What is bariatric surgery?
Bariatric surgery makes changes to the digestive tract so that food intake is restricted, food is not broken down in the stomach, and/or its absorption in the intestine is constrained. A reduction in a number of nutrients absorbed by the body allows patients to lose weight and counter the various risks posed by obesity. Since bariatric surgery ultimately enables patients to lose weight, it is generally referred to as the weight-loss surgery.
There are many types of bariatric surgeries, the most common of which is the gastric bypass surgery as it offers fewer complications than other weight-loss surgeries.
“Every 10 KG increase, reduces the life span by 3 years” says Dr. Pradeep Chowbey, Vice Chairman of Max Healthcare and Director of Institute of Minimal Access, Metabolic and Bariatric Surgery.
Why bariatric surgery?
Bariatric surgery is the last option for those for whom traditional forms of weight loss like diet, exercise, and medication have proved ineffective. Bariatric surgery allows patients to lose excess weight and their risk to other problems and disorders that result from excess body weight such as:
- Heart disease
- High blood pressure
- Gastroesophageal reflux disease
- Type 2 diabetes
- Severe sleep apnea
Body mass index (BMI) is a measure of a person’s height in relation to weight, and is used to determine level of obesity and the need for surgical intervention. A patient is considered as a candidate for bariatric surgery if his/her body mass index (BMI) is 40 or higher or has a BMI between 35 and 39.99 also shows the above weight-related health issues. A BMI of 40 and above indicates extreme obesity and that between 35-35.99 indicates obesity. Patients with lower BMI (between 30 and 34) may qualify for the surgery if they exhibit other serious weight-related health issues.
Which specialist should be consulted if the patient shows any of the signs and symptoms?
A patient must visit a general practitioner who will assess the BMI status and conduct preliminary tests to determine if the candidate should consult a bariatric surgeon. A bariatric surgeon will consider various patient factors and discuss the most suitable surgical option with the patient.
What are the screening tests and investigations before the surgery?
Once a patient qualifies for a bariatric surgery, s/he will undergo various lab tests and screening exams before the surgery. There could be a restriction on diet and medications and the patient may be counseled to start a physical activity regimen.
What is the procedure for bariatric surgery?
Bariatric surgery is performed under general anaesthesia and takes several hours. While some weight-loss surgeries are performed as open procedures, most bariatric surgeries today are carried out laparoscopically. Small incisions are made in the abdomen, and through one of these incisions is inserted a small, tube-like instrument with a fitted camera at its end (laparoscope). The camera transmits real-time images from inside the abdomen, allowing the surgeon to operate without actually needing to make large incisions and see the area being operated upon.
The laparoscopic bariatric surgery offers minimal tissue damage and scarring and quick recovery with less post-operative complications.
What are the known complications of the surgery?
Risks associated with bariatric surgery include:
- Excessive bleeding and blood clots
- Gastrointestinal leaks
- Lung problems
Obese patients with signs of diabetes or heart disease are at a higher risk of complications, as are older patients and patients with high blood pressure. Death may occur in rare cares.
More long-term complications of bariatric surgery may include:
- Bowel obstruction
- Low blood sugar
- Diarrhea, vomiting
What precautions or steps are necessary to stay healthy and happy before and after bariatric surgery?
To derive maximum gain from the surgery, patients must invest in permanent healthy changes in their diet and physical condition. A good diet and regular exercise will go a long way in maintaining the positive effects of a bariatric surgery.
What are the dietary and physical activity requirements before and after bariatric surgery?
Many teams of specialist doctors will monitor and assess a patient’s health, including heart and lung before the surgery. They may ask the patient to lose some weight prior to the surgery and generally commit to improving their overall health. Smokers face a higher risk from surgery and are advised by doctors to quit smoking before the surgery. Dietary changes must be included before the surgery itself – eating smaller portions, eating slowly and making conscious efforts to include nutritious meals will help patients to prepare themselves for the surgery and life afterward.
Patients will be required to not eat for one or two days following the surgery to allow the stomach and digestive system to heal. A specific diet plan will be charged for the next three weeks that will begin with an only liquid diet, and slowly progress towards soft foods and finally solid food.
“Bariatric Surgery – What is Bariatric Surgery?” News-Medical.net, Dr Ananya Mandal, MD, https://www.news-medical.net/health/Bariatric-Surgery-What-is-Bariatric-Surgery.aspx
“Gastric Bypass Surgery,” Mayoclinic.com, Mayo Clinic Staff, https://www.mayoclinic.com/health/gastric-bypass/MY00825
“Weight Loss Surgery Health Center,” WebMD.com, Weight Loss Surgery Health Center, https://www.webmd.com/diet/weight-loss-surgery/preparing-for-weight-loss-surgery
“Weight loss surgery,” NHS.uk, https://www.nhs.uk/conditions/weight-loss-surgery/Pages/Introduction.aspx
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