Category

Bariatric

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Introduction

When prioritizing health, we make room for a healthy beginning for healthy living ahead. Each problem has a solution, and overweight or obesity is no exception. Obesity is one of the common ailments and is on a constant upward trend in India and globally. Reports show that in India, nearly 100 bariatric surgeries are performed daily, with the year 2022 reporting about 39,949 surgeries.

With high emergence cases of obesity and overweight cases, medical professionals expect and recommend the need for effective measures to curtail them. These measures include non-surgical treatment options to start with and subsequent surgical intervention if the former does not yield the desired results.

Bariatric Surgery, the most effective and successful treatment for obesity and weight loss, is in much demand. Understanding the purpose, types, and advantages of this surgery helps patients and their caregivers form an informed decision while deciding the course of treatment for addressing the problem of obesity and weight loss. A detailed discussion in this blog serves this specific purpose.

What is Bariatric Surgery?

Bariatric Surgery is, also known as weight loss or metabolic surgery, performed to treat obesity and weight loss through surgical intervention. The surgeon resizes the stomach and intestinal tract of the patient to restrict food intake and nutrient absorption in the body. Surgery, along with treating obesity, also helps treat diabetes, high cholesterol, high blood pressure, and other related health problems through diet control when accompanied by healthy lifestyle habits and physical activity. 

Types of Bariatric Surgery

Bariatric Surgery comes with various options depending on the needs of individual cases. Each has its benefits and potential shortcomings. The different types of Bariatric Surgery are-

  • Gastric Sleeve Surgery- This sleeve gastrectomy creates a banana-sized and shaped functional portion of the stomach. Nearly 80% of the stomach portion is removed. Reducing the stomach’s capacity to hold food and fluid affects the body’s metabolism. It reduces hunger-producing hormones and provides the fullness of the stomach with less food. It is a simple procedure and hence safe and does not involve any complications of intestinal bypass. However, the surgery is non-reversible.
  • Gastric Bypass Surgery- Gastric Bypass Surgery is called Roux-en-Y surgery, which means ‘in the form of a Y’. The surgery reduces the stomach into a small egg-sized pouch. The surgeon staples the small, pouched stomach, separating it from the rest of the stomach. The small intestine is also divided. The lower portion of the small intestine is brought up and connected to the newly created stomach pouch. The bypassed stomach and upper portion of the small intestine are attached further down the small intestine. This creates a ‘Y shape’. The food passes from the new pouch to the small intestine for digestion, bypassing the major portion of the stomach and the upper portion of the small intestine. The modified course of the digestive tract enables less food consumption, fullness experience, and reduced nutrient absorption. The patients can have effective and long-lasting solutions for weight reduction when accompanied by healthy lifestyle changes, physical activity, and doctor-recommended weight control and management. It is considered the gold standard for weight reduction. It has long-lasting weight loss results if accompanied by proper weight control and management.
  • Duodenal Switch Surgery- Duodenal Switch surgery combines Gastric Sleeve and Gastric Bypass surgeries. The stomach is reduced to a banana size and shape after removing nearly 80% of the stomach portion. The newly created sleeve-shaped portion is attached to the lower portion of the small intestine, thus bypassing its upper portion. The food passes directly from the newly created stomach to the small intestine’s lower portion. This results in less food consumption and less nutrient absorption. It is a highly effective treatment for obesity and type 2 diabetes. It creates high malabsorption and possibilities of vitamin and mineral deficiencies post-surgery that need to be addressed through nutrient supplements.

Who is a Good Candidate for Bariatric Surgery?

The surgery is recommended for people who-

  • Have body mass index (BMI) >40, or
  • Have a BMI >35 but <40 with comorbidities like type 2 diabetes, high cholesterol, high blood pressure, sleep apnea, or heart problems, or
  • Are 45 kgs more than the ideal body weight (when BMI is between 18.5 to 24.9).

