Weight loss surgery or bariatric surgery helps you lose weight and reduces the risk of medical problems associated with obesity. Weight loss surgery contributes to weight loss in two main ways:
- Restriction. Weight loss surgery is done with the aim of limiting the amount of food the stomach can contain, which limits the number of calories you can eat.
- Malabsorption. Weight loss surgery is done with the aim of shortening or cutting parts of the small intestine, which reduces the number of calories and nutrients absorbed by the body.
Types Of Weight Loss Surgery Are:
- Roux-en-Y gastric bypass
- Laparoscopic adjustable gastric banding
- Sleeve gastrectomy
- Duodenal switch with biliopancreatic diversion
1. Roux-en-Y gastric bypass
Roux-en-Y gastric bypass, in this weight loss surgery the surgeon makes a small pouch in the upper part of the stomach. The pouch is the only part of the stomach that receives food. This greatly limits the amount you can eat and drink comfortably at the same time.
Then, the small intestine is cut a short distance below the main abdomen and connected to a new bag. Food flows directly from the bag to this part of the intestine. However, the main part of the stomach continues to produce digestive juice. The part of the intestine that is still attached to the main abdomen is connected lower. This allows the digestive fluid to flow into the small intestine. Because food now passes through a part of the small intestine, fewer nutrients and calories are absorbed.
There are two components in this weight loss surgery procedure. First, the small stomach pouch, about one ounce or 30 milliliters in volume, is made by dividing the upper part of the stomach from the rest of the stomach. Next, the first part of the small intestine is divided, and the lower part of the small intestine is elevated and connected to a small newly created stomach pouch. This procedure is completed by connecting the upper part of the small intestine that divides into the small intestine below so that the stomach acid and digestive enzymes in the stomach pass and the first part of the small intestine mixes with the food.
Shortcuts work with several mechanisms. First, like most bariatric procedures, the new stomach pouch becomes much smaller and facilitates much smaller meals, which translates to fewer calories consumed. In addition, because there is less digestion of food through a smaller stomach pouch, and there are segments of the small intestine that usually absorb calories and nutrients that no longer pass through food, there may be a certain degree of absorption less than calories and nutrients.
The most important thing is that changing the route of food flow produces changes in intestinal hormones that increase satiety, suppress hunger and reverse one of the main mechanisms by which obesity causes type 2 diabetes.
- Generates significant long-term weight loss (loss of 60 to 80 percent excess weight)
- Limit the amount of food that can be consumed.
- It can cause conditions that increase energy expenditure.
- It produces beneficial changes in the intestinal hormones that reduce the appetite and increase the satiety.
- Typical maintenance> 50% excess weight loss
- Technically, the operations are more complex than those of AGB or LSG and can result in higher complication rates
- It can cause long-term vitamin / mineral deficiencies, especially deficiencies of vitamin B12, iron, calcium and folic acid.
- In general, having a stay in the hospital is longer than the AGB
- Requires adherence to dietary recommendations, vitamin / mineral supplements for life and follow-up compliance
2. Laparoscopic adjustable gastric banding
In this weight loss surgery a band containing a rubber balloon is placed around the upper part of the stomach and remains in place. This creates a small abdomen on the band with a very narrow opening throughout the stomach.
Then a port is placed under the skin of the stomach. A tube connects the port to the band. When injecting or removing liquid through the port, the balloon can be pumped or deflated to adjust the size of the tape. Gastric bands limit the amount of food your stomach can hold, so it feels full faster, but it does not reduce the absorption of calories and nutrients.
A general explanation of how this device works is that with a smaller abdominal bag, eating only a small amount of food will satisfy hunger and promote a feeling of fullness. Feelings of fullness depend on the size of the opening between the pouch and the rest of the stomach created by the gastric band. The size of the abdominal opening can be adjusted by filling the band with sterile saline solution, which is injected through a port placed under the skin.
The reduction of the size of the opening is done gradually with time with repeated adjustments or “filling”. The idea that gangs are restrictive procedures (working by limiting the amount of food that can be consumed at each meal and restricting the emptying of food through the band) has been questioned by research showing that food passes through of the band, and that the lack of hunger or feeling of satisfaction is not related to the food that remains in the bag on top of the band. What is known is that there is no malabsorption; The food is digested and absorbed as usual.
The clinical impact of this band seems to reduce hunger, which helps patients reduce the amount of calories consumed.
- Reduce the amount of food your stomach can hold.
- Induces excess weight loss around 40-50 percent.
- It involves not cutting the stomach or redirecting the bowel
- Requires a shorter hospital stay, usually less than 24 hours, with some centers using patients on the same day of surgery
- It can be inverted and can be adjusted
- Have the lowest rates of postoperative complications and death among approved bariatric procedures
- Having the lowest risk of vitamin / mineral deficiency
- Weight reduction is slower and faster than other surgical procedures.
- A large percentage of patients do not lose at least 50 percent of excess weight compared to other commonly performed operations
- It requires a strange device to remain in the body.
