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Writer's pictureAkshay Patil
Aug 204 min read

“Bariatric Surgery: Know All About Promising Weight Loss Surgery”



Table of contents-

  •   Introduction

  • What does bariatric surgery mean?

  • When is this surgery recommended?

  • Types of bariatric surgery procedures?

  • Common operative note-

  • Benefits of bariatric surgery?

  • Possible potential risk and post-surgery concerns:


Introduction-

All over the world, most people are concerned with their obesity and overweight-related issues. Unnecessary changes in eating habits, overconsumption of junk food, lack of exercise, and work culture cause obesity and weight gain. Additionally, obesity and comorbidities like cardiovascular diseases, type 2 diabetes mellitus, musculoskeletal disorders, and possible risk factors for cancers are challenging the global healthcare structure. As per the World Health Organization, in 2022, 1 in 8 people in the world were struggling with obesity-like conditions. However, advanced bariatric surgery procedures promise an effective solution to this escalating healthcare issue. “In this article, we will understand all about bariatric surgery—its evolution, benefits, types, and post-surgery risk factors.”


What does bariatric surgery mean?

Bariatric surgery is a gastrointestinal procedure/operation that reduces absorption of nutrients by either removal of some portion of stomach/intestine or altering the pathways to reduce metabolic activity. This process is also known as weight loss surgery or metabolic surgery. Some portion of stomach, duodenum, and intestine removed causing less hunger and fullness effect. The decreased and controlled food absorption activity plays vital role in conditions like diabetes, high cholesterol, increased blood pressure, and sleep apnea.


When is this surgery recommended?

Technically, bariatric surgery is recommended for those patients who are unable to maintain their weight through their proper diet and exercise and who are relatively more suspected of serious health issues. The surgery is also useful for life-threatening conditions like heart stroke, high levels of cholesterol, sleep apnea, blood pressure, type 2 diabetes, and breast cancer possibilities due to obesity. Before such surgery, the patient is expected to undergo proper health check-ups and mention all history of the present illness to process further. Ideal patients are those whose body mass index (BMI) is nearly or higher than 40, i.e., extreme obesity.


Types of bariatric surgery procedures-

Generally, there are four ways to perform bariatric surgery process. The choice of surgery depends upon the two major common factors including, patient’s situation and general surgeons’ practice.


  • Sleeve gastrectomy-In this surgery, nearly about 80% of stomach is removed, to form long tube-like pouch. This adjustment allows food passes though stomach quickly with lesser absorption of rate of nutrients. This may lead to lesser secretion of appetite-regulating hormone called ghrelin, ultimately decreasing desire to eat.


  • Roux-en-Y gastric bypass-This is the most common method performed, where most of the lower part of stomach is sewed to form small pouch which directly connected middle part of the intestine. This bypass of lower stomach and part of small intestine cause to reduce absorption of most of the fat and calories.


  • Biliopancreatic diversion with duodenal switch (BPD/DS)-This is a two-part surgery usually performed in one setting. The first step involves performing a sleeve gastrectomy. During the second step, the surgeon closes off the middle section of the intestine and attaches the last part directly to the first part of the small intestine, called the duodenum. This is called a duodenal switch. The separated section of the intestine isn't removed from the body. Instead, it's reattached with the end of the intestine, allowing bile and pancreatic digestive juices to flow into this part of the intestine. This is called the biliopancreatic diversion. This surgery both limits how much you can eat and reduces the and absorption of nutrients. While it is extremely effective, it has greater risk, including malnutrition vitamin deficiencies.


  • Single-anastomosis duodena-ileal bypass with sleeve gastrectomy (SADI-S)-This is also a two-stage procedure involving sleeve gastrectomy as the first and bypass of the duodenum part as the second. The lower part of the stomach is then connected to the ilium.


Common operative note:

At present, most of the bariatric surgeries are performed with the help of a laparoscopic instrument. This is a small tube-shaped, camera-mounted instrument called a laparoscope. This tiny camera-mounted tube was then inserted into the abdomen from tiny cuts in the belly. This allows more precise work during an ongoing operation than traditional open surgeries. General anesthesia is administered before surgery starts; this causes unconsciousness for the whole procedure to be done.


Benefits of bariatric surgery?

A successful surgery provides better chances of gradual reduction of weight and reduction of over obesity. Simultaneously, it also improves or resolves life-threatening conditions like high cholesterol levels, high blood pressure, heart disease, gastroesophageal reflux disease (GERD), type 2 diabetes, and non-alcoholic fatty liver disease.


Possible potential risks and post-surgery concerns:

After surgery, most of the patients were recommended to visit a facility for periodic blood work testing to monitor vitamin and mineral levels. Some procedures are technically complex and non-reversible; hence, they can produce unwanted health issues like heartburn, new-onset reflux, frequent bowel movements, vitamin and mineral deficiencies, ulcer development, and dumping syndrome.


Keywords: Obesity, over-weight, weight loss, bariatric surgery.


References:

 

Assessed and Endorsed by the MedReport Medical Review Board


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