03 December 2008

It’s not easy to deciding which Bariatric surgery you’ll take. And after you choose the surgery type, there are still many different procedures to choose from. It’s all depends to your goals, current health, surgeon's preference, and of course, which procedures are covered by your insurance.

There are two basic types of weight loss surgery -- restrictive surgeries and malabsorptive/restrictive surgeries. They help with weight loss in different ways. They are Restrictive and Malabsorptive Strategies

Restrictive surgeries work by physically restricting the size of the stomach and slowing down digestion. These procedures make you feel full with far less food. Since you feel full more quickly, your total intake of calories is lower, resulting in weight loss. A normal stomach can hold about three pints of food. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. The surgeries are :

1. Adjustable Gastric Banding
  • It divides the stomach into two parts, although with both a band and surgical staples. Because the results weren't as good as other techniques, it's now less common.
2. Sleeve Gastrectomy
  • This operation usually done with a laparoscope, about 75% of the stomach is removed. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines. Sleeve gastrectomy is irreversible.
  • Usually, a sleeve gastrectomy is a first step in a sequence of weight loss surgeries. It's typically followed up by gastric bypass or biliopancreatic diversion, which will result in greater weight loss.
  • Standard gastric bypass or biliopancreatic diversion may be too risky for people who are very obese or sick.
  • Once they've lost weight and their health has improved (usually after 12-18 months) they can go on to have a second surgery, such as gastric bypass.
  • In people with high BMIs, sleeve gastrectomies result in an average weight loss of 40% to 50% of excess weight after three years.
  • People with lower BMIs tend to lose even more of their excess weight.
  • Because the intestines aren't affected, a sleeve gastrectomy doesn't affect the absorption of food, so nutritional deficiencies are not a problem.
  • The Risks : Typical surgical risks include infection, leaking of the sleeve, and blood clots.
See more about Vertical Sleeve Gastrectomy for more information.

Malabsorptive Surgeries
Commonly referred to as or metabolic surgeries, are more invasive surgeries that work by changing how you take in food. In addition to restricting the size of the stomach, these surgeries physically remove parts of your digestive tract, which makes it harder for your body to absorb calories and nutrients. The unprocessed food passes through the body as feces while the decrease in calories causes weight loss. One of the Malabsorptive surgeries is Gastric Bypass Surgery.

Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)
  • Gastric bypass is the most common type of weight loss surgery. It makes up about 80% of all weight loss surgeries in the U.S., and combines both restrictive and malabsorptive approaches. It can be done as either a minimally invasive or open surgery. It’s irreversible. See What is Gastricpass Surgery for more information.
  • The surgeon divides the stomach into two parts, sealing off the upper section from the lower. The surgeon then connects the upper stomach directly to the lower section of the small intestine. Essentially, the surgeon is creating a shortcut for the food, bypassing a section of the stomach and the small intestine. Skipping these parts of the digestive tract means that fewer calories get absorbed into the body. See Gastric Bypass Procedure for more information.
  • Weight loss tends to be swift and dramatic. Most of it happens in the first six months. It may continue for up to two years after the operation. Because of the rapid weight loss, health conditions affected by obesity like diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, heartburn, and other conditions often improve quickly. You'll probably also feel a dramatic improvement in your quality of life.
  • Many people keep most of the weight off for 10 years or longer.
  • The Risk : serious nutritional deficiencies, Dumping syndrome, nausea, bloating, pain, sweating, weakness, and diarrhea gallstone, blood clot. Dumping is often triggered by sugary or high-carbohydrate foods, and adjusting the diet helps. Because these weight loss surgeries are more complicated, the risks are higher. The risk of death from these procedures is low (under 1%) but they are more dangerous than gastric banding.


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