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.
Predominantly restrictive procedures aim at minimizing oral intake by restricting gastric volume. This produces early food satisfaction. Vertical banded gastroplasty involves permanent stapling of the stomach to create a small stomach to handle the food. It is regarded as one of the safest operations carried out today.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
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.
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.
Predominantly restrictive procedures aim at minimizing oral intake by restricting gastric volume. This produces early food satisfaction. Vertical banded gastroplasty involves permanent stapling of the stomach to create a small stomach to handle the food. It is regarded as one of the safest operations carried out today.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
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.
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