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.
The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options 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 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.
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 effective technique that is restrictive in nature is what is referred to as sleeve gastrectomy. As much as 15% of the stomach can be resected by use of this technique. Most of this portion is taken from the greater curvature. This technique transforms it into a tubular shape. Laparoscopes are often used 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.
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.
The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options 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 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.
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 effective technique that is restrictive in nature is what is referred to as sleeve gastrectomy. As much as 15% of the stomach can be resected by use of this technique. Most of this portion is taken from the greater curvature. This technique transforms it into a tubular shape. Laparoscopes are often used 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.
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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