Bariatric surgery has emerged as a solution to morbid obesity, as it provides a path to rapid and sustainable weight loss when adhering to the doctor’s instructions. Learn about the types of bariatric surgeries, and other information about them.
What is bariatric surgery?
Bariatric surgery is a type of surgery performed to treat morbid obesity (1) by reducing the size of the stomach and/or changing the path of food in the digestive system, (1) Most operations are performed laparoscopically, where special surgical tools are inserted through several small incisions (usually 4-6), each of which is 1-1.5 cm in size or less, as shown in the image below. (8)(9)
Bariatric surgery conditions
Before performing bariatric surgery, it is necessary to obtain an accurate evaluation by a doctor, to determine whether it is suitable for you, as these conditions must be met to perform it: (2)
1. Suffering from morbid obesity, or obesity that has caused other health problems.
2. The ineffectiveness of other weight loss methods in reducing excess weight.
3. Psychological and physical preparation for the operation.
4. Adherence to the doctor’s instructions after surgery, especially regarding diet and follow-up.
What are the benefits of bariatric surgery?
According to the American Society for Metabolic and Bariatric surgery (ASMBS), bariatric surgery achieves notable benefits, the most important of which are: (4)
·Rapid and significant weight loss: 50-60% and sometimes more during the first one to two years.
·Reducing the risk of mortality resulting from diseases resulting from obesity: such as diabetes, heart disease, etc., by 30-50%.
·Controlling chronic diseases: Most of those suffering from chronic obesity diseases have their measurements become normal, and the doctor tapper the dose of their medications until he stops them in many cases.
Types of bariatric surgeries
There are many types of bariatric surgeries, so it is necessary to obtain an accurate evaluation by a doctor before surgery to determine which one is suitable for you. In general, the more complex the surgical procedure is, the greater its result in weight loss, but the higher its side effects. (5)
Some common types of bariatric surgery are:
1. Sleeve gastrectomy
Sleeve gastrectomy surgery is the most common bariatric surgery, because it is a simple and generally safe surgery, and its effectiveness is excellent in losing weight. The sleeve gastrectomy procedure involves removing about 80% of the stomach, while keeping a small part in the form of a narrow tube, and this limits the amount of food that is you can eat, (5) and achieves approximately 33-58% weight loss within the first 1 to 2 years of operation. (10)
2. Gastric bypass
Bypass is a more complex operation than sleeve gastrectomy, as it involves not only reducing the size of the stomach, but also modifying the intestine level, as the path of food through the intestine is reduced, which reduces the absorption of calories from food. In principle, the bypass operation connects the upper part of the stomach directly to the lower part of the small intestine, bypassing what is between them. This means reducing the size of the stomach in addition to reducing the absorption of calories, which achieves a weight loss of approximately 50-65% during the first two years of the operation. (3)
3. Gastric band surgery
It involves tying an inflatable band around the stomach to divide it into two parts, a small upper part and a larger lower part, which reduces the capacity of the stomach and slows down its emptying. This helps you gradually lose weight, by 45-72% over 3-6 years. It is a procedure that can be reversed, i.e. removed at any time, but the use of gastric band has become less frequent now due to the presence of other, more effective alternatives. (10)
4. Biliopancreatic diversion with duodenal switch (BPD/DS)
This surgery is considered the most complex among the types mentioned, and its use is limited to cases of very morbid obesity that are accompanied by health complications. It combines sleeve gastrectomy and bypassing most of the small intestine, which significantly reduces the absorption of nutrients. Therefore, it is not used except in very serious and severe cases of obesity. (7)
In order to achieve the best weight loss result after bariatric surgery, you must adhere to the doctor’s instructions, especially regarding your diet.
The General Surgery Department at Al-Ahli Hospital provides specialized, high-quality medical services to patients suffering from severe obesity problems at the hands of the most skilled specialist doctors, using modern techniques according to each patient’s individual condition.
Comparison table between bariatric surgeries
The table below summarizes the most important differences between common obesity surgeries:
Comparison standard | Gastric band | Sleeve Gastrectomy | Gastric bypass | Biliopancreatic diversion with duodenal switch |
The principle | Reducing the stomach size | Reducing the stomach size | Reducing the size of the stomach + bypassing part of the intestine | Reducing stomach size + changes in the intestinal tract |
Lose weight | Intermediate | Significant | Significant | Significant |
Reversibility | Yes | Permanent | Partial | Permanent |
The complexity of the process | Low | Intermediate | Intermediate to high | High |
Recovery period | Short | Intermediate | Intermediate | longer |
Suits | Non-severe obesity | Moderate to severe obesity | Moderate to severe obesity | Severe obesity is accompanied by health complications |
Are there risks to bariatric surgery?
Bariatric surgery carries some risks that should be discussed with the doctor, but in general, most patients see a significant improvement in their health, and in general it can be said that the risks of severe obesity itself and the diseases it may cause are often much greater than the potential risks of bariatric surgery. (2)(6)
These risks vary depending on the type and degree of surgery, the individual’s health, and the extent of his compliance with post-surgical care instructions, and may include: vitamin and mineral deficiencies, gallstones, and problems such as hernia, heartburn, stomach acid reflux, diarrhea, nausea, vomiting, and others. (2)(6)
References:
- https://www.nhs.uk/conditions/weight-loss-surgery/
- https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258#:~:text=Bariatric surgery is done to,Sleep apnea
- https://my.clevelandclinic.org/health/treatments/17285-bariatric-obesity-surgery
- https://asmbs.org/resources/metabolic-and-bariatric-surgery
- https://asmbs.org/patients/bariatric-surgery-procedures
- https://my.clevelandclinic.org/-/scassets/files/org/bariatric/guides/bmi-manuel-feb2020-web.ashx?la=en
- https://www.webmd.com/obesity/weight-loss-surgery-making-the-choice
- https://bariatricsurgery.ucsf.edu/conditions--procedures/laparoscopic-gastric-bypass.aspx
- https://www.johnscreeksurgery.com/procedures/single-incision-surgery/#:~:text=The incision utilized in laparoscopic,incision resulting in minimal scaring.
