Bariatric Surgery – To understand

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Bariatric Surgery is the one to fight obesity. It helps to reduce weight. Being a critical decision of life transformation, it becomes even more important to understand the complete process, the post surgery conditions and follow up and even the cost factor involved. It even proves breakthrough in obesity related conditions like diabetes, kidney diseases, hypertension, etc.

The lifestyle and food habits of urban India have led to exponential rise in obese population. Therefore, it becomes very important to understand obesity. It is basically the condition that has excessive fat deposition in and around the organs. When the calorie intake is more than required, body starts to store fat. Obesity is diagnosed by checking Body Mass Index, i.e. BMI. When an individual’s’ BMI ranges between 25-29.9, the person is considered to be overweight. But if the BMI crosses 30, the person is categorized as Obese.  Further, if the BMI crosses over 35, the patient comes under Morbid Obesity.

Bariatric surgery is the last option after all the efforts have been put on disciplined diets, rigorous exercises and weight loss medication has not proven effective.

All about Bariatric Surgery

It is a weight-loss surgery where successful decrease in weight is attained either by reducing the size of the stomach with a gastric band or through deduction of a portion of the stomach which is known as sleeve gastrectomy/ biliopancreatic diversion with duodenal switch or by resecting and connecting the small intestine to a reduced stomach bag which is known as gastric bypass surgery.

The Bariatric surgery process is classified in 3 types:

  1. Mal-absorptive Procedure: This is done with duodenal switch method. A situation of mal-absorption is created to achieve weight loss. The over part of stomach is surgically removed and its size is brought down to a level to directly connect to the distal part of intestine. This satiates the person with a comparatively less diet. Hence the diet is reduced and instead of passing through the duodenum for digestion, the food directly enters the Ileum of the intestine bypassing the duodenum and the jejunum.
  2. Restrictive procedure: Intake of food is restricted to attain lesser calorie absorption using various methods, as follows:-
  • Vertical banded gastroplasty – It permanently reduces the size of stomach with stapling hence creating a new smaller pouch with capacity of lesser food.
  • Adjustable gastric band – This is also called the lap band method. This helps to attain weight loss by restricting intake of nutrients with a smaller gastric pouch that has a comparatively smaller outlet. An adjustable silicon band is used to restrict the stomach, which can be adjusted with a port placed underneath the skin.
  • Sleeve gastrectomy – This is a permanent procedure, wherein the size is stomach is reduced by 15% from a pouch to a tube which then holds lesser food.
  • Gastric balloon – A comparatively popular surgery wherein a small balloon is placed in the stomach covering the desired area. This area then gets restricted and the food intake reduces with the person satiating faster.
  • Gastric plication – This reduces the size of stomach but the nutrition absorption remains the same. The size of the stomach is reduced by stitching together large folds in the patient’s stomach using a surgical procedure.

Gastric Bypass Surgery: This is also known as mixed procedure, which uses both restrictive and mal-absorptive techniques. This surgery involves very less risk. Here the stomach is separated into a small upper pouch and a much larger lower pouch and the small intestine is surgically connected to both. This method is preferred to treat morbid obesity.

About author

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Dr. Rajesh Kapoor

Dr. Rajesh Kapoor is a renowened Bariatric Surgeon trained in advanced surgeries from different leading institutes of World. A gold medalist, Dr. Rajesh hold special expertise in Gastric Cancers, Bariatric & Metabolic Surgeries, etc. He is Director of GI&HPB Department at Jaypee Hospital, Noida

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