Bariatric Surgery

What is Bariatric Surgery

Bariatrics is a branch of medicine dealing with the causes, prevention and the treatment of obesity. The word ‘Bariatrics’ is derived from the Greek word ‘baro’ which means ‘weight’. The suffix ‘iatrics’ means ‘a branch of medicine’.

Bariatric Surgery is a weight loss surgery and it refers to the different procedures followed to treat obesity via the modification of the gastrointestinal tract so as to reduce the intake of nutrients and to reduce the amount of absorption within the body.

Bariatric surgery is very different from the surgical procedures of removal of fat from the body using methods such as liposuction or abdominoplasty.

Who can avail of Bariatric Surgery

Bariatric surgery is conducted for those individuals who are unable to achieve any significant weight loss through diet modifications and exercise programs. There are other criteria also which have to be met. They are:

• The body mass index (BMI) must be 40 or more or the individual is at least 100 pounds overweight compared to his normal weight. The calculation of BMI is based on the height and weight of the individual. The normal BMI is between 18.5 and 25.
• An individual who has a BMI of 35 and above, but who is suffering from life threatening illnesses (like Diabetes Type II, Heart Disease, Sleep Apnea etc) which can be cured by reducing the weight of the person.

However, this is not an easy option for weight loss. The follow up procedures for this surgery are equally important. Only those people who are committed are considered. Towards that end, often, a psychological evaluation of the patient is also conducted along with an evaluation of this lifestyle, in order to qualify for the surgery.

The patient will also receive extensive counseling about nutrition before the surgery.

Bariatric Surgery: Procedure and Process

The procedure for a bariatric surgery is quite straightforward in theory.

In this procedure, the stomach is made smaller by dividing the upper and lower section of the stomach into two parts by using staples (which are similar to stitches). Now the top part of the stomach will hold all the food which is eaten by the person.

Then, the surgeon connects the top part of the stomach to a section of the small intestine. This, thus, bypasses the lower portion of the stomach. The new connection is known as the ‘Roux Limb’.

The base of this Roux Limb is then connected to the remaining part of the small intestine (from the bottom of the stomach), thus forming a ‘Y’ shape.

This Y-shaped connection lets the pancreatic fluids and bile to mix with the food which now travels directly from the top part of the stomach to the small intestine.

Bariatric Surgery: New Innovations

Medical innovation has now improved this process and this kind of gastric bypass surgery can now be conducted via a laparoscopic procedure.

In this method, small incisions are made in the abdomen and surgical instruments including a small camera are passed through these incisions.

This technique is good because it reduces the size of incisions made, lowers the risk of scars and hernias after the procedure.

But this process is not recommended for people who have gone through some sort of abdominal surgery before, or those who weigh more than 350 pounds. The same procedure of bariatric surgery, which was mentioned prior to the laparoscopic procedure, is followed for such patients.

Nowadays, that procedure has also become quite refined with the advent of adjustable gastric bands which are tied around the stomach to divide it into two parts. This is used instead of staples or stitches.

Bariatric Surgery: After the Surgery

This kind of surgery is not easy to live with, simply because it is irreversible and because of the changes one has to undergo after the surgery.

The patient needs to be very committed to these changes.

For several weeks after the surgery, the patient will be on a liquid diet. He can then begin to take in small quantities of solid food.

However, some patients often experience vomiting and nausea because of the (now) large amount of food being present in the stomach. Some patients also experience diarrhea, dizziness, sweating and bloating.

Ideally, patients need to take vitamin supplements and follow what is now called a ‘gastric bypass diet’. They also need to take in regular amounts of exercise and keep themselves fit.

In effect, the bariatric surgery reduces the amount of absorption in the body of food by reducing the intake of food, reducing the time that the food remains in the body during the digestion process. This often causes less amounts of nutrition to be absorbed in the body. Also the amount of food consumed has to be reduced significantly because the stomach pouch has been reduced.

Also, the persons would not be able to handle large amounts of alcohol, sugar, fatty foods and products such as fries, cakes or candy.

Food intake has to be separated by the fluid intake by about 30 minutes. Also one can only sip what one is drinking.

Risks of Bariatric Surgery

The various risks involved in bariatric surgery or gastric bypass surgery are:

• Bleeding
• Infections
• Gallstones
• Inflammation of the stomach lining or gastritis
• Follow-up surgeries for the correction of complications or removal of excess skin
• Iron and / or vitamin deficiencies
• Calcium deficiency which can lead to osteoporosis and similar bone disorders
• Vomiting due to consumption of excessive food

Advantages of Bariatric Surgery

The weight loss which is the aim of the gastric bypass surgery occurs quite well if all the instructions of the doctor are properly followed.

Most patients end up losing about 10 pounds per month (on an average) and they reach stable weight within 18 to 24 months of this surgery.

However, it is very important to follow all the diet and exercise guidelines properly to achieve this objective.