Bariatric
surgery
Overview
Gastric bypass and other
weight-loss surgeries — known collectively as bariatric surgery — involve
making changes to your digestive system to help you lose weight. Bariatric
surgery is done when diet and exercise haven't worked or when you have serious
health problems because of 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
offer many benefits, all forms of weight-loss surgery are major procedures that
can pose serious risks and side effects. Also, you must make permanent healthy
changes to your diet and get regular exercise to help ensure the long-term
success of bariatric surgery.
Why it's done
Bariatric surgery is done to
help you lose excess weight and reduce your risk of potentially
life-threatening weight-related health problems, including:
Heart disease and stroke
High blood pressure
Nonalcoholic fatty liver
disease (NAFLD) or nonalcoholic steatohepatitis (NASH)
Sleep apnea
Type 2 diabetes
Bariatric surgery is
typically done only after you've tried to lose weight by improving your diet
and exercise habits.
Who it's for
In general, bariatric
surgery could be an option for you if:
Your body mass index (BMI)
is 40 or higher (extreme obesity).
Your BMI is 35 to 39.9
(obesity), and you have a serious weight-related health problem, such as type 2
diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify
for certain types of weight-loss surgery if your BMI is 30 to 34 and you have
serious weight-related health problems.
Bariatric surgery isn't for
everyone who is severely overweight. You may need to meet certain medical
guidelines to qualify for weight-loss surgery. You likely will have an
extensive screening process to see if you qualify. You must also be willing to
make permanent changes to lead a healthier lifestyle.
You may be required to
participate in long-term follow-up plans that include monitoring your
nutrition, your lifestyle and behavior, and your medical conditions.
Keep in mind that bariatric
surgery is expensive. Check with your health insurance plan or your regional
Medicare or Medicaid office to find out if your policy covers such surgery.
Risks
As with any major procedure,
bariatric surgery poses potential health risks, both in the short term and long
term.
Risks associated with the
surgical procedure can include:
Excessive bleeding
Infection
Adverse reactions to anesthesia
Blood clots
Lung or breathing problems
Leaks in your
gastrointestinal system
Death (rare)
Longer term risks and
complications of weight-loss surgery vary depending on the type of surgery.
They can include:
Bowel obstruction
Dumping syndrome, which leads
to diarrhea, flushing, lightheadedness, nausea or vomiting
Gallstones
Hernias
Low blood sugar
(hypoglycemia)
Malnutrition
Ulcers
Vomiting
Acid reflux
The need for a second, or
revision, surgery or procedure
Death (rare)
How you prepare
If you qualify for bariatric
surgery, your health care team gives you instructions on how to prepare for
your specific type of surgery. You may need to have various lab tests and exams
before surgery. You may have restrictions on eating and drinking and which medications
you can take. You may be required to start a physical activity program and to
stop any tobacco use.
You may also need to prepare
by planning ahead for your recovery after surgery. For instance, arrange for
help at home if you think you'll need it.
What you can expect
Bariatric surgery is done in
the hospital using general anesthesia. This means you're unconscious during the
procedure.
The specifics of your
surgery depend on your individual situation, the type of weight-loss surgery
you have, and the hospital's or doctor's practices. Some weight-loss surgeries
are done with 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 on the tip of the laparoscope
allows the surgeon to see and operate inside your abdomen without making the
traditional large incisions. Laparoscopic surgery can make your recovery faster
and shorter, but it's not suitable for everyone.
Surgery usually takes
several hours. After surgery, you awaken in a recovery room, where medical
staff monitors you for any complications. Depending on your procedure, you may
need to stay a few days in the hospital.
Types of bariatric
surgery
Each type of bariatric
surgery has pros and cons. Be sure to talk to your doctor about them. 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 not reversible. It works by
decreasing the amount of food you can eat at one sitting and reducing
absorption of nutrients.
The surgeon cuts across the
top of your stomach, sealing it off from the rest of your stomach. The
resulting pouch is about the size of a walnut and can hold only about an ounce
of food. Normally, your stomach can hold about 3 pints of food.
Then, the surgeon cuts the
small intestine and sews part of it directly onto the pouch. Food goes into
this small pouch of stomach and then directly into the small intestine sewn to
it. Food bypasses most of your stomach and the first section of your small
intestine, and instead enters directly into the middle part of your small
intestine.
Sleeve gastrectomy.
With sleeve gastrectomy, about 80% of the stomach is removed, leaving a long,
tube-like pouch. This smaller stomach can't hold as much food. It also produces
less of the appetite-regulating hormone ghrelin, which may lessen your desire
to eat.
Advantages to this procedure
include significant weight loss and no rerouting of the intestines. Sleeve gastrectomy
also requires a shorter hospital stay than most other procedures.
Biliopancreatic
diversion with duodenal switch. This is a two-part surgery
in which the first step involves performing a procedure similar to a sleeve
gastrectomy. The second surgery involves connecting the end portion of the
intestine to the duodenum near the stomach (duodenal switch and biliopancreatic
diversion), bypassing the majority of the intestine.
This surgery both limits how
much you can eat and reduces the absorption of nutrients. While it is extremely
effective, it has greater risk, including malnutrition and vitamin
deficiencies.
Which type of weight-loss
surgery is best for you depends on your specific situation. Your surgeon will
take many factors into account, including body mass index, eating habits, other
health issues, previous surgeries and the risks involved with each procedure.
After bariatric
surgery
After weight-loss surgery,
you generally won't be allowed to eat for one to two days so that your stomach
and digestive system can heal. Then, you'll follow a specific diet for a few
weeks. The diet begins with liquids only, then progresses to pureed, very soft
foods, and eventually to regular foods. You may have many restrictions or
limits on how much and what you can eat and drink.
You'll also have frequent
medical checkups to monitor your health in the first several months after
weight-loss surgery. You may need laboratory testing, blood work and various
exams.
Results
Gastric bypass and other
bariatric surgeries can provide long-term weight loss. The amount of weight you
lose depends on your type of surgery and your change in lifestyle habits. It
may be possible to lose half, or even more, of your excess weight within two
years.
In addition to weight loss,
gastric bypass surgery may improve or resolve conditions often related to being
overweight, including:
Heart disease
High blood pressure
Obstructive sleep apnea
Type 2 diabetes
Nonalcoholic fatty liver
disease (NAFLD) or nonalcoholic steatohepatitis (NASH)
Gastroesophageal reflux
disease (GERD)
Osteoarthritis (joint pain)
Gastric bypass surgery can
also improve your ability to perform routine daily activities, which could help
improve your quality of life.
When weight-loss
surgery doesn't work
Gastric bypass and other
weight-loss surgeries don't always work as well as you might have hoped. If a
weight-loss procedure doesn't work well or stops working, you may not lose
weight and you may develop serious health problems.
Keep all of your scheduled
follow-up appointments after weight-loss surgery. If you notice that you are
not losing weight or you develop complications, see your doctor immediately.
Your weight loss can be monitored and factors potentially contributing to your
lack of weight loss evaluated.
It's also possible to not
lose enough weight or to regain weight after any type of weight-loss surgery,
even if the procedure itself works correctly. This weight gain can happen if
you do not follow the recommended lifestyle changes, such as getting regular
physical activity and eating healthy foods.
Jan Ricks Jennings, MHA,
LFACHE, AMHFMA
Senior Consultant
Senior Management
Resources, LLC
JanJenningsBlog.Blogspot.com
724.733.0509 Office
412.913.0636 Cell
December 9, 2021
No comments:
Post a Comment