Advantages of Bariatric Surgery

This surgery offers many benefits, the foremost being weight loss to treat obesity. The others on the list are-

  • Improves cardiovascular health with the control of high cholesterol, blood pressure, and type 2 diabetes, enabling the control of heart diseases like heart stroke, myocardial infarction, and peripheral vascular diseases.
  • Relieves depression by treating obesity, one of the causes of anxiety, stress, and social, emotional, and physical embarrassment in obese people.
  • Relieves joint pain and eliminates chances of knee joint replacement by reducing excess weight on joints.
  • Prevents other medical conditions like the risk of miscarriage in women, pregnancy complications, gall bladder disease, and other metabolic syndrome.

What to Expect in Bariatric Surgery

Pre-surgery evaluation for patients

Bariatric Surgery could be a life-changing procedure that helps patients achieve weight loss, treat obesity, and enable healthy living with overall well-being, with proper diet and weight loss control and management. 

For the successful outcomes of the surgery and better patient care, it is crucial to identify the barriers that need to be addressed and post-operative instructions to be followed. A multidisciplinary team of experts does a preoperative evaluation to rule out the chances of complications and adverse surgical results in patients. 

Preoperative evaluation focuses on the issues unique to the patient. The evaluation includes:

  • The patient’s medical history.
  • Physical examination.
  • Various tests for psychological, psychosocial, behavioral, nutritional, and anatomical assessment.

Each assessment evaluates a specific aspect of the patient to ensure effective risk management, surgical performance, and efficient patient care.

Preoperative requirements 

The patient who qualifies for the surgery needs to –

  • Commit to the doctor’s recommended diet plan. This may require a reduction in calorie consumption, the type of food intake, and quitting smoking and alcohol.
  • Exercise and perform physical activity as part of the doctor-recommended health plan. 
  • Either continue or stop medications as advised by the doctor.
  • Stay positive and participate in preoperative education and counseling sessions, if any, provided by their healthcare providers.
  • Explore and discuss the various surgical options and stay informed about the risks, benefits, and complications to make an informed decision.
  • Gather information about the cost of the surgery, hospital stay, insurance coverage, and other incidental medical expenses.

During the surgery

The patient is put under general anesthesia, and the surgery may be done traditionally or laparoscopically. The duration of the surgery depends on the type and method of surgery. 

In the case of traditional surgery, there is a large incision on the abdomen to gain access to the surgical site. While under laparoscopic surgery, small incisions are made. A laparoscope with a tiny camera attached to its tip is inserted through the incision. The camera enables the surgeon to view and operate through a small incision. The healing and recovery depend on the method, with laparoscopic surgery providing faster healing and recovery compared to traditional.

Post-operative care

After a few days of post-operative hospital stay, the patient is discharged with doctor-prescribed medications, pain control, and management guidelines. Weight loss is not a one-time fix but requires regular follow-up visits with the doctor, monitoring the weight changes, and reporting the same to the doctor if severe. A controlled diet, routine exercise, healthy lifestyle, stress management, and patient commitment to adhere to the same consistently is a must.

Conclusion

Bariatric Surgery is a healthy beginning towards achieving desired weight loss goals and treating obesity, the root cause of various cardiovascular diseases. India is preferred for Bariatric Surgery for its low operative cost, prompt and timely medical attention, and intervention by expert and qualified professionals.

Although the most effective weight loss treatment, Bariatric Surgery needs post-surgical constant and consistent patient commitment, regular checks, and diet control, accompanied by routine physical activity, positive lifestyle changes, and stress management to make it a long-term success story with desired results.