- It can cause the possibility of bands of slippage or erosion of the stomach band in a small percentage of patients
- You may experience mechanical problems with bands, tubes or ports in a small percentage of patients
- Can cause esophageal dilation if the patient eats too much
- Requires strict adherence to postoperative diets and postoperative follow-up visits
- The highest level of restart operation
Related article: Weight Loss Camp
3. Sleeve gastrectomy
In this weight loss surgery the abdomen is separated and removed from the body. The remaining part of the stomach is formed in a tubular structure. This smaller stomach can not accommodate so much food. It also produces less ghrelin that regulates your appetite, which can reduce your desire to eat. However, arm gastrectomy does not affect the absorption of calories and nutrients in the intestine.
This procedure works with several mechanisms. First, the new stomach pouch maintains a volume much smaller than the normal stomach and helps reduce the amount of food significantly (and therefore calories) that can be consumed. However, the greatest impact seems to be an operative effect on intestinal hormones that have an impact on several factors, such as hunger, satiety and control of blood sugar.
Short-term studies show that the arm is as effective as gastric bypass in Y in terms of weight loss and repair or remission of diabetes. There is also evidence that the arms, similar to the gastric bypass, are effective in increasing type 2 diabetes regardless of weight loss. The complication rate of the arm falls between them from the adjustable gastric band and the gastric bypass in Roux and.
- Limit the amount of food your stomach can hold.
- It induces a rapid and significant weight loss that the comparative studies find similar to the Roux-en-Y gastric bypass. Weight loss> 50% for data 3-5 years or more, and weight loss comparable to referral with maintenance> 50%
- Does not require foreign objects (AGB), and there is no deviation or re-routing of the food flow (RYGB)
- It implies a relatively short stay of about 2 days.
- It causes beneficial changes in the intestinal hormones that suppress hunger, reduce appetite and increase satiety.
- It is a non-reversible procedure.
- Has long-term vitamin deficiency potential
- Has an initial complication rate higher than AGB
Biliopancreatic diversion with duodenal switch
Like Sleeve gastrectom, this weight loss surgery procedure begins when the surgeon removes most of the stomach. The valve that releases the food is left to the small intestine, along with the first part of the small intestine, called the duodenum.
Then, the surgeon closes half of the intestine and attaches the last part directly to the duodenum. This is the duodenal switch.
The separated parts of the intestine are not removed from the body. Instead, it is connected to the end of the intestine, which allows bile and pancreatic digestion to flow into this part of the intestine. This is a biliopancreatic transfer.
As a result of these changes, foods cut most of the small intestine, which limits the absorption of calories and nutrients. This, together with a smaller stomach size, causes weight loss.
The duodenum, or the first part of the small intestine, is divided only through the gastric tract. The distal segment of the small intestine (the last part) is then transported and connected to a newly created abdominal outlet, so that when the patient eats, the food passes through the newly created tubular abdominal pouch and empties directly into the last segment. of the small intestine. Approximately three quarters of the small intestine is passed through the food stream.
The small intestine that passes, which transports the bile and pancreatic enzymes necessary for the breakdown and absorption of proteins and fats, is linked back to the last part of the small intestine so that it eventually mixes with the flow of food. Like the other operations described above, BPD / DS initially helps reduce the amount of food consumed; However, over time this effect decreases and the patient can finally consume foods that are close to the “normal” amount. Unlike other procedures, there is a large amount of small intestine that goes through the flow of food.
In addition, food does not mix with bile and pancreatic enzymes well below the small intestine. This results in a significant reduction in the absorption of calories and nutrients (especially proteins and fats) and nutrients and vitamins that depend on fat for absorption (vitamins and fat-soluble nutrients). Finally, BPD / DS, similar to gastric bypass and arm gastrectomy, affects intestinal hormones in ways that affect hunger and fullness and control blood sugar. BPD / DS is considered the most effective operation for the treatment of diabetes among those described here.
- Generate a greater weight loss than RYGB, LSG or AGB, that is, 60-70% of excess or greater weight loss, after 5 years of follow-up
- Allows patients to finally eat near “normal” foods
- Reduces fat absorption by 70 percent or more
- It causes beneficial changes in the intestinal hormones to reduce appetite and increase satiety.
- It is the most effective against diabetes compared to RYGB, LSG and AGB.
- It has a higher rate of complications and risk of death compared to AGB, LSG and RYGB
- Requires a longer hospital stay than AGB or LSG
- It has a greater potential to cause protein deficiency and long-term deficiency in a number of vitamins and minerals, namely iron, calcium, zinc, fat-soluble vitamins such as vitamin D
- Compliance with follow-up visits and care and strict adherence to guidelines for vitamin and food supplementation are very important to avoid serious complications of proteins and certain vitamin deficiencies.
You can get complete information about weight loss surgery at Blossom Bariatrics. No references, permits or preoperative tests are required before arrival. The complete consultation, tests and operations are completed at home in 5 days and include ground and hotel transportation to and from all appointments.