Obesity is a great epidemic & health problem in many developed countries and is becoming an increasing concern in developing countries. Presently, Bariatric surgery is the only available treatment for morbid obesity that consistently achieves and maintains substantial weight loss, decreases the incidence and severity of obesity-related medical diseases and improves overall quality of life and survival.
The first bariatric surgery performed in humans was reported in 1954. Due to the continued demand for weight loss operations, subsequent procedures were developed that focused more on gastric restriction and limited mal-absorption. The most commonly performed Bariatric operations at present are the Roux-en-Y gastric bypass and the adjustable gastric band and vertical sleeve gastrectomy, affecting on hormonal, inflammatory, central nervous system and gut microbial flora factors.
Laparoscopy allows surgery to be performed through small incisions, minimizing pain and wound complications. Comparing the success and complications of the contemporary bariatric operations has been difficult but it surely outweighs on cons.
OBESITY IS THE MOTHER OF MOST OF THE DISEASES !!!
Bariatric surgeries are considered only in patients who have failed on expertly guided LIFE STYLE MODIFICATION programme.
Various weight loss surgeries have been developed and refined over the years. Today there is a wide variety to choose from. The top three types of weight loss surgery are Roux-en-Y Gastric Bypass, gastric banding, and gastric sleeves. Each has its pros and cons.
LAPAROSCOPIC GASTRIC BANDING
This entails a laparoscopic implantation of a Silastic Band around the upper part of the stomach. This creates an Hour-Glass effect. Since the outlet is small, food stays in the pouch longer and one feels satiated for a longer time. Band can be inflated or deflated by injecting water into the port as an outpatient. Hospital stay is one day.
LAPAROSCOPIC SLEEVE GASTRECTOMY
In this, approximately 80-90% of the stomach is excised and removed as per the patient’s need. Stomach takes the shape of a small tube. It also removes the part of the Ghrelin Hormone thus by reducing the appetite. This complements the restriction of the intake. Hospital stay is two days.
LAPAROSCOPIC GASTRIC BYPASS
A small stomach pouch is created by dividing the stomach. This causes restriction of the food intake. Next y-shaped section of the small intestine is attached to the pouch to allow food to bypass the first part of the small intestine for mal-absorption. This rearrangement allows good gut hormones to be secreted and which in turn helps control adverse metabolic diseases like diabetes, high blood pressure etc. Hospital stay is three days.
1. Assured weight loss.
2. Easy to maintain lost weight.
3. Resolution of Obesity related diseases.
4. Improved quality of life.
5. Improved self-esteem.
6. Improved social image.
7. Short hospital stay.
8. Almost painless procedures.
1. Potential peri-operative or post-operative complications.
2. They are rare about 1%-5% depending on the quality of a surgeon, hospital and the equipment.
3. Cost. This is mainly because of the equipment used in the surgery. Overall cost cutting may lead to deaths and sufferings.
4. Nutritional complications.
5. Regular follow up visits with the primary doctor minimises the chances.
Bariatric surgery is not a cure, it’s a beginning. Self-motivation is primary.
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