References

https://asmbs.org/patients/bariatric-surgery-procedures
https://health.clevelandclinic.org/7-bariatric-surgery-benefits-besides-helping-you-lose-weight/
https://www.ncbi.nlm.nih.gov/books/NBK594256/#:~:text=The%20preoperative%20assessment%20helps%20identify,and%20improves%20weight%20loss%20outcomes.
https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258
https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258

Introduction

Bariatric Surgery, for all good reasons, has been in increasing demand as an effective weight reduction alternative by people struggling to lose those extra pounds through non-surgical methods without any positive outcome. When at the peak of one’s weight, apart from the social, emotional, and physical embarrassment, the cardiovascular risks weighing on these obese people are the real cause of concern. One of the studies conducted by the American College of Cardiology reviewed the role of Bariatric Surgery in lowering CV risks in obese and suggested that it significantly lowered CV mortality and reduced heart failure, myocardial infarction, and stroke incidences.

Weight Loss Surgery or not, is always a difficult decision to make for people trying to lose weight. However, when no non-surgical treatment works, people often resort to this surgery as their final call.

In this blog, let us explore the connection between Bariatric Surgery and cardiovascular risks. For this, we need to understand how this treatment works and affects the cardiovascular health outcomes in a patient.

Understanding Bariatric Surgery

Bariatric Surgery treats obesity. But many of us feed on the misconception that surgery removes fat from your body. No, it does not. The surgery aims to reduce the size of your stomach and re-route the intestine track to restrict the food intake and the body’s ability to absorb nutrients. The smaller the stomach size, the fuller one feels with less food. The re-routing of the digestive tract limits digestion and absorption of the nutrients. Thus, it leads to considerable weight loss in a shorter span, when combined with proper diet, exercise, and lifestyle changes.

Obesity is the Root Cause of Cardiovascular Diseases (CVDs).

Obesity is an excessive or abnormal accumulation of fat in the body that risks one’s health. It is a chronic and complex medical condition and has become common in people of all ages. It is the root cause of CVDs, often leading to death if left unaddressed. Obese are at a high risk of developing various heart-related issues like-

  • High Cholesterol – A high amount of fat in the body causes blockages in the blood vessels, increasing the chances of stroke or heart attack.
  • Type 2 Diabetes- Excessive storage of fat results in the muscles and tissues becoming more resistant to insulin, leading to the risk of developing type-2 diabetes. This impairs the circulatory, immune, and nervous system and leads to stroke or heart attack.
  • High blood pressure- The amount of pressure the blood flow exerts on the inner walls of the arteries increases with the accumulation of fatty tissue. The heart needs to work hard to pump blood throughout the body.
  • Heart Diseases- Buildup of fatty substances in blood vessels leads to atherosclerosis, impairing cardiac function. Fat accumulation may cause the heart to pump blood more rigorously, and when it fails, the blood gets collected in parts of the body, like the lungs, legs, or feet.

With weight reduction, a person is at a lower risk of these diseases and discomfort associated with managing excess body weight and can enjoy a healthier and fuller life.

Bariatric Surgeries to Treat Obesity

Bariatric Surgeries aim to treat class III obesity, also known as morbid obesity. People with a BMI of 40 or more, or 35 or more in people with any co-morbidity fall under class III obesity. Though weight reduction is not a one-time solution or a quick fix to obesity, proper diet checks, regular exercise, and positive lifestyle changes help achieve it sustainably.

  • Gastric Sleeve Surgery- Known as Sleeve Gastrectomy, the surgery reduces the stomach size by approx. 80%, thus leaving behind a tubular sleeve that is banana-shaped. The reduced stomach size makes one feel fuller with less food intake. The surgery also reduces the amount of hunger hormones the stomach produces, thus restricting the impulses to eat more.
  • Gastric Bypass Surgery- Gastric Bypass Surgery is also known as Roux-en-Y surgery. It is common bariatric surgery and is performed when diet and exercise fail to reduce weight. The surgeon creates a small pouch from the stomach and staples it. The small pouch gets separated from the rest of the stomach. This new pouch becomes the functional portion of the stomach. The newly created pouch is attached to the lower part of the small intestine, bypassing the upper portion. The swallowed food will go to the small pouch of the stomach, and then directly to the lower portion of the small intestine. The new route bypasses a major part of the stomach, and the upper portion of the small intestine.
  • Duodenal Switch Surgery- The combination of Gastric Sleeve and Intestinal Bypass surgeries, this surgery removes a major portion of the stomach and attaches the smaller pouch to the lower intestine, creating a shorter path for the food to pass from the stomach to the intestine.

