People with extreme, excessive obesity will require more than just exercise and diet restrictions. Bariatric surgery is a type of weight reduction surgery that helps individuals lose weight in the case of uncontrolled weight gain and obesity. The operation aims at restricting food intake and minimizes death rates among severely obese patients. It brings about positive lifestyle changes and healthy eating habits after the operation.
As a principle, the surgery decreases food intake and reduces absorption in the intestines. It interrupts the digestive process to alter the breakdown of food nutrients and to reduce the calories that are absorbed to enable patients to decrease weight and obesity-related disorders. Weight-loss surgeries are generally done using minimally invasive or laparoscopic techniques.
Some of the most common and popular bariatric surgeries are:
Sleeve Gastrectomy: The laparoscopic sleeve gastrectomy removes 80% of the stomach leaving behind a tubular pouch that resembles a banana. The new stomach holds only a small volume of food and weight loss is significant and rapid. Positive changes in the gut hormones reduce appetite, hunger and improve satiety. A reduction of 60 to 70% of excess body weight can be expected by this surgery.
Gastric Bypass: Also known as the Roux-en-Y gastric bypass, it is the gold standard of weight loss procedures due to its visible impact. The surgery has two steps - first the top half of the stomach is divided to create a small pouch about one ounce in volume. Next, the small intestine is divided, and the bottom portion is attached to the new stomach. The gastric bypass procedure is well-known for its long-term weight loss with a significant increase in energy expenditure.
Gastric Band surgery An inflatable, adjustable band is tied around the upper portion of the stomach. A small pouch of stomach is created just above the band. A feeling of fullness is derived depending on the size of the opening of into the stomach. The band is adjusted when required by filling it with sterile saline solution injected into it through a port in the skin. This procedure is not very popular due to its complications and need for repeated adjustments of the band. Moreover, this is a temporary procedure andthe patient can gain weight again once the band is removed.
BPD with DS The biliopancreatic diversion with duodenal switch also induces a greater amount of weight loss. The small intestine is divided just above the stomach, and the distal portion is brought up to connect with the new stomach. With this procedure, patients can eat near-normal meals. Fat absorption is reduced by more than 70%.
Bariatric surgery should be performed in a multidisciplinary center as these patients are having an inherenttendency for lung and cardiac complications. The team should be well equipped to manage the potential complications during and after the surgical procedure. Post bariatric surgery, it is important that patients are compliant to follow-up visits and adhere to a strict regimen of supplementations and guidelines as provided by the doctor. We have conducted many high-level bariatric surgeries to dissipate stubborn fat and help individuals re-live their lives with self-esteem.Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)
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