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Nuances of Bariatric Surgery

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Nuances of Bariatric Surgery

Gastro Sciences | by CMRI | Published on 10/04/2020

Bariatric surgery or more commonly referred to as weight-loss surgery is a metabolic surgical method that involves making changes to the digestive system to reduce overall body fat. These types of surgeries also include gastric bypass surgery. General bariatric surgery helps a person lose 50% of the excess weight during the first 6 months. The surgery makes the stomach smaller and limits the amount of food one can eat at one time by making you feel fuller earlier. More so, the surgery may involve changes in the small intestine so that there is limited absorption of calories and nutrients form food and beverages. Bariatric surgery may include one of these techniques or could include both, depending on case to case.


Bariatric surgery is recommended medically in cases where a person is unable to lose weight through diet and exercise, and the excessive weight has been causing increasing health problems such as high blood pressure, heart issues, Gastroesophageal reflux disease, severe sleep apnea, diabetes, stroke, etc. However, today bariatric surgery has become very common since it is medically very safe and often provides effective results.


Types of Bariatric Surgery


There are multiple types of bariatric surgery which vary per the effectiveness and speed of the result, as well as the medical condition of the person. Some of the basic types of bariatric surgery include:


Roux-en-Y: In this type of surgery, the doctor cuts off the top of the stomach and seals it to form a small pouch that has a very limited capacity to hold food. The doctor also removes the small intestine and directly attached the mechanism to the newly-formed pouch. This is one of the most common and also irreversible forms of bariatric surgery. This method enables a person to intake limited food and also restricts the absorption of nutrients and calories from food.


Biliopancreatic Diversion with Duodenal Switch: This form of surgery is a complex form of Roux-en-Y in which the surgeon cuts away most of the stomach (80% of it) and attaches the remaining part with the last portion of the small intestines, completely bypassing the first two portions. This surgical form is recommended for patients with a BMI of more than 50 since it limits the intake of food, as well as the absorption of nutrients from food. This is a very complicated and also a very risky procedure.


Laparoscopic adjustable gastric banding (LAGB): In this type of bariatric surgery, the surgeon places an inflatable band around the top portion of the stomach, which is inflated to compress the stomach separating it into two parts. One part is a very tiny pouch that communicates with the rest of the stomach through a passage created by the band. A LABG limits the amount of food consumption, depending on the capacity of the new pouch. However, the band is adjustable and that makes this the most preferred form of bariatric surgery. Though results of this procedure may be less effective in comparison to other methods, since the band might lose its grip over time and would require adjustments.


Sleeve Gastrectomy: In this form of bariatric surgery, the surgeon changes the overall structure of the stomach to represent that of a tube that restricts the absorption of calories and nutrients from food intake.


Risks of a Bariatric Surgery


Though safe, bariatric surgery can cause several short and long-term complications.


Short-term risks such as below:


  • Excessive bleeding
  • Infection
  • Reaction to anesthesia
  • Blood clots in legs transfer to the heart and lungs
  • Breathlessness
  • Lung diseases
  • Gastrointestinal system leak
  •  Body pain
  •  Peeling and dry skin
  • Excessive hair loss


Lon-term risks such as below:


  • Bowel impediment
  • Diarrhoea
  • Consistent nausea
  • Vomiting
  • Strictures
  •  Hernias
  • Gallstones
  • Low blood glucose
  • Malnutrition
  • Digestive problems
  • Ulcers
  • Intestinal issues
  • Punctured stomach    


In addition to these, some other risks that might incur after bariatric surgery include (but are not limited to):


  •    Pouch stretching to its original size over time
  •    Falling apart of staples
  •    Extreme nutritional deficiencies
  •    Stoma stenosis


Results of Bariatric Surgery


Overall, bariatric surgery can aid in effective and long-term weight loss but the amount of weight lost depends on the type of procedure, the adherence to precautions, and adaptation of lifestyle modifications, as well as on the overall health factors. Generally, bariatric surgery helps to shed half of the excess weight over two years.


On the other hand, bariatric surgery can help manage various health conditions such as:


  •    Diabetes
  •    Heart problems
  •    High blood pressure
  •    Severe sleep apnea
  •    Acid reflux disease


It also improves overall life quality by making one more active and efficient. It also helps to cure people of depression caused because of excessive fat or obesity.


Overall, bariatric surgery is highly effective and also very much in demand in countries such as India where more than 140 million people are suffering from weight issues such as obesity. If proper care is taken and precautions are followed, bariatric surgery has more advantages than disadvantages.