Thursday, October 11, 2007

Bariatric Surgery Glossary

Last updated: October 4, 2012

A.M.I. Soft Gastric Band: A type of adjustable gastric bands that is produced by the Austrian Agency for Medical Innovations Ltd, Austria. It is not available in USA.

Abdominoplasty: Also called "Tummy Tuck", is a plastic (cosmetic, aesthetic) surgical procedure that involves dissection and preservation of the umbilicus itself, and a more extensive skin mobilization and more aggressive skin removal than panniculectomy. A complete abdominoplasty also includes tightening of the abdominal wall muscles. This is not considered a "Weight Loss (=Bariatric) Surgery"

Adjustable Gastric Band: A weight loss surgery tool that is essentially a band with an inner balloon. It is placed by a laparoscopic surgical procedure. The band is folded and locked around the top-most part of the stomach to produce a constriction, between a small pouch of the stomach above the band, and the rest of the stomach. The balloon is connected, via a narrow tube, to a small reservoir that sits under the skin . By adding or removing saline from the reservoir (aka, the port), the balloon of the band can be inflated or deflated. Hence, the band is adjustable. Types of adjustable bands in no particular order: the Lap Band, the Swedish Adjustable Band (and the REALIZE Band), the Heliogast Band, the Bioring Band, the Midband, the A.M.I Soft Gastric Band, the MiniMizer band, the GastroBelt II, the EasyBand Gastric Banding System.

Alimentary limb: In a Roux-en-Y gastric bypass and other operations that employ the Roux-en-Y configuration, the "alimentary limb" is the length of small intestine that extends from the gastric pouch to the Y-junction (which leads, then, to the common channel). It is the limb through which ingested food would travel from the pouch to the distal intestine.

Anastomosis: Surgical connection of two hollow organs or parts of an organ, allowing their lumina(cavities, plural of lumen) to be open to each other and to be continuous with each other. Example: A gastro-jejunal anastomosis means an anastomosis between the lumen (cavity) of a part of the stomach (gastro-) and the part of the small intestine called jejunum (jejuno-), providing an opening between their cavities to each other.

Arm lift: See "Brachioplasty".

BMI: See "Body Mass Index"

Balloon: See "Intragastric Balloon"

Bariatric Surgery: Same as "Weight Loss Surgery". See "Weight Loss Surgery"

Bariatrics: The branch of medicine that deals with the causes, prevention, and treatment of obesity. The American Heritage® Dictionary of the English Language: Fourth Edition. 2000.
(Baros = weight. -iatrics = healing. Origin: Greek)

Bile: A fluid that is produced and secreted by the liver. It travels down the bile ducts to end in the duodenum, the upper-most portion of the small intestine. If the gallbladder is still in place, it normally concentrates the bile, stores it, before squeezing it into the duodenum. The bile is yellow-green in color, alkaline in reaction and is very bitter. The bile helps with the digestion and absorption of fat.

Biliopancreatic diversion (BPD): A bariatric operation originally described by Dr. Nicola Scopinaro in Italy in 1979. It is a predominantly malabsorptive operation. It also has a modest restrictive component. The stomach is reduced to a 200-500 mL pouch, after removing the distal part of the stomach (hemigastrectomy). The small intestine is divided into an alimentary limb and a biliopancreatic limb. The proximal end of the alimentary limb is attached (anastomosed) to the remaining proximal stomach. The lower end of the biliopancreatic limb is then anastomosed to the terminal ileum within 50 to 100 cm distance from the ileocecal valve (the end of the small intestine, where the colon starts). Therefore, the intestinal tract is reconstructed to allow only a “common channel” of the distal 50-100 cm terminal ileum for absorption of fat and protein.

