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.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
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.
In the immediate post-operation period, one should only take liquid foods such as fruit juices and broth and gelatin desserts which are sugar-free. One should eat these foods until the gut fully recovers from the operation. Other diets to be introduced slowly include skimmed milk, cream soup, protein drinks and blended foods.
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.
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.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
The restrictive procedure is one that minimizes eating by restricting the stomach volume. Persons that have undergone this type often get satisfied earlier than normal. Vertical banded gastroplasty is one of the procedures that can be used here. It involves the permanent placement of staples on the stomach in a manner that results in the creation of a smaller pouch. It is the safest.
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.
In the immediate post-operation period, one should only take liquid foods such as fruit juices and broth and gelatin desserts which are sugar-free. One should eat these foods until the gut fully recovers from the operation. Other diets to be introduced slowly include skimmed milk, cream soup, protein drinks and blended foods.
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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