Who Are Potential Candidates For Bariatric Surgery?

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Many adults across the whole world are facing the same common issue, which is obesity. Obesity is more than just increased weight. It causes many health risks like blood pressure, laziness, coronary diseases, and more such diseases. A person is termed obese when he has excess BMI and started to have other issues related to the weight. Apart from exercise, slimming treatment, diet, and other treatments, medical science has another cure for this, i.e., Bariatric surgery. Bariatric surgeries are operations that modify or change the structure of a patient’s stomach and intestines to cause weight loss. 

Bariatric surgical procedures either restrict the capacity of the stomach to hold the reduced amount of food, or with it, they also minimize the passage of intestines, which causes malabsorption of nutrients. Bariatric procedures also cause hormonal changes in the body. Fortunately, science has found ways to ignore much wear and tear so that most surgeries can be performed in a minimally invasive way (laparoscopic surgery). Today bariatric surgery in India is on a rising curve and is even being boosted by the increasing medical tourism industry. For bariatric surgery, first, one needs also to know whether he/she is a candidate for it or not.

Who Can Opt For Bariatric Surgery

Bariatric surgery can be an option for adults who have:

  • A body mass index (BMI) of 40 or more
  • A BMI of 35 or more with a serious health problem that is linked to obesity, like type 2 diabetes, heart disease, or sleep apnea
  • A BMI of 30 or more with a serious health problem that is linked to obesity (but they will be eligible for the gastric band only)

Opting for bariatric surgery is a serious decision, and one can’t undo it. The changes in the stomach and intestine are irreversible and will be there for the whole life. Patients are given full knowledge regarding it, and all FAQs are answered. It is advisable first to try other means of getting fit and healthy, nonsurgical ways like lifestyle moderations or medical drug treatments. If not, then also the treatment seeker should study the eligibility, risk, and benefits of different types of bariatric surgeries. Consider the changes in your body and diet once you would have done the surgery. After bariatric surgery, you will have to opt for healthy eating and increased physical activity for a lifetime. There’s no turning back, and also you might need to take extra vitamins and minerals.

Types of Bariatric Surgery:

Bariatric Surgery has two broad categories: 

  • Restriction- In this, the stomach’s natural capacity to hold food is reduced. It results in lesser intake of food. 
  • Malabsorption- In these, a part of the small intestine is shortened or bypassed, thus reducing the number of calories and nutrients the body can absorb. 

Following are the types of restrictive weight-loss surgery:

  • Vertical banded gastroplasty (VBG)- It is also known as stomach stapling. The upper section of the stomach is made into a small pouch by using a band and staples. The pouch has a small hole in bottom for contents to flow to the stomach for the normal digestive process.
  • Laparoscopic adjustable gastric band (LAGB)- In this, an inflatable bland is positioned around the top portion of the stomach. When inflated, the band acts like a belt and divides the stomach into two pouches (upper small and lower big). 
  • Sleeve gastrectomy or gastric sleeve- It is the process of surgical removal of a large portion of the stomach, leaving behind only fifteen percent of the original one. The edges are then attached with surgical staples, sutures, or both. 
  • Gastric plication or sleeve plication- It is a newer minimally invasive weight-loss surgery technique which done to reduce the size of the stomach capacity by 3 ounces. It is also considered as a sophisticated version of sleeve gastrectomy. The sleeve is created by folding the liver rather than removing the stomach a part of it. 

Following are the types of malabsorption weight-loss surgery are:

  • Roux-en-Y (Gastric Bypass)- The top part of the stomach is removed, and remaining is sealed. Then the small intestine is joined at the shortest distance from the cut at the stomach by sewing them. This results in food getting bypass the maximum section of the stomach. 
  • Biliopancreatic diversion with duodenal switch- It’s the most complex version of all bariatric surgeries. First, the eighty percent of the stomach is removed, then the point (duodenum) where contents exit the stomach and enter the small intestine is cut. Another cut is made in the small intestine like the one in the gastric sleeve. Duodenum is sealed and attached back at the stomach, the second head of this part of the intestine is attached to the rest of the small intestine, 75-100 cm before the colon. The stomach is smaller so the patient will feel full sooner, and as the certain part of the small intestine is shortened, the nutrients will be absorbed less.

The below methods and techniques are the nonsurgical but bit complex ways that are often debated to be included in bariatric surgery or not. They are done by bariatric surgeons, though. 

  • Gastric balloon- In this, a silicone balloon inflated with saline solution is placed in the stomach. This makes the patient feel full sooner and reduces the appetite.
  • Vagal blockade or Vblock- In this, a device similar to a heart pacemaker is implanted, the electrical impulses leads to stimulating the external surface of the stomach to modify the activity of the enteric nervous system, which is then interpreted by the brain to give a sense of fullness. 

Risks in Bariatric Surgery

Every surgery in the world comes with certain risks, so risks are present in bariatric surgeries as well. The bariatric surgeons will surely take all the possible measures to make your sugery smooth. Chances of any mishappening are always there. That’s why it is repeatedly advised not to choose surgery until the doctor states that it is a final way to treat your problem. So even after all the measures and precautions, a patient shall be aware of all the possible risks that are related to bariatric surgery. 

  • These procedures are not cosmetic surgeries. Many patients confused the two.
  • This doesn’t mean liposuction. Only your hunger will be reduced through it.
  • Most of these types of surgeries are not reversible. 
  • The success of these types of surgeries is dependent upon the long-term lifestyle changes in diet and exercise.
  • In rare cases, problems are at the extent of causing re-operations. 
  • Surgery can result in internal bleedings or scar tissues.
  • In the case of malabsorption, malnutrition or other deficiencies is also possible.

Today, bariatric surgeries have high demand, but they are always considered as the last option only. Other than surgery types and risks associated with it, like in any other surgery, the qualification and experience of a bariatric surgeon matter a lot in the success and smooth completion of the surgery. 

Author’s Bio:
Heena Motwani is among the renowned bariatric surgeons in India. She has performed many bariatric surgeries, and in her experience, she has mastered how to reduce complications of such surgeries. She is a skilled laparoscopic surgeon who believes in being updated with technology. Her patients have mentioned in their feedbacks that with medical treatment, she supports them morally and emotionally as well. Apart from, this she always tries to add up to the industry. For this, she is affiliated with different hospitals as a bariatric surgery consultant.

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