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Bariatic Surgery

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Bariatic surgery or weight-loss surgery is a way to help one lose weight by making changes in the digestive system. These changes limit the amount of food one eats or the way the body absorbs nutrients. There are many types of weight-loss surgeries, that are together known as bariatic surgery. The surgery is only carried out when the patient is suffering from morbid obesity that is not cured with diet and exercise.

What is Bariatic Surgery?

Bariatic surgery, metabolic surgery or weight-loss surgery is used to treat people who have excessive body fat or potentially life-threatening obesity. There are different types of surgeries used to reduce body weight.

Who Are Eligible for Bariatic Surgery?

People with the following options are eligible for bariatic surgery.

  • Body mass index (BMI) is 40 or higher (morbid obesity)
  • BMI of 35 to 39.5 with serious weight-related health issues like type 2 diabetes, high BP, severe sleep apnea, etc.
  • In some cases, with serious health issues, people with BMI 30 to 34 are also eligible.

Everyone who is severely obeseare not eligible for bariatic surgery. A stringent screening process is carried out to qualify one for bariatic surgery. After the surgery is complete, one has to live a healthier lifestyle and monitor their nutrition intake.

Also, it’s an expensive surgery, thus, one needs to make sure if their insurance covers it.

Are There Any Risks Involved with Bariatric Surgery?

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Bariatic surgery is a major invasive surgery. It poses a lot of health risks, both short term and long term. These risks include:

  • Excessive bleeding during the surgery
  • Infection
  • Blood clots
  • Lung problems or breathing difficulties
  • Leaks in the gastrointestinal system
  • Reaction to anesthesia
  • Death, in rare cases

After the surgery, one can develop complications that include:

  • Gallstones
  • Hernias
  • Malnutrition
  • Hypoglycemia
  • Ulcers
  • Dumping syndrome that leads to vomiting, diarrhea
  • Stomach perforation
  • Hypoglycemia
  • Death, in rare cases

Types of Bariatric Surgery

There are different types of bariatic surgeries that have different uses and effects. It is a very difficult task to choose which surgery will be the best for a particular patient. The most common bariatic procedures performed include:

  • Adjustable Gastric Banding
  • Sleeve Gastrectomy
  • Roux en-Y Gastric Bypass
  • Biliopancreatic Diversion with Duodenal Switch

Different  Methods for Bariatic Surgery

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The above types of bariatic surgeries can be performed by different methods. These surgeries can be:

  • Open surgery
  • Laparoscopic surgery

Depending on the type of lifestyle changes you may have to undergo after the surgery, the surgeries are described as:

  • Malabsorbtive – The digestion is altered by rerouting the intestines causing food to be properly digested, but incompletely absorbed.
  • Restrictvie – The surgery causes decrease in food intake by the creation of a small upper stomach pouch, that limits the food intake.

What Happens During the Surgery?

The process is carried out under general anesthesia. Thus, one remains unconscious throughout the surgery. The surgery can be carried by the traditional open method or laparoscopic method. However, laparoscopic surgeries are more common today than the open surgery.

The surgery takes several hours to be complete. After the surgery the patient is wheeled into the recovery room and monitored for vital signs.

Bariatic surgery is done according to the type of surgery as follows:

Vertical banded gastroplasty

Also called as stomach stapling, in this procedure the stomach is divided into two parts.The upper pounch and lower pouch. The upper pouch is small  than the lower pouch. It empties into the lower pouch. Thus, when one eats, they feel relatively fuller with small amounts of food. Thus, resulting in weight-loss.

Sleeve gastrectomy

In vertical sleeve gastrectomy, the process involves creating a diversion with duodenal switch. In some cases, the surgery further processes without creating a bilopancreatic diversion. The structure of the stomach changes like a tube. This restricts the amount of calorie intake.

Laparoscopic adjustable gastric banding (LAGB)

An inflatable band is placed on the upper part of the stomach. When the band gets inflated, it compresses the stomach. Thus, it acts like a tightening belt. The small pouch limits the food one eats. The band can be adjusted to restrict more or less food. This is the most common method to carry out weight loss surgeries.

Bilopancreatic diversion with duodenal switch

The switch is carried out only for people with BMI more than 50.This is a complex procedure where 80% of the stomach is removed. The pyloric valve remains along with the small part of small intestine that connects with the stomach. Majority of the intestine is bypassed in the procedure. Thus, it helps limit the amount one eats and absorbs nutrients. However, it can lead to malnutrition and vitamin deficiencies.

Roux-en-Y

The most common of all gastric bypass surgeries. This is more or less an irreversible procedure. It decreases the amount of food one eats at a time and reduces the absorption of nutrients. The stomach is cut across at the top and sealed. It now looks ike a walnut sized pouch. It can hold about an ounce of food. Then, the small intestine is cut and sewn to the pouch. Thus, the food directly enters the middle part of the small intestine.

What Happens after the Surgery?

After the surgery, one can achieve long-term weight loss. The amount of weight loss that occurs depends on individuals and their lifestyle habits. Apart from weight loss, other health problems like GERD, cardiovascular problems, diabetes, blood pressure, etc. get rsolved or under control.

Bariatic surgery is not a quick fix solution for obesity. Instead, it is a long process to control the weight, wherein the patients determination plays  role. Speak to your doctor regarding bariatic surgery and the pros and cons of each surgery. Think a lot before you decide about bariatic surgery.

Written by: Saptakee sengupta
Date last updated: March 29, 2015