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.
There are three main categories of surgery to consider. They broadly include the restrictive, malabsorptive and mixed. The malabsorptive technique is one that results in a malabsorption state of the gut. An example here is what is referred to as billiopancreatic diversion with duodenal stitch or BDS/DS. What this means is that a portion of the stomach is cut and removed and the remaining is fashioned into a smaller pouch that is connected to the small intestine bypassing the jejunum and duodenum. Side effects are mainly related to vitamin and mineral deficiency.
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.
Another effective technique that is restrictive in nature is what is referred to as sleeve gastrectomy. As much as 15% of the stomach can be resected by use of this technique. Most of this portion is taken from the greater curvature. This technique transforms it into a tubular shape. Laparoscopes are often used to improve on the accuracy.
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.
There are three main categories of surgery to consider. They broadly include the restrictive, malabsorptive and mixed. The malabsorptive technique is one that results in a malabsorption state of the gut. An example here is what is referred to as billiopancreatic diversion with duodenal stitch or BDS/DS. What this means is that a portion of the stomach is cut and removed and the remaining is fashioned into a smaller pouch that is connected to the small intestine bypassing the jejunum and duodenum. Side effects are mainly related to vitamin and mineral deficiency.
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.
Another effective technique that is restrictive in nature is what is referred to as sleeve gastrectomy. As much as 15% of the stomach can be resected by use of this technique. Most of this portion is taken from the greater curvature. This technique transforms it into a tubular shape. Laparoscopes are often used to improve on the accuracy.
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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