Gastric bypass and other weight loss surgeries - collectively known as bariatric surgery - involve making changes to your digestive system to help you lose weight. Bariatric surgery is done when diet and exercise don't work or when you have serious health problems due to your weight. Some procedures limit how much you can eat. Other procedures work by reducing the body's ability to absorb nutrients. Some procedures do both.
While bariatric surgery can provide many benefits, all types of weight loss surgery are important procedures that can pose serious risks and side effects. Also, to ensure the long-term success of bariatric surgery, you must make permanent healthy changes to your diet and exercise regularly.
Bariatric surgery is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems.
Bariatric surgery is typically done only after you've tried to lose weight by improving your diet and exercise habits.
In general, bariatric surgery may be an option for you if:
Bariatric surgery is not for everyone who is overweight. You may need to follow certain medical guidelines to qualify for weight loss surgery. You will likely have a thorough screening process to see if you are eligible. You must also be willing to make permanent changes to maintain a healthier lifestyle.
You may need to participate in long-term follow-up plans that include monitoring your diet, lifestyle and behavior, and medical condition.
As with any major procedure, bariatric surgery poses potential health risks, both in the short and long term.
Risks associated with the surgical procedure can include:
The longer term risks and complications of weight loss surgery vary depending on the type of surgery. They can include:
If you qualify for bariatric surgery, your healthcare team will give you instructions on how to prepare for your specific type of surgery. You may need to have various laboratory tests and examinations before surgery. You may have restrictions on eating, drinking, and what medications you can take. You may need to start a physical activity program and stop any tobacco use.
You may also need to be prepared by planning your post-operative recovery period in advance. For example, get help at home if you think you will need it.
Bariatric surgery is performed in the hospital using general anesthesia. This means you are unconscious during the procedure.
The characteristics of your surgery depend on your personal situation, the type of weight loss surgery you have, and the practices of the hospital or doctor. Some weight loss surgeries are done through traditional large or open incisions in your abdomen.
Today, most types of bariatric surgery are performed laparoscopically. A laparoscope is a small tubular instrument with a camera attached. The laparoscope is inserted through small incisions in the abdomen. The tiny camera at the end of the laparoscope allows the surgeon to view and process the inside of your abdomen without making traditional large incisions. Laparoscopic surgery can make your recovery faster and shorter, but it is not suitable for everyone.
The surgery usually takes a few hours. After surgery, you wake up in a recovery room where medical staff will watch you for any complications. Depending on your procedure, you may need to stay in the hospital for a few days.
All types of bariatric surgery have pros and cons. Be sure to talk about them with your doctor. Here's a look at common types of bariatric surgery:
Roux-en-Y (roo-en-wy) gastric bypass
This procedure is the most common method of gastric bypass. This surgery is typically irreversible. It works by reducing the amount of food you can eat in one sitting and reducing the absorption of nutrients. The surgeon cuts the upper part of your stomach, separating it from the rest of your stomach. The resulting pouch is about the size of a walnut and can only hold about 28.34g of food. Normally your stomach can hold about 3 liters of food. Then the surgeon cuts the small intestine and sews some of it directly onto the pouch. The food then goes to this small stomach pouch and then directly to the small intestine sewn onto it. Food bypasses most of your stomach and the first part of your small intestine and instead enters directly into the middle of your small intestine.
In sleeve gastrectomy, approximately 80% of the stomach is removed and a long, tube-like pouch is left. This small stomach cannot hold much food. It also produces less of the appetite-regulating hormone ghrelin, which can reduce your cravings to eat. The advantages of this procedure include significant weight loss and no bowel reorientation. Gastric sleeve surgery also requires a shorter hospital stay than many other procedures.
Biliopancreatic diversion with duodenal switch
This is a two-part surgery where the first step involves a procedure similar to sleeve gastrectomy. The second surgery involves bypassing most of the bowel and connecting the end portion of the bowel to the duodenum near the stomach (duodenal switch and biliopancreatic diversion). This surgery limits both how much you can eat and reduces the absorption of nutrients. While highly effective, it carries greater risk, including malnutrition and vitamin deficiencies.
The best type of weight loss surgery for you depends on your particular situation. Your surgeon will take into account many factors such as body mass index, eating habits, other health issues, previous surgeries, and the risks associated with each procedure.
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