Biliopancreatic diversion with a duodenal switch (BPD/DS): See "Duodenal Switch"

Biliopancreatic limb: In Roux-en-Y configuration, this is the length of small intestine that includes the duodenum and the upper jejunum, and ends at the Y-junction. Distal to that, the small intestine is called "the common channel". The biliopancreatic limb is given that name because the common bile duct and the pancreatic duct open into the second (descendind) part of the duodenum, which is part of the biliopancreatic limb. Bile and pancreatic juices flow through the biliopancreatic limb and meet with food (that traveled down the alimentary limb) in the common channel.

Bioring Band: A type of adjustable gastric bands that is made by "Cousin Biotech", France. It is not available in USA.

Body Contouring: (also known as "body lift", "body shaping" or "body reshaping") This is a group of plastic surgery procedures performed after massive weight loss, to manage hanging excess skin. Patients have to have reached a stable plateau weight before any such plastic surgery procedures. The person should have achieved a stable weight after the maximum weight loss, and be in good health and not planning on becoming pregnant.

Body Mass Index (BMI): The weight in kilograms divided by the height in meters squared. Using pounds and inches, the formula is BMI = (weight in pounds x 703)/squared (height in inches). The Body Mass Index(BMI) formula was developed by Belgian statistician Adolphe Quételet (1796-1874), and was known as the Quételet Index. BMI Categories: Underweight less than 18.5; Normal from 18.5 to less than 25; Overweight from 25 to less than 30; Obesity Class I from 30 to less than 35; Obesity Class II from 35 to less than 40; Obesity Class III from 40 and above. Calculate your BMI.

Brachioplasty: Also called "Arm Lift" is a plastic (cosmetic, aesthetic) surgical procedure that involves removing excess or loose skin and fat from the upper arms.

Cholecystectomy: An operation to remove the gallbladder. It is most commonly performed with the laparoscope, in which case it is called "laparoscopic cholecystectomy" . See also "Laparoscopic Surgery"
Colon: Also called the "large intestine" or "large bowel" is the part of the intestines that extends after the small intestine and ends at the rectum. Its parts, from proximal to distal: the cecum, the ascending colon, the transverse colon, the descending colon, and the sigmoid (pelvic) colon.

Comorbidities (Co-morbidities): In the context of obesity, means medical conditions that a patient may have, and that are either caused by, or are made worse by, obesity. Examples include diabetes type 2, hypertension, sleep apnea, gastroesophageal reflux disease (GERD), hyperlipidemia/dyslipidemia (elevated total cholesterol, low density lipoprotein, triglycerides or low high density lipoprotein), musculo-skeletal problems, shortness of breath, heart disease, and certain types of cancer.

Desirable Body Weight: These weights are derived from the tables of the best weight for each height for longevity, based on collected insurance data, released in 1959 by the Metropolitan Life Insurance Company released. They are outdated. In 1993, the Metropolitan Life Insurance Company released the "Ideal Body Weight". The reference for the Desirable Body Weight tables: Metropolitan Life Insurance Company: New weight standards for men and women. Stat Bull Metrop Life Insur Co 1959; 40: 1-10.
Duodenal Switch: The full name is "Biliopancreatic diversion with a duodenal switch" (BPD/DS). This is a surgical weight loss procedure utilizing both restrictive and malabsorptive methods. The malabsorption element in this surgery is more significant than proximal Roux-en-Y gastric bypass. The BPD/DS procedure involves the reduction of the stomach to a tube (called the sleeve) gastric pouch of 100 to 150 mL volume. The pyloric valve is left intact. The duodenum is divided a short distance below the pyloric sphincter. More distally, the small intestine is divided, thus an alimentary limb and a biliopancreatic limb are created. The alimentary limb is brought up and is connected to the duodenum and, thus, to the stomach tube. The biliopancreatic limb is attached to the distal intestine, to form a common channel that leads to the colon.

Dumping Syndrome: A group of symptoms that result from the quick "dumping" of food into the small intestine. The most typical forms may occur after gastric bypass, following the ingestion of liquid diet that is rich in refined sugar or glucose. One form (Early Dumping) occurs shortly after such a meal, and consists of any combination of lightheadedness, flushing, diarrhea, and extreme weakness. Transient hypotension may contribute to the symptoms. Another form of the dumping syndrome (called "Delayed Dumping") may occur an hour or later after a meal, and is believed to be a result of hypoglycemia. Not all gastric bypass patients develop dumping syndrome.

