Question

All of the following are primary restrictive operations for morbid obesity, except:

• A. Vertical banded gastroplasty
• B. Duodenal switch operation
• C. Roux-en-Y gastric bypass
• D. Laparoscopic adjustable gastric banding

Hint:

Which listed operation works mainly by bypassing small bowel rather than shrinking the stomach?

Answer 1

The Correct Option is B

Sort each operation by how it produces weight loss. Restriction means making the stomach hold less food; malabsorption means rerouting bowel so fewer calories are taken up. Vertical banded gastroplasty staples off a tiny upper pouch and is therefore restrictive. The adjustable gastric band squeezes the top of the stomach with a silicone ring and is also purely restrictive. The Roux-en-Y bypass relies mainly on its very small pouch to limit intake, so it behaves restrictively in this list. The duodenal switch is different in kind: it adds a long biliopancreatic limb that diverts bile and pancreatic juice away from most of the small intestine, so the dominant mechanism is malabsorption. Because the question asks which one is not a primary restrictive procedure, the duodenal switch is the answer.\[\boxed{\text{Duodenal switch operation}}\]