolerance to certain foods like meat, making patients prefer to ingest large quantities of high calorie liquids (ice cream, pudding, chocolate, etc. that determine the success of the technique.
Currently two restrictive techniques are practiced: a vertical banded gastroplasty (GVB), on which there are many experienced physicians in this country using this technique (Fig. 2), and adjustable lap-band surgery (BGA) that is a less invasive procedure done via laparoscopy (fig. 1).