EasyBand Gastric Banding System: This Telemetric Adjustable Gastric Band (TAGB), uses remote controlling electronic technology to adjust the inner diameter of the band without the need for a needle access. The access port is replaced by a simple electronic receiver, through which a telemetric signal is directed to achieve an adjustment. EasyBand Gastric Banding System was approved by the European Commission for use in Europe in mid-2006. It is not available in the USA. On 2/22/2007, Allergan Inc. announced the completion of its acquisition of the Swiss medical technology developer EndoArt SA.  A clinical trial by Allergan, the "EasyBand GOAL Trial" "has been withdrawn prior to enrollment. (This study was withdrawn to further optimize the device. No patients were enrolled in the trial.)" ( Available online at <;jsessionid=691DC358A2A44879996FE2C6D0487E22?order=27> [Accessed on October 4, 2012])

EGD See "Esophagogastroduodenoscopy"

EndoBarrier: The EndoBarrier™ is a gastrointestinal tube liner that acts as an impermeable barrier. Food travels down the tube liner without touching the wall of the the duodenum and proximal jejunum parts of the small intestine. This may limit the patient's absorption of nutrients. The EndoBarrier™ is, therefore, a sort of bypassing the absorption capability of the upper small bowel. The EndoBarrier is placed and removed endoscopically. It is a reversible procedure. The EndoBarrier™ is an investigational device. It is not yet commercially available in the USA. It is produced by GI Dynamics, Inc., Lexington Massachusetts, USA.

Endoscopy: Visual examination of the inside of the body, using a tube that has light and camera in it. Examples are EGD, colonoscopy, etc. The term is also used to include "laparoscopy"

Enterra Therapy : See Implantable Gastric Stimulator. Produced by Medtronic, Minneapolis, Minnesota. Enterra Therapy is indicated for use in the treatment of chronic, intractable (drug refractory) nausea and vomiting secondary to gastroparesis of diabetic and idiopathic etiology.

Esophagogastroduodenoscopy (EGD) is an examination of the inside of the esophagus, the stomach, and the upper part of the duodenum. An endoscope (that is, a flexible tube with a camera at the end) is inserted down the throat, and is advanced under vision to the esophagus, stomach and upper duodenum. Typically, the procedure is done under sedation (that is, an intravenous medication that makes the patient sleepy and forgetful). Patients typically go home the same day, when awake enough.

Excess Weight: The individual's current weight minus the ideal body weight for the height, gender and body frame.

FDA: U.S. Food and Drug Administration

French Band: The following are the types of adjustable gastric bands produced in France in alphabetical order: the Bioring band, the Heliogast Band, and the Midband.

Gallbladder: This is a sac that receives the bile secreted from the liver, concentrates it, and then squeezes it to the duodenum. This function is not essential, and removing the gallbladder (an operation called cholecystectomy) does not cause a loss of an essential function.

Gastric: (Greek) Related to the stomach

Gastric Balloon: See "Intragastric Balloon"

Gastric Bypass: A type of bariatric (weight loss) surgery. A surgical procedure that includes stapling (usually, with dividing)the stomach into a small part called the "pouch", to separate it from the rest of the stomach. The intestine is divided, attached to the pouch, and re-arranged in a Y-shaped configuration (Roux-enY). The final result is that the majority of the stomach, and the uppermost portion of the small intestine, are bypassed.

Gastric Electrical Stimulation (GES): See Implantable Gastric Stimulator. Also called Gastric Pacemaker.

Gastric Pouch: In different bariatric surgery operations (eg, gastric bypass, adjustable gastric banding), the "pouch" is the upper-most part of the stomach that remains attached to the esophagus, and serves as a limited-size reservoir for ingested food. The small pouch helps in achieving weight loss by making it easier for the patient to limit the size of the meal (portion control)

Gastric Pacemaker: See “Implantable Gastric Stimulator”.

