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Most people have heard of a gastric bypass – more usually called “stomach stapling” – but few are aware that there are actually two types of bypass surgery, rather than one. The standard bypass (also called Roux-en-Y) was developed in the US by Dr Edward Mason. in the 1960’s and remained the “gold-standard” procedure for decades. But in recent years, a new operation, called the mini-gastric bypass (MGB), has dramatically increased in popularity. It was developed by Dr Robert Rutledge in the late 1990’s and today it is rapidly becoming the preferred option by many bariatric surgeons. But why is...

It is widely believed that the gastric band works by creating a feeling of fullness (satiety) in the recipient. This feeling is believed to be due to stimulation of the vagus nerve which carries information from the body’s organs – including the stomach, pancreas and liver – to the brain. In the gastric band patient, food ingested into the stomach above the band (pouch) results in stimulation of special branches of the vagus nerve (vagal afferents) which then transmit a satiety response to the appetite centre in the brain. This results in reduced food intake and weight loss. However, until...