it's a restrictive procedure and it consists the formation of what’s called a virtual pouch this is a actual pouch and this is a virtual pouch in the sense that it's not divided ok okay and made Nitro Shred separate but its partitioned by this band that is adjustable and can narrow the opening through which the food go through okay we'll talk more about that okay so the rule I gastric bypass again it's a combination restriction andmalabsorption it's the most frequently performed bariatric procedure in the US about fifty percent and procedures are done a with the bypass for laparoscopic ally since you get very significant weight loss arm .
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