Weight reduction surgery or bariatric surgery describes a series of surgical procedures that are performed on obese persons. In the process the stomach is reduced in size by removing a portion. This is achieved by use of what is referred to as sleeve gastrectomy or a simple gastric band. Another option involves the resection and diversion of the small gut to the stomach. Such a procedure is very beneficial to persons that have underlying medical conditions such as diabetes and hypertension. It reduces the risk of complications in these persons.
Bariatric surgery is most helpful in persons that have a body mass index, BMI, of more than 40. It is also recommended for those that have medical conditions that are likely to be worsened by obesity. These include among others, glucose intolerance, hyperlipidaemia and diabetes. Surgical options are reserved for cases that are unresponsive to medical therapy.
There are a number of advantages and disadvantages associated with this surgery. All these need to be taken into account before a decision is made on whether the procedure is necessary. Some of the possible complications that should be anticipated include malabsorption of nutrients and gall bladder disease. The risk of depression is also high and as such these persons should be counselled.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
There is a need to make dietary changes after operation. The food types that should be taken include liquids such as broth, juices and sugar-free gelatin desserts. These should be maintained until full recovery of the gut takes place. As one recovers, the next foods to be introduced include blended substances that should also be sugar free.
As happens with any surgical operation, there are a number of risks that should be anticipated both in the short term and long term. In these patients calcium absorption is often compromised leading to metabolic bone diseases. Osteopenia and secondary hyperparathyroidism are some clinical features that may be encountered. Rapid loss of weight is a predisposing factor for gall stone formation and one will therefore need to have this at the back of their mind. Other complications of weight reduction surgery include decreased absorption of nutrients such as vitamin B12, thiamine, iron and folate.
Bariatric surgery is most helpful in persons that have a body mass index, BMI, of more than 40. It is also recommended for those that have medical conditions that are likely to be worsened by obesity. These include among others, glucose intolerance, hyperlipidaemia and diabetes. Surgical options are reserved for cases that are unresponsive to medical therapy.
There are a number of advantages and disadvantages associated with this surgery. All these need to be taken into account before a decision is made on whether the procedure is necessary. Some of the possible complications that should be anticipated include malabsorption of nutrients and gall bladder disease. The risk of depression is also high and as such these persons should be counselled.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
There is a need to make dietary changes after operation. The food types that should be taken include liquids such as broth, juices and sugar-free gelatin desserts. These should be maintained until full recovery of the gut takes place. As one recovers, the next foods to be introduced include blended substances that should also be sugar free.
As happens with any surgical operation, there are a number of risks that should be anticipated both in the short term and long term. In these patients calcium absorption is often compromised leading to metabolic bone diseases. Osteopenia and secondary hyperparathyroidism are some clinical features that may be encountered. Rapid loss of weight is a predisposing factor for gall stone formation and one will therefore need to have this at the back of their mind. Other complications of weight reduction surgery include decreased absorption of nutrients such as vitamin B12, thiamine, iron and folate.
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