Weight reduction surgery, also called
bariatric surgery refers to a series of procedures carried out on
overweight people. The size of the stomach is either reduced or a
portion of it removed. This is possible either through use of a gastric
band or sleeve gastrectomy respectively. Gastric bypass can also be done
by resecting and diverting the small intestine to the stomach. Research
has shown that this procedure helps in improving the condition of
diabetic patients and reducing the risk of cardiovascular risks.
The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options have failed.
The benefits and risks of the procedure should be considered in full before a decision is made as to whether or not to have it. Most common complications that should be considered are malabsorption syndromes and gall bladder diseases. There is a high risk of patients getting into depression and as such pre-operation counselling is warranted.
There are three surgical options that one may choose from. The common thing about them is that they are aimed at minimizing the recurrence of obesity and to encourage loss of weight. These are broadly classified into malabsorptive, restrictive and mixed type. In the malabsorptive procedure, the aim is to encourage malabsorption of some components in food. Such a procedure includes, for example, what is known as billiopancreatic diversion that is usually accompanied with a duodenal stitch (BDS/DS). The main downside is that some essential nutrients may not be absorbed and this often results in metabolic diseases.
Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.
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.
Adverse effects of weight reduction surgery are common. Due to reduced calcium absorption, patients can develop metabolic bone disease in form of secondary hyperparathyroidism and osteopenia. Rapid weight loss can also result in gallstones. In addition, reduced absorption of nutrients such as thiamine, folate, iron and vitamin B12 can lead to nutritional derangements. Defective renal handling has also been reported.
The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options have failed.
The benefits and risks of the procedure should be considered in full before a decision is made as to whether or not to have it. Most common complications that should be considered are malabsorption syndromes and gall bladder diseases. There is a high risk of patients getting into depression and as such pre-operation counselling is warranted.
There are three surgical options that one may choose from. The common thing about them is that they are aimed at minimizing the recurrence of obesity and to encourage loss of weight. These are broadly classified into malabsorptive, restrictive and mixed type. In the malabsorptive procedure, the aim is to encourage malabsorption of some components in food. Such a procedure includes, for example, what is known as billiopancreatic diversion that is usually accompanied with a duodenal stitch (BDS/DS). The main downside is that some essential nutrients may not be absorbed and this often results in metabolic diseases.
Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.
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.
Adverse effects of weight reduction surgery are common. Due to reduced calcium absorption, patients can develop metabolic bone disease in form of secondary hyperparathyroidism and osteopenia. Rapid weight loss can also result in gallstones. In addition, reduced absorption of nutrients such as thiamine, folate, iron and vitamin B12 can lead to nutritional derangements. Defective renal handling has also been reported.
By Kathy Kaufman
About the Author:
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