Bariatric Surgery

Bariatric surgical methods usually cause much weight loss by limiting the average quantity of food the stomach can contain, leading to malabsorption of nutrients, or by joining together both gastric restriction and malabsorption. Bariatric procedures also often cause hormonal changes. Majority of weight loss surgeries done today are performed with the use of minimally invasive techniques (laparoscopic surgery).

At the moment, the most prevalent bariatric surgery procedures are the gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch. And each of all this surgery process has advantages and disadvantages which are attributed to them.

The weight loss surgery assists typically individuals suffering from obesity and who wants to reduce their excessive weight. It may be an alternative if you cannot lose weight through diet and yoga or have serious health problems that occur as a result of obesity.

What are the main procedures available for bariatric surgery?

1. Gastric Bypass Surgery

Gastric bypass surgery is done in order to reduce the size of the stomach; this will reduce the amount of food you eat. During this procedure, the surgeon will also re-route, or bypass, part of your digestive system thereby reducing that quantity of food you consume. Some types of gastric bypass surgery are explained below:

i. Roux-en-Y gastric bypass: This type of gastric bypass surgery is regarded as the most common surgery performed in the United State. This can be done by making a small cut, shown to have a faster recovery time than more complicated surgery.

In the beginning, the surgeon creates a small stomach pouch by joining part of the stomach together or by vertical banding. This process reduces the amount of food you can eat. After which the surgeon will attach a Y-shaped section of the small intestine to the pouch. This creates a bypass for food which skips part of your digestive system. As a result of this, fewer calories and nutrients will be absorbed.

ii. Extensive gastric bypass (biliopancreatic diversion): This type of bariatric surgery is a more complicated type of gastric bypass. During this procedure, the surgeon removes the lower part of the stomach. Then he will connect the small pouch that remains directly to the last part of the small intestine, this completely bypasses the first two parts. It works effectively for weight loss, but it's not widely used due to the fact that it has a great complication rate and can reduce the number of nutrients you absorb.

What are the risks of Gastric Bypass Surgery?

Individuals who undergo gastric bypass surgery are at risk for:

  • Pouch stretching. As time goes on, the stomach gets bigger, thereby stretching back to its initial size.
  • A collapse of staple lines. The staples fall apart.
  • Nutritional, vitamin, and mineral deficiencies. The body will absorb fewer nutrients from food.
  • Stomal stenosis. A narrowing form at the connection of the stomach and small intestine results in nausea, vomiting, reflux, and then it will be difficult to eat. In this situation, there will be a need for dilation.

Gastric bypass surgery can also lead to "dumping syndrome." Whenever these happen, the food we take moves too quickly from the stomach down to the small intestine. The symptoms may include nausea, weakness, sweating, fainting, and, occasionally, diarrhea after eating, as well as becoming extremely weak after eating sweets. When weight loss is rapid, the individual can get gallstones. In the event that this occurs your doctor can give you drugs which will help to dissolve the gallstones. Because these surgeries can alter the way your body handles food, it is necessary to get in touch with your doctor so that you can discuss with him about ensuring that you get all the needed nutrients.

What are the benefits of the gastric bypass surgery?

In gastric bypass surgery, weight loss tends to be more fast and dramatic than other weight loss procedures. If you are looking to get a weight loss surgery that will offer you the best chance of losing the most weight, then gastric bypass surgery might be the best option for you.

Generally, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose approximately 60 percent, and gastric banding patients will lose about 50 percent. However, the amount of weight lost by each patient will vary depending on their circumstances.

After gastric bypass, it is likely you feel dramatically better with rapid improvements in conditions which have been shown to affect obesity such as diabetes and hypertension, high cholesterol, asthma, arthritis, sleep apnea, and heartburn. When you weigh less, it will be easy for you to move around and to your daily activities, which helps in boosting your quality of life.

Gastric bypass provides excellent long-term results, and a lot of individuals have the ability to keep most of the weight off.

2. Gastric Band Surgery

What Is gastric banding Surgery?

In this procedure, the surgeon makes use of laparoscopy (which involves small cuts in the belly) to insert an adjustable silicone band around the upper part of the stomach. The stomach is squeezed by the silicone band, and it becomes a pouch with about an inch-wide outlet. After banding, the stomach has the ability to hold only about an ounce of food.

During the surgery, plastic tube which passes through the silicone band to a device just underneath the skin. Saline (sterile salt water) can be injected or eliminated via the skin, which will flow into or out of the silicone band. The band will be filled by injecting saline and makes it tighter. In this way, the band can be tightened or loosened as needed in order to reduce the side effects and improve weight loss.

What are the results of gastric banding?

If you undergo gastric banding, you will lose about 35% to 45% of excess weight. For instance, an individual who is 100 pounds overweight may expect to lose about 35 to 45 pounds after gastric banding. However, there is different in these results as it varies widely. Gastric banding is regarded to be the least invasive weight loss surgery and also the safest. Gastric banding procedure can be reversed if necessary, and in time, the stomach generally returns to its standard size.

What Are the Side Effects of gastric banding?

Few problems are likely to happen as a result of gastric banding surgery. There is a lower risk of death in gastric banding surgery and it is less than one in 3,000. The most prevalent problems after gastric banding surgery include:

  • Nausea and vomiting. These can usually be reduced by making an adjustment to the tightness of the band.
  • Minor surgical complications. These are problems that are attributed to the adjustment device, wound infections, or minor bleeding, and they occur less than 10% of the time.

Unlike gastric bypass surgery, gastric banding does not impact the rate at which food is absorbed. For this reason, vitamin deficiencies are less common after gastric banding.

What are the benefits of the gastric band?

  • Gastric band reduce the quantity of food the stomach can hold
  • Gastric band induce excess weight loss of about 40 – 50 percent
  • A gastric band does not involve cutting of the stomach or rerouting of the intestines
  • It requires a shorter stay at the hospital, usually less than 24 hours, with some centers releasing their patient the same day as surgery
  • A gastric band is reversible and adjustable
  • Gastric band has the lowest rate of early postoperative complications and mortality among the approved bariatric procedures
  • Gastric band has the lowest risk for vitamin/mineral deficiencies

3. Sleeve Gastrectomy

The Sleeve gastrectomy is a common surgical method which will influences weight loss by decreasing the normal food intake. With this method, which is often done laparoscopically, the surgeon removes around 75 percent of the stomach.  This results in the stomach taking on the shape of a tube or "sleeve" which holds less food.  Though it is originally devised as the initial stage of a two-stage procedure for superobese or high-risk patients, the sleeve gastrectomy is presently known widely and successfully used as a destination procedure for weight loss in individuals who have a body mass index that is greater than 40.

With records, the reported weight loss for this procedure ranges from 60% of the excess weight; better results are achieved with good adherence to dietary and behavioral procedures.  With healthy food choices, regular exercise and good eating habits, patients who have had a sleeve gastrectomy will enjoy and maintain good weight loss.

Why it's done                                      

Sleeve gastrectomy has been put to practice in order to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including:

  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Stroke
  • Infertility

Sleeve gastrectomy can be only done only after you've tried to lose weight by improving your diet and exercise habits.

What are the Benefits of Sleeve Gastrectomy?

Sleeve gastrectomy stimulates rapid and effective weight loss compared to gastric bypass surgery. The patient has the expectation to lose 50% or more of their excess weight for the next three years. In this procedure, it does not involve the implantation of a band, nor does it re-route the digestive process. Changes in hormone after the procedure assist the patients to feel sated, eat less, as well as improve or resolve diabetes.

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