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Outcomes of Bariatric Surgery - Aims, Advantages, and Disadvantages

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Bariatric surgery is a surgical treatment for obesity that involves balancing calorie and diet intake. Read the article to know more.

Medically reviewed by

Dr. Shivpal Saini

Published At February 17, 2023
Reviewed AtFebruary 27, 2024

Introduction:

Bariatric and metabolic surgery is a weight-loss surgery as it impacts an individual's weight and metabolism (energy from the breakdown of food). As a matter of fact, obesity is the gateway to many health-related problems. As a result, these procedures can treat obesity; they are also very effective in treating diabetes, high blood pressure, sleep apnea, and high cholesterol. Additionally, they also help in controlling future health problems.

Metabolic and bariatric procedures have advanced over the last few decades and are now considered the most thoroughly researched treatments in modern medicine. They are accomplished through small incisions and minimally invasive surgical procedures such as laparoscopic and robotic technology. These operations are particularly safe, with lower complication rates than common operations.

What Is the Bariatric Surgery Procedure?

The procedures below have been listed and explained by the American Society for Metabolic and Bariatric Surgery:

  • Sleeve Gastrectomy.

  • Roux-en-Y Gastric Bypass.

  • Procedures For Adjustable Gastric Bands.

  • Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S).

What Is the Aim of This Procedure?

These procedures aim to modify the stomach and intestines to treat obesity and related diseases by making the stomach smaller and bypassing a portion of the intestine, resulting in less food intake and shifting the body's absorption of food, which cause decreased hunger, increased fullness, and leads to weight loss.

What Is Sleeve Gastrectomy?

Sleeve gastrectomy, also known as "sleeve" operation, this is achieved by withdrawing approximately 80 percent of the stomach; the remaining stomach is the size and shape of a banana. The stomach is released from the organs around it. With the help of surgical staplers, it staples 80 percent of the stomach, making it much smaller, which holds less food and liquid, helping reduce the amount consumed, thus helping to maintain a balancing effect on the metabolism. The operation is safe without the potential for complications in the small intestine.

What Are the Advantages of Sleeve Gastrectomy?

  • Technically easy with a shorter surgery time.

  • High-risk medical conditions patient.

  • Severe obesity in an individual.

  • Used as a bridge to gastric bypass.

  • Useful in weight loss and modification of obesity-related conditions.

What Are the Disadvantages of Sleeve Gastrectomy?

  • Non-reversible procedure.

  • The onset of reflux and heartburn.

  • Less effect on metabolism.

What Is the Roux-En-Y Gastric Bypass?

It is also called gastric bypass surgery. It is one of the most standard operations and is very productive in treating obesity and obesity-related diseases. During the procedure:

  • The stomach is divided into a smaller top portion that forms a pouch about the size of an egg, whereas the larger portion of the stomach is bypassed and no longer stores or digests food.

  • The small intestine is also divided and joined to the new stomach bag to permit food to leave, resulting in a bypass by the small bowel segment, with the bowel assembly shaped like a "Y."

  • Like many bariatric procedures, the recently assembled stomach pouch is smaller and can harbor less food, meaning fewer calories are ingested.

  • Also, the food does not reach the first part of the small bowel, which makes absorption less effective.

  • The patient is expected to take responsibility for making appropriate food choices and avoid tobacco derivatives and non-steroidal anti-inflammatory drugs (NSAIDs).

What Are the Advantages of the Roux-En-Y Gastric Bypass Procedure?

  • Long-lasting weight loss.

  • Remission of obesity-associated conditions.

  • Standardized technique.

  • Helps patients with reflux and heartburn.

What Are the Disadvantages of the Roux-En-Y Gastric Bypass Procedure?

  • Technically more complex.

  • As the abortion part is interrupted, it causes vitamin and mineral deficiencies.

  • Small bowel complications and obstruction.

  • Peptic ulcers, especially with the use of NSAIDs or tobacco.

  • Dumping syndrome is when a person feels sick after eating or drinking.

What Are the Surgical Procedures for Adjustable Gastric Bands?

The adjustable gastric band is a silicone apparatus positioned and secured around the stomach's top part, creating a small pouch above the band to restrict the food consumed by a person. How full you feel depends on the space between the pouch and the rest of the stomach. The opening is modified with fluid injections via a port underneath the skin.

Food usually goes through the stomach but is restricted to the small opening of the band. So it helps with type two diabetes and doesn't change the metabolism much.

What Are the Advantages of Adjustable Gastric Band?

  • The complication rate is low.

  • No sectioning of the organs like the stomach or intestines.

  • Out-patient surgery.

  • The band can be withdrawn if required.

  • Reduced risk for vitamin and mineral deficiencies.

What Are the Disadvantages of Adjustable Gastric Band?

  • The band may require several adjustments monthly.

  • Gradual and less weight loss.

  • Slippage of the band or damage to the stomach over time leads to erosion.

  • Needs an unfamiliar implant to stay in the body.

  • High rate of reoperation.

  • Issues like difficulty in swallowing and enlargement of the esophagus.

What Are the Surgical Procedures for Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)?

The operation begins exactly as with the sleeve gastrectomy by constructing a smaller tube-shaped stomach, and then the first portion of the small intestine diverges just after the stomach. The loop of the intestine is probably a few feet from the end, and it is then attached to the stomach. This procedure helps the patient swallow, and food goes through the pouch and straight into the portion of the small bowel. The bolus then combines with digestive juices from the first part of the small intestine. This lets enough vitamins and minerals be absorbed to maintain healthy nutrition and helps people lose weight, feel less hungry and fuller, and improve their diabetes.

What Are the Advantages of Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)?

  • Long-term weight loss and remission in type two diabetes.

  • Simpler and faster.

  • This is ideal for a patient who has already done a sleeve gastrectomy.

What Are the Disadvantages of Single Anastomosis Duodenal-Ileal Bypass With Sleeve Gastrectomy (SADI-S)?

  • Vitamins and minerals deficiency as it is not absorbed.

  • Worsens the new-onset reflux.

  • More frequent bowel movements.

Conclusion:

Bariatric surgery is a metabolic intervention for weight loss that limits overeating and controls obesity-related diseases such as diabetes and hypertension. The surgery is best for people who are overweight, can't control how much they eat, and feel tired because they are overweight.

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Dr. Shivpal Saini
Dr. Shivpal Saini

General Surgery

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