Gastric Stapling: This is a generic inaccurate name sometimes used by media. Although stapling techniques are used in several bariatric and non-bariatric operations, the term "gastric stapling" is usually applied to a particular bariatric surgical procedure, that is "vertical banded gastroplasty" (VBG). The procedure includes warding off a small portion of the top-most part of the stomach (called the pouch) from the rest of the stomach, usuing surgical staplers. The pouch opens to the rest of the stomach via a very small opening (ostium). Notice that the term "gastric stapling" is also used currently for Gastric Bypass. Due to its lack of definition and accuracy, medical professionals generally avoid use that term.

GastroBelt II Band: A type of adjustable gastric bands, produced by Tyco Healthcare in Europe. It is not available in the USA. Rather than fixing the band in place using gastro-gastric sutures, the band is fixated to the wall of the stomach itself, to minimize the incidence of slippage. Also it has 2-step locking mechanism.

Gastroparesis: A condition in which the stomach loses, partially or completely, the ability to contract and empty. The mainstay of the diagnosis is a delayed gastric emptying. The most common causes are diabetes and idiopathic (of unknown cause). Lines of treatment include medications that attempt to stimulate the gastric motility (prokinetic agents), and gastric electrical stimulation (Enterra Therapy). Studies are underway as to the role of a Ghrelin agonist as a novel prokinetic agent.

Gastroscopy : See "Esophagogastroduodenoscopy"

Ghrelin: A "gut hormone" or "gastrointestinal hormone" that is also commonly called the "hunger hormone". Most of the cells that express ghrelin are located in the stomach. Fasting increases stomach ghrelin expression. Circulating levels of ghrelin in humans increase before, and fall after, food ingestion. These findings strongly suggest a role for ghrelin in appetite regulation. There are ghrelin receptors in the hypothalamus in the brain. Structurally, ghrelin is a 28–amino acid growth hormone–releasing factor. Ghrelin antagonism is being studied as a way to suppress appetite and try to help with weight loss. On the other hand, Ghrelin agonists (that is, stimulating the effects of Ghrelin), are being studied as a novel treatment for gastroparesis.

Heliogast Band: A type of adjustable gastric bands, manufactured by Hélioscopie, Vienne Cedex, France. It is not available in USA.

Hunger Hormone: See "Ghrelin"

Ideal Weight: See "Ideal Body Weight"

Ideal Body Weight (see also "Desirable Body Weight"): The ideal weight tables were released in 1983 by the Metropolitan Life Insurance Company in New York. These were based on the Build Study of 1979, determined by the Society of Actuaries in Chicago. The data represented 4.2 million insured individuals. Using the Ideal Body Weight to categorize weight and obesity has been largely superseded by the Body Mass Index (BMI) concept. Still, the Ideal Body Weight is used to calculate the "Excess Weight". One of the outcome mesaurements of weight loss surgery is to monitor the weight loss as a percentage of the excess weight. (Reference for the Ideal Body Weight data: 1983 Metropolitan Height and Weight Tables. New York: Metropolitan Life Foundation. Statistical Bulletin 1983; 64(1): 2-9)Implantable Gastric Stimulator (IGS): Also called "Gastric Pacemaker". A device that is implanted to generate electric stimulation to the stomach wall. Historically, the first gastric stimulator for the treatment of morbid obesity was implanted by Dr. Valerio Cigaina in Italy, in 1995. The Enterra Therapy System (Medtronic, Minneapolis, MN) is currently the only gastric electrical stimulator that has received approval from the U.S. Food and Drug Administration (FDA). Enterra Therapy is indicated for use in the treatment of chronic, intractable (drug refractory) nausea and vomiting secondary to gastroparesis of diabetic and idiopathic etiology. There is no available FDA-approved obesity treatment gastric stimulation in the USA. Medtronic acquired Transneuronix company which manufactured the Transcend II Gastric Stimulator. On Dec 8, 2005, Medtronic, Inc. announced that the preliminary results of the Screened Health Assessment and Pacer Evaluation (SHAPE) trial, , did not meet the efficacy endpoint of a difference in mean excess weight loss at one year. Medtronic has indicated that it will continue following patients enrolled in the SHAPE trial through 24-months of follow-up. The company is not making the IGS available for obesity surgery world-wide. On the other hand, the results of the "Appetite Suppression Induced by Stimulation Trial" (ASSIST) study which evaluates Medtronic's IGS therapy in obese patients with type 2 diabetes are not out yet. Study completion date was February 2008.

