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.
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.
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 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.
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.
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.
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 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.
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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