Bariatric Surgery -Lowering CVD Risks

By treating excess weight, the cause of CVDs, Bariatric Surgery lowers the future risk of these diseases. When excess weight is treated, the associated diseases are either prevented or eventually treated. When a person has to carry less weight, the heart has to put in less effort to pump blood and, hence, is at a lower risk of heart-related problems. For obese people already having CVD, studies show that those who had the surgery were at a lower risk of adverse outcomes than those with similar conditions who did not undergo the surgery. It reduces the incidence of heart failure, myocardial infarction, and stroke in obese patients. Without weight loss management or surgery, morbid obesity sooner or later leads to cardiovascular health issues. These chances could be reduced if one undergoes Bariatric Surgery. The surgery is a long-term treatment solution for weight loss and curtailing the associated health issues of high cholesterol, high blood pressure, type 2 diabetes, heart attack, stroke, and congestive heart failure.

Conclusion

Obesity is complex and chronic. It is not an aesthetic concern to be ashamed of or feel embarrassed about, but a medical concern that requires a proper line of treatment combined with a sustained diet plan, exercise routine, and positive lifestyle changes. Bariatric Surgery is the best long-term solution, safe and effective, with most patients experiencing losing excess weight, post-surgery. However, the outcome of each surgery varies and depends upon the post-operative care and weight management. The benefits outweigh the associated risks and complications that this surgery carries of a typical surgical procedure.

References

https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2022/03/14/15/47/Bariatric-Surgery-and-CV-Disease
https://my.clevelandclinic.org/health/treatments/17285-bariatric-obesity-surgery
https://www.heart.org/en/news/2021/04/05/for-heart-patients-bariatric-surgery-may-lower-risk-of-future-cardiovascular-problems
https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2022/03/14/15/47/Bariatric-Surgery-and-CV-Disease

Introduction
Are you familiar with the surgical procedure known as laparotomy? It may not be a household term, but it’s a critical procedure to diagnose and treat various medical conditions. From abdominal trauma to digestive disorders, laparotomy can make all the difference in a patient’s recovery. But what exactly is laparotomy, and when is it needed? In this article, we’ll explore the ins and outs of laparotomy, from the procedure to the recovery process.

What Is Laparotomy?
Also known as open abdominal surgery, laparotomy is an invasive procedure requiring high skill and expertise. It is a surgical procedure involving an incision in the abdomen to access the internal organs. Doctors can access the organs and tissues and identify abnormalities or issues causing symptoms. Laparotomy may be necessary for trauma, tumours, infections, and digestive disorders.

In addition to its diagnostic capabilities, laparotomy can also be used to treat various medical conditions. For example, a surgeon may remove a tumour or cyst during laparotomy or repair damage caused by trauma. By addressing these issues directly, patients can often experience relief from their symptoms and a better overall quality of life.

Which Medical Conditions Require Laparotomy?
Some of the medical conditions that require laparotomy include:

  • Tumours: To remove tumours (cancerous or non-cancerous) located in the abdomen.
  • Intestinal blockages: To remove a blockage in the intestine that is causing severe abdominal pain and discomfort.
  • Ectopic pregnancy: To terminate a pregnancy that is located outside of the uterus, which can be life-threatening.
  • Trauma: To treat internal injuries resulting from trauma, such as those caused by accident.

Laparotomy Procedure
The laparotomy procedure is performed under general anesthesia, meaning you will be asleep. The procedure typically takes several hours and is performed in a sterile operating room.