Intragastric Balloon: The BioEnterics® Intragastric Balloon (BIB®) System is manufactured by Inamed, a division of Allergan, Santa Barbara, California, USA. It is designed to provide short-term weight loss therapy. BIB is placed endoscopically and is inflated with saline. It is made of silicone, and contains no latex. The concept is to partially fill the stomach to help with portion control. The BioEnterics® Intragastric Balloon (BIB®) System is not currently approved for sale in the USA. It is exported to the global market, though.

Lap Band: A type of adjustable gastric band that is manufactured by Inamed Health (formerly BioEnterics®) which is now a wholly owned subsidiary of Allergan, Santa Barbara, California, USA. The Lap Band was approved by the FDA in June 2001. A laparoscopic surgical procedure, it was initially implanted by an open surgery when invented by Dr. Lubomyr Kuzmak (New Jersey) in the 1980's. Drs. Mitiku Belachew and M. Legrand from Huy, Belgium, developed the laparoscopic application of the same. For a while, the Lap Band had been the only commercially available gastric band in the USA. However, the REALIZE (Swedish Adjustable Band) has recently been approved by FDA for marketing in the USA. The Lap Band is also the standard in Australia, and is very popular in Europe.

Laparoscopic Cholecystectomy: See "Cholecystectomy"

Laparoscopic Surgery: also called "Minimally Invasive Surgery", is a way of performing abdominal surgical procedures through multiple small holes or incisions, which allow the introduction of the visualizing telescope (so-called camera) and multiple long instruments. The surgeons see by looking at monitors (like TV screens) which project the pictures from the camera.

Laparoscopy: The visualization of the inside of the abdomial cavity using a tube (laparoscope) that has a camera or a visualizing system at its tip, as well as a light-emitting mechanism. In its most typical form, the patient is under anesthesia, and the abdominal cavity is insufflated with air or CO2 to tent the abdominal wall up, and allow for a clear field of visualization.

Large Bowel: Same as "Large Intestine" and "Colon". See "Colon"

Liposuction: A plastic (cosmetic, aesthetic) surgical procedure that involves suctioning out a varying amount of fat from under the skin (subcutaneous fat). Liposuction is not a type of "Weight Loss Surgery" as defined by the surgical community.

Lower Body Lift: A plastic (cosmetic, aesthetic) surgical procedure that involves a combination of an abdominoplasty, plus a thigh and buttock lift. It requires a large incision around the belt line to lift the lower body.

Malabsorptive Surgery: A type of weight loss surgery (bariatric surgery) that works by bypassing a portion of the small intestine. The small intestine is the organ that performs almost all of the absorption of nutrients. By bypassing a portion of the small intestine, the absorption becomes incomplete, and patients lose weight. Gastric bypass is a combined restrictive and malabsorptive procedure, but the malabsorptive component in the "proximal" gastric bypass (the most common version, with Roux limb up to 150 cm length) is significantly less than that of the biliopancreatic diversion (BPD) operation. Biliopancreatic diversion is another combined restrictive and malabsorptive surgery, but the restriction is less, and the malabsorption is much more than proximal gastric bypass. So, in general, biliopancreatic diversion (BPD) is considered to be primarily malabsorptive. Jejuno-ileal bypass is a purely malabsorptive procedure that has been abandoned.

