Weight reduction surgery is stepwise procedure that is done to correct obesity in persons that are struggling with excess weight. It is also termed bariatric surgery. During the procedure, it is often necessary to reduce the size of the stomach as well through a number of techniques. This may be done either by use of sleeve gastrectomy or by use of a special gastric band. The former cuts off some portion whereas the latter only shrinks the volume. The bariatric procedure greatly benefits people struggling with conditions such as hypertension and diabetes.
The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options have failed.
The benefits and risks of the procedure should be considered in full before a decision is made as to whether or not to have it. Most common complications that should be considered are malabsorption syndromes and gall bladder diseases. There is a high risk of patients getting into depression and as such pre-operation counselling is warranted.
Surgical procedures are grouped in to three main categories. These are malabsorptive, restrictive or mixed. The most commonly performed is the malabsorptive procedure. Malabsorptive operations aim at creating a physiological state of malabsorption. Biliopancreatic diversion combined with duodenal switch (BDS/DS) is one such undertaking. A section of the stomach is resected, creating a smaller pouch which is then directly connected to the ileum, bypassing the duodenum and jejunum. The malabsorption that results can be severe enough to cause serious deficiency diseases such as osteoporosis and anemia unless vitamins and mineral supplements are administered.
Predominantly restrictive procedures aim at minimizing oral intake by restricting gastric volume. This produces early food satisfaction. Vertical banded gastroplasty involves permanent stapling of the stomach to create a small stomach to handle the food. It is regarded as one of the safest operations carried out today.
Another restrictive technique is known as sleeve gastrectomy. In the hands of a skilled surgeon, up to 15% of the original size of the stomach can be successfully removed. The greatest portion is taken from the greater curvature. The stomach shape is transformed into more of a tube. In advanced centers, laparoscopes are used so as to improve on the accuracy.
The diet of the patient after surgery becomes restricted to liquid foods such as broth, fruit juice and gelatin desserts that are sugar free. This kind of diet is maintained until the alimentary canal recovers from the surgery. The next diet is composed of blended substances which are sugar free, consisting of foods such as cream soup, skimmed milk, protein drinks among others.
As with any surgical procedure, there are a number of side effects associated with weight reduction surgery. Persons that have had this operation frequently have difficulties absorbing calcium. As a result, they often get various forms of metabolic bone disease of which osteopenia and secondary hyperparathyroidism are clinical features. The fact that loss of weight has occurred suddenly predisposes these individuals to gall stone formation. Other complications include reduced absorption of essential nutrients such as folate, iron, vitamin B12 and thiamine.
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