The Fobi technique is performed in exactly the same manner as our laparoscopic Roux-en-Y gastric bypass except for the addition of a nonadjustable silastic ring that is placed just above the connection between the new stomach pouch and the Roux-en-y limb of the small bowel.
One of the concerns about gastric bypass surgery has been the potential for weight regain as years go by. One of the mechanisms that may be responsible for weight regain is the stretching of the connection between the pouch and the small bowel. If this opening stretches over time the potential for allowing more food to be eaten increases and the feeling of fullness may be decreased. The purpose of Dr. Fobi's band is to stabilize the diameter of the opening that leads out of the stomach pouch and to prevent its stretching. The band is made from a silastic material and is placed around the pouch and secured in a very loose fashion. The purpose of the band is not to increase weight loss but rather to prevent long-term weight regain. Because the band is made out of an artificial material, it has a risk of erosion into the stomach pouch. The risk of this erosion is thought to be approximately 1.89% however new studies are yielding a lower percentage. When erosion occurs the results can be varied. It is possible that the erosion may go unnoticed entirely and the band will pass through the gastrointestinal tract without incident. On other occasions the band may cause discomfort, bleeding, or other gastrointestinal distress and may require removal. In some cases the removal can be performed endoscopically, in other cases a second operation may be required. There is statistical evidence suggesting that the band can prevent weight regain significantly. The option of adding the silastic band is in most cases entirely up to the patient.