  • Preparation for Laparotomy: Before the procedure, you must fast for several hours to ensure your stomach is empty. You may be given laxatives to clean your bowels, antibiotics to prevent infection, and medication to prevent blood clots.
  • Exploration and Surgery: During the laparotomy procedure, the surgeon will make an incision in your abdomen. The surgeon will then explore the abdominal cavity to identify any medical conditions that require treatment. If a medical condition is identified, the surgeon will perform the necessary surgery to remove or repair the affected area.
  • Closing the Incision:After the surgery, the surgeon will close the incision using stitches or staples. A sterile dressing will be applied to the incision to prevent infection. You will then be taken to a recovery room, where you will be closely monitored as you wake up from anesthesia.

Recovery after Laparotomy

  • Hospital stay and aftercare: After laparotomy, you will need to stay in the hospital for a few days to a week, depending upon the requirement of immediate aftercare for proper recovery. During this time, medical staff will monitor you closely, and you will have several tests to guarantee no complications.
  • Pain management and medication: Post-laparotomy, you will experience pain and discomfort. Your doctor will provide you with pain medication to help manage your pain. Taking your medication as prescribed is crucial to ensure you are comfortable and prevent complications.
  • Physical therapy and rehabilitation: You may need physical therapy and rehabilitation to regain strength and mobility. Your doctor will develop a plan tailored to your specific needs. However, following the plan ensures you recover fully and quickly.
  • Follow-up appointments: Once discharged from the hospital, you must attend follow-up appointments with your doctor. These appointments will allow them to monitor your progress and ensure that you are recovering properly.

Conclusion
In conclusion, laparotomy is a critical surgical procedure to diagnose and treat various medical conditions. From abdominal trauma to tumours and infections, laparotomy can help doctors better understand the internal complications of the body and provide targeted treatment to the affected area. While recovery may involve discomfort and rehabilitation, following your doctor’s instructions carefully is essential to ensure a full and speedy recovery. With early diagnosis and treatment, you can improve your chances of a successful outcome and return to your daily life as quickly as possible.

FAQs

Q: What medical conditions typically require laparotomy?
A:
 Laparotomy may be necessary to diagnose or treat various conditions, including abdominal trauma, tumours, abdominal infections, digestive disorders, and more.

Q: How can I tell if I need a laparotomy?
A:
 If you are experiencing symptoms of a medical condition that may require laparotomy, such as severe abdominal pain, fever, or vomiting, it is important to seek medical attention immediately. Your doctor can evaluate your symptoms and determine if laparotomy is necessary.

Q: How can I prepare for a laparotomy?
A:
 Your doctor will provide you with detailed instructions on how to prepare for laparotomy. This may involve fasting for some time before the procedure and abstaining from certain medications or supplements.

Q: What is the recovery process like after laparotomy?
A:
 Recovery after laparotomy may involve pain management, physical therapy, and rehabilitation. You might need to stay in the hospital for a few days to a week, depending upon the need for immediate aftercare for proper recovery. You must attend follow-up appointments with your doctor to ensure you are recovering properly.

Reference links –
https://www.medicalnewstoday.com/articles/laparotomy
https://my.clevelandclinic.org/health/treatments/24767-laparotomy
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/laparotomy

What is Laparoscopic Surgery?

It is a minimally invasive surgical technique that allows doctors to perform surgeries through small incisions rather than large ones. The procedure involves using a laparoscope, a thin, long tube with a camera and light attached to it.

As part of the procedure, the laparoscope will be inserted through one of the incisions by the surgeon. The attached camera sends images to a monitor in the operating room. This allows the surgeon to see inside the patient’s body without making large incisions. The other ports will be used to insert small specialised instruments that the surgeon will use to manipulate and remove tissue.

Laparoscopic surgeries can perform a wide range of surgical procedures, including hernia repair, hysterectomy (uterus removal), appendectomy (appendix removal), and more.

