Bariatric surgery – Advantages & Disadvantages

Journey to weight loss

This is also called weight-loss surgery.

Bariatric surgery is suggested for people who are morbidly obese and also for those with co-morbidities along with battling obesity.

The advantages of weight loss are innumerable and help in the treatment of Diabetes, Hypertension, Fatty liver, Osteoarthritis of the knee and reduced risk for cancers, respiratory disorders and gallstones. 

The patients must be disciplined in diet and highly motivated to exercise. They should not have calorie-rich foods.

 Procedures one can choose from 

1) Intra-gastric balloon

2) Gastric bypass 

3) Sleeve gastrectomy 

Intra–gastric balloon 

• Procedure involves the deployment of a balloon in the stomach done by an endoscope.  
• It is a temporary procedure done; after waiting for 3-6 months, this balloon can be removed, and the patient learns to eat less. 
• This balloon gives a sense of fullness all the time, which prevents the patient from eating any further. 

Advantages 

It is reversible, needs no anaesthesia and is the least expensive, least risk involved. 

Disadvantages  

It is temporary, and the patients can go back to their ways of overeating and thus can become obese again. 

Gastric bypass 

• This usually involves restrictive surgery with malabsorptive surgery. 
• Here, the gastric pouch is created and anastomosed (sutured) to a Roux-en-Y limb (cut limb of the small intestine) to reduce the exposure of food to the digestive enzymes and also causes Diarrhoea due to improper absorption. 
• Limiting the food to a lesser extent in the small intestine also reduces the absorption of food (by passing a significant length of the small intestine).
• The surgery is done under anaesthesia, and all the precautions for general anaesthesia have to be followed, and the risk should be borne in mind.

Gastrectomy – Sleeve gastrectomy

• This is a procedure that is done under general anaesthesia usually. 
• It does require extensive preparation and has all its associated risks.
• The common risk is cardiovascular, respiratory, neurological and venous thrombosis. 
• In this procedure, the stomach is cut along its long axis so that it is not distensible to accommodate a large meal, this is a restrictive surgery. 
• This is a permanent loss of distensibility.
• The stomach can expand over a period of 3 years and can accommodate a big meal. 

 Gastric band – Adjustable type

• Placement of the band is done by the laparoscopic procedure under general anaesthesia.
• It is a reversible procedure by which food intake is drastically decreased.
• An inflatable band is placed over the upper part of the stomach, in which fluid is filled to constrict that area.
• Regular checkups with the surgeon are mandatory to check the tube to avoid complications such as rupture, abnormality in the stomach wall lining etc.
• Abstain from intake of alcohol and smoking permanently. These patients may suffer from Anaemia, as red meat is to be avoided.
• Patient needs to be on a liquid diet till recovery and then slowly change to soft solids and then to the normal diet. So intake of multivitamins is mandatory in this case.

Conclusion

Almost all Bariatric procedures have occasional but lifelong visits to the hospital and are compulsory. The patient should maintain a balanced diet and indulgence in high-calorie food, alcohol and smoking to completely abstain. Also, regular physical activity is mandatory in their everyday life.

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