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.
It is recommended for people with a minimum body mass index of forty and those with existing medical conditions in which obesity is a predisposing factor. Such conditions may include diabetes, hyperlipidaemia, hypertension and impaired glucose tolerance. Surgery is considered when all other programs including exercise, diet and drug therapy have failed.
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.
Another restrictive technique is known as sleeve gastrectomy. In the hands of a skilled surgeon, up to 15% of the original size of the stomach can be successfully removed. The greatest portion is taken from the greater curvature. The stomach shape is transformed into more of a tube. In advanced centers, laparoscopes are used so as 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.
As with any surgical procedure, there are a number of side effects associated with weight reduction surgery. Persons that have had this operation frequently have difficulties absorbing calcium. As a result, they often get various forms of metabolic bone disease of which osteopenia and secondary hyperparathyroidism are clinical features. The fact that loss of weight has occurred suddenly predisposes these individuals to gall stone formation. Other complications include reduced absorption of essential nutrients such as folate, iron, vitamin B12 and thiamine.
It is recommended for people with a minimum body mass index of forty and those with existing medical conditions in which obesity is a predisposing factor. Such conditions may include diabetes, hyperlipidaemia, hypertension and impaired glucose tolerance. Surgery is considered when all other programs including exercise, diet and drug therapy have failed.
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.
Another restrictive technique is known as sleeve gastrectomy. In the hands of a skilled surgeon, up to 15% of the original size of the stomach can be successfully removed. The greatest portion is taken from the greater curvature. The stomach shape is transformed into more of a tube. In advanced centers, laparoscopes are used so as 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.
As with any surgical procedure, there are a number of side effects associated with weight reduction surgery. Persons that have had this operation frequently have difficulties absorbing calcium. As a result, they often get various forms of metabolic bone disease of which osteopenia and secondary hyperparathyroidism are clinical features. The fact that loss of weight has occurred suddenly predisposes these individuals to gall stone formation. Other complications include reduced absorption of essential nutrients such as folate, iron, vitamin B12 and thiamine.
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