Benefits of Laparoscopic Surgeries

  • Reduced pain and scarring: Compared to traditional open surgeries, laparoscopic surgeries cause less pain and scarring. This is because the incisions used for laparoscopic surgeries are smaller and require less cutting of the skin and tissue. Patients undergoing laparoscopic surgeries are less likely to need strong pain medications and will experience less discomfort during recovery.
  • Faster recovery times and shorter hospital stays: Laparoscopic surgeries have shorter recovery times than traditional open surgeries. Patients who undergo laparoscopic surgeries can typically return to normal activities sooner and require less time in the hospital. This is because laparoscopic surgeries are less painful to the body, and patients experience less discomfort and inflammation.
  • Lower risk of infection and other complications: Laparoscopic surgeries have a lower risk of infection and other complications than traditional open surgeries. This is because the small incisions used for laparoscopic surgeries are less likely to become infected, and there is less tissue trauma and blood loss during the procedure. This can also result in less scarring and better cosmetic outcomes.
  • Reduced blood loss: Laparoscopic surgery often involves less bleeding than traditional open surgeries, reducing the need for blood transfusions. Insufflation is one of the key factors contributing to reduced blood loss in laparoscopic surgery, which involves filling the abdominal cavity with gas (usually carbon dioxide) to create space for the surgeon to work. By doing so, the gas pressure helps to constrict blood vessels and reduce bleeding during the surgery.
  • Improved cosmetic outcomes: Laparoscopic surgeries result in better cosmetic outcomes than traditional open surgeries. The small incisions used for laparoscopic surgeries heal faster and leave minor scars, resulting in less visible scarring and improved cosmetic outcomes.

Conclusion

In recent years, laparoscopic surgeries have become a popular alternative to traditional surgeries, and for a good reason. These surgeries significantly benefit patients, making the entire surgical process more manageable and less painful. So, if you or someone you know requires surgery, talk to your healthcare provider about the possibility of laparoscopic surgery. 

FAQs

Q: What is laparoscopic surgery, and how does it differ from traditional open surgery?
A:
 Laparoscopic surgery is a minimally invasive surgical technique that uses small incisions and a camera to perform surgeries. It differs from traditional open surgery, which requires larger incisions and more tissue trauma.

Q: What types of surgeries can be performed using the laparoscopic approach?
A:
 Laparoscopic surgeries can be used to perform a wide range of surgical procedures, including hernia repair, hysterectomy (uterus removal), appendectomy (appendix removal), and more.

Q: What are the benefits of laparoscopic surgeries for patients?
A:
 The benefits of laparoscopic surgeries for patients include reduced pain and scarring, faster recovery times and shorter hospital stays, lower risk of infection and other complications, reduced blood loss, and improved cosmetic outcomes.

Q: What is the typical recovery time for laparoscopic surgery?
A:
 The recovery time for laparoscopic surgery depends on the type of surgery and the individual patient. However, generally, patients who undergo laparoscopic surgery have shorter recovery times than those who undergo traditional open surgery and can typically return to normal activities sooner.

References:
https://medlineplus.gov/ency/presentations/100166_1.htm
https://my.clevelandclinic.org/health/treatments/22552-laparoscopic-surgery
https://www.nhs.uk/conditions/laparoscopy/#:~:text=Laparoscopy%20is%20a%20type%20of,surgery%20or%20minimally%20invasive%20surgery.
https://www.laparoscopyhospital.com/v1.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992667/

Introduction

Bariatric surgery can be an extremely positive experience for your body. As you know, bariatric surgery involves getting you a smaller stomach through surgery toward your weight-loss goal. Most people who have this type of surgery feel better afterwards. It’s also one of the most successful weight-loss surgeries available today. If you’re considering undergoing Bariatric surgery, you should probably get ready as your hospital team will also have many questions for you. So ensure you have all the answers beforehand so there are no last-minute hiccups during your surgery.

