People suffering from severe obesity are susceptible to many health problems. Weight loss surgery or Bariatric surgery can help to treat this chronic condition by restricting food intake or interrupting digestive processes in patients suffering from severe obesity. As with any other surgical procedure, this treatment too has its own benefits and risks, which must be clearly understood before making a decision.
How Does The Normal Digestive Process Function?
Different digestive juices and enzymes are secreted as the ingested food moves from the esophagus down to the stomach. These juices help to digest and absorb various nutrients from the food. To speed up the process of digestion, Bile and pancreatic juices act on the food as it moves from the stomach into the small intestine. Most of the iron and calcium from our foods is absorbed in the duodenum while the rest of the nutrients are absorbed in the jejunum and the ileum. Undigested food particles are stored in the large intestine and ejected through the anus.
Types Of Weight Loss Surgery
Gastric surgery involves making changes to the stomach and small intestine. According to the American Society for Bariatric Surgery, there are two main approaches to performing this weight loss surgery:
- Restrictive procedures that decrease food intake
- Mal-absorptive procedures that alter digestion.
Due to these procedures the food is digested properly but absorbed incompletely so that it can be eliminated in the stool.
The following are the commonly used Bariatric surgery procedures:
Gastric Restrictive Procedure – Vertical Banded Gastroplasty – It is a purely restrictive procedure in which the upper stomach is stapled to create a small pouch. It is here that the food first goes after it is swallowed. The outlet of this pouch is restricted by a band or ring of synthetic mesh to slow down its emptying. This gives the patient a sense of fullness after eating only a few bites of food.
Biliopancreatic Diversion – This type of surgery includes the removal of about three fourths of the stomach for restricting food intake and reducing acid output. The small intestinal tracts are rearranged to divert the bile and pancreatic juices so that they meet the food almost towards the end of the small intestine. This helps reduce absorption of fats and starches while allowing almost complete absorption of proteins and sugars. This procedure can bring about a significant reduction in calorie intake without reducing the amount of food eaten by the patient.
Biliopancreatic Diversion With Duodenal Switch – In this method, stomach removal is restricted to the outer margin. This leaves a sleeve of the stomach and pylorus and the start of the duodenum at its end. After these operations, patients are able to eat larger meals than other methods which leads to better patient satisfaction.
Gastric Bypass Roux-en-Y – According to the American Society for Bariatric Surgery, this is the most commonly used procedure for weight loss surgery in the United States. This is a combined restrictive and malabsorptive procedure, which brings about an early sense of fullness thereby reducing the desire to eat more. In this method, a small stomach pouch is created by stapling and instead of removing the remaining stomach; it is stapled shut and divided from the stomach pouch. Calorie absorption is bypassed by emptying the stomach pouch directly into the jejunum.
Laparoscopic Adjustable Gastric Banding – This is a purely restrictive procedure which involves placing a band around the outside of the upper stomach to create an hourglass-shaped stomach. This divides the stomach into two portions – a smaller and a larger portion. This band can be inserted using a laparoscope without having to open or staple the stomach.