Bariatric/weight loss surgery

Surgeries

Overview

Bariatric surgeries or Weight loss surgeries is making changes to your digestive system to help you lose weight. Bariatric surgeries make permanent but safe changes in your digestive system, tending to reduce the weight in obese people.

Some procedures limit the food consumption quantity, while others reduce the body’s ability to absorb nutrients. Few procedures do both. Success of this surgery depends on the diet and exercise routine followed thoroughly by the patient.

Bariatric surgery is performed when diet and exercise haven’t worked or when there are grave health problems because of body weight. Gastric Bypass, Sleeve DJB, Mini gastric Bypass, Ballooning are some forms of bariatric/weight-loss surgery.

When is bariatric surgery recommended?

Surgery is recommended for extremely Obese people whose BMI is 35 or higher. Age limit is more than 18 years.

For special situations where the age of a patient is below 18 years, a paediatrician / endocrinologist certificate is explicitly required before going forward with bariatric surgery.

A proper guidance and screening are provided before opting for this surgery. Obese individuals are well informed about results, risks, side effects, post-surgery care well in advance.

The doctor verifies the BMI index of the patient before providing an option for this surgery:

If the BMI (Body Mass index) of an individual is 40 or higher. Such individuals are known as extremely obese people.

  • The BMI range of obesity is 35 to 39.9.  If an individual has severe health problems like sleep apnea, Type II diabetes, or other diseases.
  • If BMI is above 32.5 and there is a presence of Type II diabetes or obesity-related co-morbidities.
  • Patients have tried conservative ways to lose weight but did not achieve their expected weight reduction.

Benefits of Bariatric surgery

Bariatric surgery helps to achieve: 

  • Reduces the risk of heart disease and stroke.
  • Alleviates sleep apnea symptoms.
  • Improves Diabetes control and remission.
  • Enhances fertility in women.
  • Boost physical activities and energy levels.
  • Long-term health goals with a proper healthy lifestyle

Sleeve gastrectomy

A surgical procedure that helps Obese people lose weight. The idea behind this surgery is Calorie intake is directly proportional to size of stomach. It involves the removal of approximately 80% of the stomach, leaving behind a narrow sleeve-shaped portion that is about the size of a banana. This smaller stomach size limits the amount of food a person can eat at one time, leading to a feeling of fullness and reducing overall caloric intake.

RYGB

Roux-en-Y Gastric Bypass (RYGB), pronounced as “Roo-en-why”, involves creation of a small stomach pouch about size of an egg by stapling some part of it, this restricts the food intake.

It helps weight loss in 2 ways:

Restriction: The upper portion of the stomach is separated from the lower portion. The upper portion (or the “pouch”) is then connected to Roux limb of the small intestine. This pouch restricts the amount of food you can eat or basically restrict the calories intake, making you feel full after eating only a small amount of food resulting to weight loss.

Mal-Absorption: Post creation of the smaller pouch, your digestive system is rerouted to bypass the larger part of stomach and part of small intestine. The result of the bypass is you absorb fewer calories and nutrients from the food you eat (mal-absorption).

Sleeve Duodeno-Jejunostomy (DJB):

This is procedure, primarily for Diabetic Mellitus patients who may not be Obese as well.

It’s a novel bariatric procedure and is carried out by creating a sleeve and surgically removing 2-3rd of the stomach and then bypassing the initial 100- 150 centimetres of the small intestine, and joining it as a loop to the duodenum (part of small gut).

Results of this surgery are promising with 70 to 75% excess weight loss over 12 to 18 months.

Gastric Bypass

Gastric bypass is a type of weight loss surgery that involves dividing the stomach into a small upper pouch and a larger lower pouch, and then connecting the small intestine to the upper pouch. This results in a significant reduction in the amount of food a person can eat, and also reduces the amount of calories and nutrients that can be absorbed by the body. During the procedure, a surgeon makes several small incisions in the abdomen and uses a laparoscope (a thin tube with a camera) to guide the surgical instruments. The upper portion of the stomach is divided from the lower portion, and the small intestine is then rerouted to the new, smaller stomach pouch.

Gastric bypass is generally considered to be a safe and effective weight loss surgery option for people with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with one or more weight-related health problems. It can lead to significant weight loss, improvement in weight-related health conditions such as diabetes and high blood pressure, and an overall improvement in quality of life.

As with any surgery, there are risks associated with gastric bypass, including bleeding, infection, blood clots, and adverse reactions to anesthesia. Additionally, some people may experience complications such as dumping syndrome (rapid emptying of the stomach contents into the small intestine), hernias, and nutritional deficiencies.

It is important for people considering gastric bypass to discuss the risks and benefits with their healthcare provider and to carefully consider whether it is the right choice for them. It is also important to make lifestyle changes such as adopting a healthy diet and increasing physical activity in order to achieve long-term success after surgery.

Mini Gastric Bypass:

Gastric bypass is a type of weight loss surgery that involves dividing the stomach into a small upper pouch and a larger lower pouch, and then connecting the small intestine to the upper pouch. This results in a significant reduction in the amount of food a person can eat, and also reduces the number of calories and nutrients that can be absorbed by the body. During the procedure, a surgeon makes several small incisions in the abdomen and uses a laparoscope (a thin tube with a camera) to guide the surgical instruments. The upper portion of the stomach is divided from the lower portion, and the small intestine is then rerouted to the new, smaller stomach pouch.

Gastric bypass is generally considered to be a safe and effective weight loss surgery option for people with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with one or more weight-related health problems. It can lead to significant weight loss, improvement in weight-related health conditions such as diabetes and high blood pressure, and an overall improvement in quality of life.

As with any surgery, there are risks associated with gastric bypass, including bleeding, infection, blood clots, and adverse reactions to anaesthesia. Additionally, some people may experience complications such as dumping syndrome (rapid emptying of the stomach contents into the small intestine), hernias, and nutritional deficiencies.

It is important for people considering gastric bypass to discuss the risks and benefits with their healthcare provider and to carefully consider whether it is the right choice for them. It is also important to make lifestyle changes such as adopting a healthy diet and increasing physical activity in order to achieve long-term success after surgery.

Intragastric Ballooning:

Intragastric ballooning is a weight-loss surgery that is carried out by placing a balloon like object (saline filled silicone) in your stomach under endoscopic guidance. It can be left in the stomach for 6 months and results in average weight loss of 10-15 kg. This helps you lose weight by limiting how much you can eat and ultimately less calorie intake.

Gastric Banding:

Gastric banding (aka. “Lap Band” or “Realize band”) is considered most popular surgery for weight loss. The procedure is carried out by placing a soft silicone band with an expandable balloon in the centre, rounding the upper part of the stomach.

It basically divides stomach into 2 compartments, with a much smaller top part above the band. A person eats enough food only to fill the upper part of the stomach. After the meal, over time, the food slowly passes through the opening of the band into the lower part of stomach, and digestion occurs normally.

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