What is Bariatric Surgery?

Obesity is a leading risk factor for diabetes and heart disease. There is no treatment for obesity that is predictive and consistent with results except for bariatric surgery. Bariatric surgery is a medical procedure used to help people with obesity lose weight by reducing the size of the stomach and the intestines. Such reduction and resizing of the stomach can help the patient feel full after eating smaller portions of food. This ensures fewer calories go into the body, thus enabling losing weight much faster.

Who should go for Bariatric Surgery?

Bariatric surgery may be suitable –

  • For a person who is morbidly obese (meaning the said patient is very overweight and at high risk of developing other health problems, such as diabetes or heart disease). Bariatric surgery candidates are generally either overweight than 500 pounds or obese with a Body Mass Index (BMI) of 40 or higher.
  • To someone who is unable to reduce weight through exercise and diet control.
  • In cases where it is safe, look at the patient’s medical condition.
  • Where the obesity-related health issues are life-threatening and need immediate addressing

One should also be ready to commit to the lifestyle change that comes with Bariatric surgery.

Advantages and Disadvantages of Bariatric Surgery

There are many benefits to undergoing bariatric surgery. First, you will likely feel better about yourself. You’ll also have more confidence and feel more in control of your life. And Bariatric surgery can help you lose weight much faster than dieting alone. Bariatric surgery can also help you avoid other weight-loss methods that may be unsafe or ineffective. That’s because Bariatric surgery is the only type of weight-loss surgery proven to work long-term. You may be wondering if there are any disadvantages to undergoing bariatric surgery. However, studies show very few disadvantages to this surgery.

Like any other surgical procedure, Bariatric surgery too has associated risks. The related risks or side effects could be infection, vomiting, stomach obstruction, inability to eat a specific food, failing to lose weight, and risks related to anaesthesia or acid reflux.

How and Why is Bariatric Surgery Performed?

Weight reduction is generally obtained through two types of Bariatric surgery — Restrictive and Malabsorptive — each with its advantages and disadvantages or a combination of both. In Restrictive surgery, the surgeon removes a section of your stomach larger than the average amount. This will reduce the amount of food you can eat at one time. In Malabsorptive surgery, the surgeon removes some of your small intestine — which means one will not be able to eat food with high sugar content, such as bread, fruit and sugar-sweetened beverages. These bariatric surgeries are slightly different and are generally chosen based on the person’s lifestyle.

  • Restrictive Surgery aims at reducing the intake of food by reducing the size of the stomach
  • Malabsorptive Surgery aims at reducing the absorption of nutrients by the body by resizing the small intestine.

The various types of Bariatric Surgeries include-

  • Sleeve gastrectomy is a surgery where the portion of a stomach is removed along a greater curvature. The remaining portion of the stomach is a banana-shaped stomach.
  • Gastric Bypass Surgery- It is also known as Roux-en-Y. Here a portion of a stomach is created like a small pouch and directly connected to the small intestine.
  • Intragastric Air Balloon- A saline-filled silicone balloon is placed in the stomach through the endoscopic route.
  • Endoscopic Gastroplasty- Using an endoscope, the suturing device sutures the stomach reducing its shape and size to that of a tube.
  • Metabolic Surgery – This surgery specifically addresses diabetes and metabolic dysfunctions, which have stopped responding to any lifestyle or medication changes as opposed to obesity per se.
  • Biliopancreatic diversion– Also known as Duodenal Switch, this is a type of surgery where the food bypasses some part of the small intestine. This can be considered both a malabsorptive and restrictive type of surgery.

Preparation and Procedure of Bariatric Surgery

Before surgery, you should probably be completely ready for the change. It is a holistic approach and assessment by an inter-professional team of stakeholders. There will be a nutritional evaluation, psychological evaluation, a weight loss plan, and medical clearance from the concerned departments, including the anaesthetic one.

