Bariatric Surgery (Greek “baros” = weight) is not a new type of surgery, it has been performed for over 50 years. All types of bariatric surgeries are now performed laparoscopically (Key-hole surgery). The type of procedures have also seen a change over this half a decade. Some of the commonly performed procedures are given a brief look below but this list is not inclusive or description complete as it is beyond the scope of this web-site to do so…..
Common weight loss Procedures
- The availability of multiple procedures gives us freedom to choose best suited surgery for a given patient. The principle of any kind of surgery today is to customize the procedure for any given patient.
- All kinds of weight loss surgeries result in complete or partial resolution in various obesity associated diseases like- Diabetes, high blood pressure, high cholesterol, breathing problem, infertility, risk of heart disease, joint pains etc.
The most common procedures now are –
Sleeve Gastrectomy Surgery
Stomach size is reduced by removing excess stomach and leaving behind a sleeve of stomach. It decreases the hunger as well as eating capacity. This reduced intake of food along with rapid movement of food from the stomach leads to weight loss. It also helps is resolving other problems like diabetes, high blood pressure, joint pains etc.
- Major Advantages: No part of bowel is bypasses, so absorption of most nutrients remains adequate. Good for young (as strict follow-up may not be essential after long time) and elderly patients (probably safer in them as compared to bypass procedures).
- Major Disadvantages: Total weight loss may not be as great as with bypass procedures. Resolution of associated diseases like diabetes, high blood pressure etc. may not be as great as with bypass procedures.
Roux-en-Y Gastric Bypass Surgery
Stomach is stapled to create a small pouch which defines the quantity of food that can be consumed at one time after surgery. Small bowel is divided and joined to this stomach pouch. Proximal portion of small intestine is bypassed to prevent food coming in contact with digestive juices. This arrangement further decreases absorption of food. It also helps in resolving other problems like diabetes, high blood pressure, joint pains etc.
- Major Advantages: This surgery is considered as gold-standard bariatric at present time. It results in adequate weight loss which is maintained over long-term and also good resolution of obesity associated diseases like diabetes, high blood pressure etc.
- Major Disadvantages: Is more aggressive surgery than sleeve gastrectomy. Part of bowel is bypassed which can result in vitamin deficiency if vitamin supplements are not taken as per advice of the doctor. It also involves two joints – one between small bowel and another between small bowel and stomach.
Mini Gastric Bypass Surgery
A long tube of stomach is created almost like sleeve gastrectomy (albeit little bigger) and attached to a loop of small bowel. This procedure involves more mal-absorption as compared to other procedures described above. It also helps in resolving other problems like diabetes, high blood pressure, joint pains etc.
- Major Advantages: This procedure involves only one anastomosis as small bowel is not dis-connected anywhere. Patient can eat more food as compared to other procedures above as pouch is bigger.
- Major Disadvantages: Bile (juice secreted by liver) can re-enter stomach pouch and can cause its irritation. As with Roux-en-Y Gastric Bypass, this procedure also involves bypassing part of bowel which can result in vitamin deficiency if patient doesn’t follow advice of doctor properly.
Adjustable Gastric Banding Surgery
A band is inserted at upper part of stomach which is connected to a reservoir. The band can be tightened or loosened by inserting or removing water into the reservoir. The adjustments in tightness of band are done for a few times after surgery so as to achieve adequate weight loss. This procedure also helps in improving other conditions like diabetes, high blood pressure etc. but the effect is less as compared to other procedures.
- Major Advantages: No part of bowel is cut so this procedure is quite safe initially and patient can be discharged same day. It is completely reversible as band can be removed anytime. Weight-loss is adjustable as size of the band can be adjusted by inserting or removing fluid from the reservoir with the help of a simple syringe in OPD by your doctor.
- Major Disadvantages: Weight loss is not as good as with other procedures described above. It involves placement of a foreign device inside your body which can lead to its own complications. Popularity of this surgery has been decreasing over last few years world-wide.
Disclaimer : – Results may vary from person to person
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