Bariatric Surgery

Bariatric Surgery

What is Bariatric Surgery?

Extreme and severe obesity is frequently not efficiently treated with diet and exercise alone. A procedure called bariatric surgery is done to assist these people in losing weight. Bariatric surgery may reduce mortality rates for people with extreme obesity, according to evidence, particularly if it is combined with post-operative lifestyle and nutrition modifications.

Principles of bariatric surgery

The fundamental idea behind bariatric surgery is to limit food consumption and reduce the amount of food that is absorbed in the intestines and stomach.

Food is first broken down in the mouth, where it is combined with saliva and other fluids that contain enzymes. The meal is subsequently broken down and combined with digestive fluids in the stomach to allow for the absorption of calories and nutrients. Food next passes into the duodenum, the first segment of the small intestine, where it is combined with pancreatic juice and bile, speeding up digestion.

By changing or stopping this digestive process, bariatric surgery aims to prevent food from being absorbed and broken down normally. Losing weight and lowering the risk of obesity-related health hazards or illnesses are made possible by reducing the number of calories and nutrients consumed.

Body mass index (BMI)

The body mass index (BMI), which is a measurement of height in proportion to weight, is used to identify obesity levels and assess if bariatric surgery is necessary. A body mass index (BMI) of 40 kg/m2 or greater than 35 kg/m2 combined with serious health issues is considered clinically severe obesity.

Heart disease, severe obstructive sleep apnea, arthritis, and type 2 diabetes are among the health issues linked to obesity. Patients who have a BMI of 30 kg/m2 or more with at least one of these diseases are eligible to undergo adjustable gastric banding, according to FDA approval.

Types of Bariatric Surgery

It is possible to undertake many kinds of bariatric operations. An "open" method to surgery entails cutting the belly open, whereas a laparoscopy involves making tiny, half-inch incisions in the abdomen to guide surgical equipment into the abdomen. 

Nowadays, laparoscopic bariatric surgery is the most common type since it needs fewer large incisions, results in less tissue damage, has fewer post-operative problems, and enables earlier hospital departure than open surgery.

Four types of operations are offered:

• AGB, or adjustable gastric banding
• RYGB, or Roux-en-Y gastric bypass
• BPD-DS, or biliopancreatic diversion with a duodenal switch
• Gastrectomy with vertical sleeves (VSG)

Diagram of Surgical Options. Image credit: Walter Pories, M.D. FACS.

Each surgical type has pros and cons, and a variety of patient criteria, including BMI, eating habits, obesity-related health issues, and prior stomach surgery history, influence the technique that is selected. After weighing the advantages and disadvantages of each surgical procedure, the patient and provider should decide on the best course of action.

Surgical and post-operative risks

In order to minimize problems and weight gain following bariatric surgery, patients must follow a strict, lifetime diet and exercise regimen. Patients may also acquire extra loose and folded skin, which will need to be tightened and removed by further surgery.

The dangers of bariatric surgery are the same as those of any other operation, and they include infections, pulmonary embolism (blood clot in the lungs), internal bleeding, and deep vein thrombosis. It is believed that there is a 1 in 200 chance of dying soon after bariatric surgery.

Reference:

https://www.nature.com/subjects/bariatric-surgery