  • Start by researching the procedure carefully. Ask your doctor if they have had this surgery before and the expected recovery time. Make sure you talk to your doctor about the benefits and risks of the procedure.
  • Keep your expectations realistic – you will not wake up lean the day after surgery.
  • Rally for all kinds of support; you cannot do this surgery alone. Have someone from your family come in as your caregiver. Join an online support group.
  • Review your resources – medical assistance, nutrition guidance, exercise regime.
  • Identify and understand the risks of food cravings and addictions and seek medical help before the surgery.
  • Be ready for lifestyle changes in your daily life, such as taking it easy at work or not drinking liquids for 12 hours before bed.

Before surgery, you will have a pre-op appointment where you can ask your doctor any questions about the procedure, the procedure itself and what you will experience during your surgery. During this appointment, you and your doctor can review your diet and medications, if any. You may also want to ask about what you should do in the days before your surgery and what you can do to get yourself ready for surgery. And if you are undergoing pre-op testing, such as a blood test or an EKG, ensure you have all the results when you arrive at the hospital. Finally, if you have any pre-operative medications, bring them with you.

Procedure of Bariatric Surgery

Bariatric Surgery could be either an Open Surgery or Laparoscopic Surgery. Most of the weight loss surgeries are done laparoscopically unless the patient is highly obese, has undergone any stomach surgery previously, or has other health complications.

Depending upon the need of the patient the surgeon will perform either Restrictive or Malabsoptive Surgery. The surgery will be done under general anesthesia.

With Bariatric surgery, you can bypass the struggle of weight loss journeys not yielding results. The patient will get hospitalised for a day or two. In that time, the surgeon will make several small incisions in the abdomen and then insert a port so that the patient can get medication and fluids intravenously. Post-surgery, the patient will probably be free to go home. However, the patient may need to take it easy for a few days. 

Comply With Your Post-Op Diet and Restrict your Food Choices

Post your Bariatric surgery, and your diet will be restricted once you return home. You will be able to eat only a tiny amount of food and nothing high in sugar. Your diet will consist of either clear liquids or thick, bland blended food. You will only be able to drink fluids with a straw or a cup with a lid. You will not be able to cook or eat anything that has sugar added to it. You must follow these rules the entire time you are on a post-op diet. If you need to eat something that has sugar, you are allowed to have fruit or honey. However, these are the only foods you can eat on your post-op diet. It is important to note that you will be allowed to eat only minimal food. Eating smaller portions throughout the day is better than eating a large meal in one sitting.

Stay Safe and Keep Track of When to Return to Normal Life

It is important to keep yourself safe during your recovery. Make sure you do not fall, get hurt, or go near any dangerous activity. It is also vital to track when it is safe to return to work or school. You should also ensure enough rest, especially during the first few weeks after surgery. It is also important that you drink plenty of fluids.

FAQs

1. Do we have to lose weight before bariatric surgery?

Answer – Yes, Some patients are asked to lose 10 percent of their weight before their weight loss surgery to avoid complications.

2. How long is the preparation for bariatric surgery?

Answer – The entire process from preparation to surgery involves an inter-professional team of stakeholders who will evaluate the patient on multiple aspects, which can be up to six months.

3. What is the preparation for bariatric surgery?

Answer – The preparation is a holistic approach and assessment by an inter-professional team of stakeholders. There will be a nutritional evaluation, psychological evaluation, a weight loss plan, and medical clearance from the concerned departments, including the anesthetic one.

4. Who cannot undergo bariatric surgery?

Answer – Those with BMI below 35 cannot undergo bariatric surgery.

5. What foods to avoid after bariatric surgery?

Answer – All forms of red meat, high fat, and greasy food, spicy and seasoned food, processed food, alcohol, sugars, and sweets.

6. What are the risks of bariatric surgery?

Answer – The risks are infection, blood clots, failure to lose weight, chronic nausea and vomiting, acid reflux, allergy to certain foods, etc.