Mastopexy: Same as "Breast lift".

Midband Band: A type of adjustable gastric band that is manufactured by the French company, Médical Innovation Développement, Limonest, France. It was designed with the advice and guidance of Dr. Vincent Frering of Lyon, France. The Midband is not available in USA.

Minimally Invasive Surgery: See "Laparoscopic Surgery"

MiniMizer Band: A type of adjustable gastric band that is manufactured by HospiMedical GmbH, Switzerland. The MiniMizer Regular gastric band has no retaining loops. Therefore, gastro-gastric sutures are required. The MiniMizer Extra has retaining loops that are designed to be sutured to the stomach wall itself, rather than placing gastro-gastric sutures. Both types incorporate a 2-phase closure mechanism. The HospiMedical MiniMizer bands are not available in USA.

Morbid Obesity: The old definition used to be: having 100 pounds above the "Ideal Body Weight". This definition excluded many patients as it does not take the height into consideration. A more widely accepted definition is: having a body mass index (BMI) of 40 or above (also known as Obesity Class III). It is described as "morbid" because of the higher likelihood of having comorbidities.

Obese: Having a Body Mass Index (BMI) of 30 or above. Obesity Class I from 30 to less than 35; Class II from 35 to less than 40; Class III from 40 and above

Obstructive Sleep Apnea: See "Sleep Apnea"

Obstructive Sleep Hypo-pnea: Same as Sleep Apnea. See: "Sleep Apnea"

Oesophagogastroduodenoscopy (OGD) same as "Esophagogastroduodenoscopy"

OGD Oesophagogastroduodenoscopy same as EGD see "Esophagogastroduodenoscopy"

Overweight: Having a Body Mass Index (BMI) of 25 to less than 30.

Panniculectomy: A plastic (cosmetic, aesthetic) surgical procedure that involves excising the "panniculus", which is the excess hanging skin that is present below the belly-button. Panniculectomy is not a type of "Weight Loss Surgery" as defined by the surgical community.

Peptide YY (PYY): One of the gut hormones. It is 36 amino acids in length, naturally produced by specialized endocrine cells (L-cells) in the gut in proportion to the calorie content of a meal. PYY is located in enteroendocrine cells of the ileum and colon and nerves of the enteric nervous system. It modulates appetite circuits in the hypothalamus and, therefore, reduces appetite and food intake.

Peptide YY3–36: See Peptide YY (PYY)

Pouch: See "Gastric Pouch"

PYY: See Peptide YY

REALIZE Adjustable Gastric Band: See also Swedish Adjustable Band. This is one of two adjustable gastric bands that are approved by the FDA for marketing in the United States. Realize is produced by Ethicon Endo-Surgery, Inc. (a subsidiary of Johnson & Johnson). Compared to Lap-Band®, the most important difference according to the official website is the Realize mySuccess™ program, which is implemented to answer questions, listen to concerns, and provide support.

Restrictive Surgery: A type of bariatric surgery that induces weight loss by making only a small portion of the stomach (the pouch or, in the case of sleeve gastrectomy, a tube) available to receive food from the esophagus. Typical examples of pure restrictive operations are: Adjustable Gastric Banding, Sleeve Gastrectomy, Vertical Banded Gastroplasty (VBG). The Intragastric Balloon is not a surgical procedure, although it also produces restriction.

Roux-en-Y: A way of surgically dividing and re-arranging the intestine in a Y-shaped configuration, rather than the linear configuration. The three limbs of the Y configuration are: the "biliopancreatic limb", the "alimentary limb" and the "common channel". It was first described by the Swiss surgeon César Roux (1857-1934), as a means to bypass gastric outlet obstruction. The same concept or configuration has been employed to reconstruct the intestine as part of the bariatric surgical procedure "gastric bypass". Hence the name :"Roux-en-Y Gastric Bypass"

Roux limb: See "Alimentary limb"

Satiety: The dictionary definitions vary. The definition that I prefer is "feeling satisfied", and I use this as a different term than feeling "full"

Sleep Apnea: A medical condition that causes patients to stop breathing or to have very poor respiratory ventilation during deep sleep. The "obstructive" type of sleep apnea is one of the typical comorbidities that may be associated with obesity. It has been reported that obstructive sleep apnea was resolved in 85.7% of patients after bariatric surgery, and was resolved or improved in 83.6% of patients.

