The pouch is attached at one end to the esophagus. At the other end is a very small opening into the small intestine. Food flows though this pouch, bypassing the main portion of the stomach and emptying slowly into the small intestine where it is absorbed. Vertical banded gastroplasty. In this procedure an artificial pouch is created using staples in a different section of the stomach.
Plastic mesh is sutured into part of the pouch to prevent it from dilating.
In both surgeries the food enters the small intestine farther along that it would enter if exiting the stomach normally. This reduces the time available for absorption of nutrients. Now a rarely performed procedure, jejuoileal bypass involves shortening the small intestine. Because of the high occurance of serious complications involving chronic diarrhea and liver disease, it has largely been abandoned for the other, safer procedures Preparation After patients are carefully selected as appropriate for obesity surgery, they receive standard preoperative blood and urine tests and meet with an anesthesiologist to discuss how their health may affect the administration of anesthesia. Pre-surgery counseling is done to help patients anticipate what to expect after the operation.