Bariatric surgery is an umbrella term used to define a variety of surgical weight loss procedures that are performed to treat excessive obesity.
How Bariatric Surgery works?
Bariatric (weight-loss) surgeries are performed using either of the two procedural methods:
- Restrictive method
- Malabsorptive method
Restrictive Bariatric surgery
In predominantly restrictive bariatric surgery the aim is to reduce the oral intake of food by restricting the volume of the stomach, this causes hunger to be satisfied sooner, and allows the normal passage of the food through the alimentary canal.
Examples of restrictive bariatric surgeries are:
- Vertical banded gastroplasty
- Adjustable gastric band
- Sleeve gastrectomy
- Intra-gastric balloon surgery
- Gastric Plication
Malabsorptive Bariatric Surgery
In predominantly malabsorptive type of bariatric surgery the aim of the procedure is to reduce the size of the stomach, this result in less absorption of nutrition from the food and in turn creates a psychological condition of malabsorption.
Examples of malabsorptive bariatric surgeries are:
- Biliopancreatic Diversion surgery
- Jejunoileal Bypass surgery
- Endoluminal Sleeve surgery
Mixed Bariatric surgery
Mixed bariatric surgical procedures are those weight-loss surgical procedures which involve aspects of, the restrictive and malabsorptive, procedural approaches.
Examples of mixed bariatric surgeries are:
- Gastric Bypass surgery
- Sleeve Gastrectomy with Duodenal Switch
- Implantable Gastric Stimulation
Bariatric Surgery procedures
There are various types of different methods used for bariatric surgeries, such as:
Biliopancreatic Diversion – This is one of the more complex weight loss procedures and is also known as the Scopinaro Procedure. This surgery is combined with a duodenal switch (BPD/DS) procedure.
This surgery requires resecting (removing) a major portion of the stomach and create a smaller gastric pouch, then the lower part of the small intestine is connected to the new gastric pouch in such a way that the jejunum and the duodenum is bypassed completely.
Jejunoileal Bypass – This is an older procedure and was performed by removing the small bowel by cutting it and shortening it to around 12-18 inches in order to treat morbid obesity.
Vertical Banded Gastroplasty – Also known as the ‘Mason Procedure’ or ‘Stomach Stapling’, this surgical method aims to decrease the volume of the stomach through surgically stapling it to create a smaller pouch near the upper end. This smaller pre-stomach pouch acts as the new stomach.
Adjustable Gastric Band – The stomach can also be restricted by using silicone band implants that can be adjusted into different circumference by injecting it with, or removing from it, a saline solution from outside. This is also a minimally invasive procedure that is performed using a laparoscope.
This surgery is also known as a ‘lap band procedure’ and the weight loss takes place due to decreased food intake due to the smaller gastric (stomach) pouch. This is one of the safest bariatric procedures and is reversible as well.
Sleeve Gastrectomy – This is also known as ‘gastric sleeve surgery’ and works by reducing the complete stomach to around 15% of its original size. This is done by surgically removing around 80-85% of the gastric region. The remaining stomach is stitched together using sutures, surgical staple or both along the major curve thus leaving the stomach similar to a tube with a banana shape.
This is a permanent procedure to decrease the size of the stomach.
Gastric Balloon – Also known as intra-gastric balloon weight-loss surgery this procedure involves using a laparoscope to insert a deflated surgical balloon through the esophagus (food pipe) down into the stomach. The gastric balloon is then filled with a sterile colored saline solution so that is occupies a significant amount of space in the stomach. The gastric balloon is usually implanted for maximum 6 months and this result in a decrease of an average 5-9 BMI during this period.
This surgery is also performed before another bariatric surgery to help the morbidly obese patients to lose weight to surgery-suitable levels.
Gastric Plication – This is a surgical procedure similar to a gastrectomy or a gastric sleeve procedure where a banana-shaped sleeve is created of the stomach by stitching it smaller but not removing the remaining portion of the stomach to retain the nutrient absorption capabilities. This gastric plication surgery reduces the size of the stomach significantly so it gets full with a less amount of food.
Gastric Bypass surgery – The most common form of a gastric bypass surgery is the ‘Roux-en-Y’ gastric bypass. This surgery involves making the stomach smaller in size by stapling a major portion out and connecting it to the lower small intestine. The upper end of the small intestine is then reconnected in a ‘Y-shape’.
Sleeve Gastrectomy with Duodenal switch – This is a combination of the biliopancreatic diversion with a duodenal switch procedure. The surgery starts with the surgeon removing majority portion of the stomach along the outer curve and made into a sleeve shape. This reduces the volume of the stomach and restricts the amount of food intake and is an irreversible procedure. The surgeon will then disconnect the duodenal connection and attach it to the lower part of the small intestine. The upper portion of the small intestine and the duodenum are reconnected near the colon.
Who is a candidate for Bariatric Surgery?
Bariatric surgery is a very efficient surgical method that assists in weight loss in an obese person. This helps by removing excess weight as well as reducing the risk of dangerous weight-related disorders such as:
- Heart disease
- High Blood Pressure
- Severe Sleep Apnea
- Type 2 Diabetes
- Gastro-esophageal reflux disease
A Bariatric surgery is ideally suggested only after other alternate and non-surgical methods of weight loss have been unsuccessful.
This surgery is ideal for you if:
- You have a BMI (Body Mass Index) of 40 and more (extreme obesity)
- You have a BMI between 30 and 40 and suffer from serious obesity complications such as type 2 diabetes, severe sleep apnea and high blood pressure.
The doctor will take into consideration your overall health and medical history as well before determining the effectiveness of a bariatric surgery in helping to lose weight in your individual case.
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Benefits of Bariatric Surgery
Research has shown that the malabsorptive methods are more effective in weight loss within a short period of time they also carry more risk of complications.
These surgeries are however effective in providing long-term loss in weight and the amount of weight loss depends on the type of surgery as well as your lifestyle. Many cases show a weight loss of half, or more, of loss in total weight.
Bariatric surgery may also help in reducing the symptoms of other weight-related complications, such as:
- Type 2 Diabetes
- Severe Sleep Apnea
- High Blood Pressure
- Heart Disease
- Gastro-esophageal reflux disease.
Bariatric surgery helps you in losing weight and ultimately improves your performance of daily activities and results in boosting your quality of life.
Possible Complications of Bariatric Surgery
There are certain common complications that may arise after a bariatric surgery as is seen with most major surgical procedures.
These are some risks seen in few cases after a bariatric surgery:
- Gastro-intestinal leakage
- Pulmonary (breathing) problems
- Blood clots
- Anesthetic reaction
- Excessive bleeding (hemorrhage)
There are certain long term risks that may be seen in rare cases, such as:
- Dumping syndrome (diarrhea accompanied by nausea and vomiting)
- Bowel obstruction
- Hypoglycemia (low blood sugar level)
- Stomach perforation
Why people choose to get Bariatric Surgery in Goa?
Goa, besides being a popular winter vacation destination, is also known for its number of world-class hospitals and clinics that are efficient in managing all types of bariatric surgeries. These hospitals and clinics are equipped with the latest surgical technology and instruments. The bariatric specialists and surgeons are well-experienced and extensively trained in managing gastric surgery in the most effective way. The bariatric surgery in Goa is performed with global-standards of quality at the lowest and most affordable price in India.