Sleeve Gastrectomy: Also called Vertical Sleeve Gastrectomy. A type of weight loss surgery that produces weight loss because of limiting how uch can be eaten (see "Restrictive Surgery"). There is evidence that it may do more than restriction. By removing the fundus of the stomach, the main source of Ghrelin is removed. So, there may be also a benefit related to a hormonal effect. It is generally performed laparoscopically. The surgeon removes approximately 60 % of the stomach so that the stomach takes the shape of a tube or "sleeve." Classically, this operation is performed on superobese or high risk patients as a first-stage procedure, with the intention of performing gastric bypass or duodenal switch later on. There is growing trend to consider this surgery as a stand-alone operation. So far, long-term (≥ 5 yr) weight loss and comorbidity resolution data for sleeve gastrectomy are not available.

Small Bowel: Same as "Small Intestine". See "Small Intestine"

Small Intestine: The part of the gut (gastro-intestinal tract) that starts from the end of the stomach, and ends with the start of the large intestine. Its parts are: Duodenum, Jejunum, and Ileum in that order.

Soft Gastric Band®: See "A.M.I. Soft Gastric Band"

Stapling: See "Stomach Stapling"

Stoma: In the narrow context of bariatric surgery, it is the opening between two connected hollow structures. Typically, used to describe the opening (mouth) between a pouch and the rest of the stomach (after placing an Adjustable Gastric Band) or between a pouch and the intestine (for example, after a Gastric Bypass). The origin if Greek (stoma = mouth).

Stomach Stapling: See "Gastric Stapling"

Swedish Adjustable Band: An adjustable gastric band that is manufactured by Obtech Medical AG of Switzerland (not Sweden!) It was invented by Professor Dag Hallberg, from Sweden, in 1984. Although the patent was awarded in 1985 in Sweden , Denmark and Norway, the product was manufactured in Switzerland. On September 28, 2007, Ethicon Endo-Surgery, Inc. (a subsidiary of Johnson & Johnson) announced that the U.S. Food and Drug Administration (FDA) approved for marketing their product, the REALIZE™ Adjustable Gastric Band. The REALIZE™ Band, has been marketed under the name Swedish Adjustable Gastric Band (SAGB) outside the U.S., and has been commercially available outside the U.S. since 1996. It is probably the most commonly used band in the UK, Scandinavia and Mexico.

Upper Endoscopy Same as "Esophagogastroduodenoscopy"

Vertical Banded Gastroplasty (VBG): The procedure includes warding off a small portion of the top-most part of the stomach (called the pouch) from the rest of the stomach, using surgical staplers. The pouch opens to the rest of the stomach via a very small opening (ostium)that is surrounded with a band, to prevent dilation of the ostium. Before the era of the adjustable gastric bands, VBG was the most common restrictive operation for surgical weight loss.

Vertical Sleeve Gastrectomy: See "Sleeve Gastrectomy"

Weight Loss Surgery: Also called "Bariatric Surgery". A discipline of surgery on the alimentary tract, that includes surgical procedures that lead to weight loss. Generally, the procedures produce restriction of the ability to eat, malabsorption of nutrient, or a combination of those two mechanisms. Plastic surgery procedures (including liposuction and the different "lift" surgeries) are not considered types of "weight loss (=bariatric) surgery" by definition. Bariatric surgery is considered a long-term therapy for morbid or severe obesity. It is not considered a cosmetic surgery.

(This Bariatric Surgery Glossary is a work-in progress with on-going updates. First prepared by Hanafy M. Hanafy, MD on October 11, 2007. Last updated on October 04, 2012)