Bariatric Surgery

Obesity is a worldwide epidemic. Currently, bariatric surgery is the only real and available option to tackle this.

The gastric band was very popular in the 1990s, and seemed a simple but safe and effective procedure to fix obesity. Unfortunately, the original enthusiasm faded away, as more and more complications emerged as time went on. Slippage and erosion are the two most common; and these conditions required emergency operations. However, there were a lot of patients who simply did not tolerate the "restriction" caused by the gastric band, so the regaining of weight and a bad quality of life led to this procedure to become more or less extinct these days.

Nevertheless, if you have a gastric band fitted, and that works well for you, there is no need for opting to remove it.

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Nowadays the sleeve gastrectomy has gained a significant interest, as the procedure is less complicated than the gastric bypass (mentioned below).

Essentially, the volume of the stomach is reduced by 80-85%, and this is physically removed from the body. The consequence of this is that the person can eat much less than before, and there is a subsequent weight loss. You are expected to lose around 60% of your pre-existing excess weight, however personal results vary from this statistical average.

Due to the reduced food consumption, the nutrient and vitamin absorption is impaired, and it is recommended for you to take specific vitamins on a daily basis.

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Roux-en-Y gastric bypass (RYGB), commonly called simply “gastric bypass”, is one of the most commonly performed bariatric procedures worldwide and has long been considered the “gold standard” of bariatric surgery.

The operative procedure involves staple-dividing the stomach into two chambers. The upper chamber - called the pouch - receives food and is very small, holding about 20-30 cc. The lower chamber - called the gastric remnant - is “bypassed” and does not receive food. The small intestine is divided at a certain point and one end is connected (“anastomosed”) to the pouch. A second connection (“anastomosis”) is made to connect the disconnected stomach and duodenum to the small bowel. This connection enables the digestive fluids to meet the ingested food to enable nutrient breakdown and absorption. The distance between the two connections can vary by surgeon preference but is generally 50 to 150 cm.

Following bypass surgery, patients can expect to lose around one third of their total body weight, or 70-75% of the original excess weight. The usual weight loss is 6 kg (1 stone) per month.

However, the gastric bypass procedure can result in significant vitamin and mineral deficiencies including iron, vitamin B12, vitamin B1, calcium, zinc, vitamin D and folate.

 

Therefore, as with all bariatric procedures, the patients  require life-long surveillance and vitamin and mineral supplementation.

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Should you require more information about the procedures, please visit either of the following websites: