Obesity – Surgical procedures

Persons who are severely obese face increased risk of health problems and are at critical state most often. Their health risk increases as their weight increases. So the only solution available to them is to undergo surgical procedure which is intended to reduce the volume of their stomach or to reduce the amount of food that is digested by not ingesting some portion of the food eaten by the patient. Roux-en-Y Gastric Bypass, Duodenal Switch, Gastric Banding and Gastric Sleeve are the common surgical procedure followed by the surgeons. These surgeries are explained one by one.

Roux-en-Y Gastric Bypass:

Gastric-Bypass

Usually food we eat passes through stomach and enters small intestine where nutrients and calories of food are absorbed. The remaining portion of the food passes through large intestine and the waste is excreted through the rectum. In Roux-en-Y-gastric bypass a new stomach roughly the size of an egg is created and this small stomach is connected to the middle portion of the small intestine. Bypassing of jejunum portion of the small intestine and a good portion of the stomach reduces the amount of food that can be eaten at a time which naturally reduces the nutrients and calorie value of food absorbed leading to weight reduction. The Roux-en-Y gastric bypass surgery is usually carried out as a laparoscopic surgery which is a minimally invasive surgery in which only three or small incisions of size 1 to 2 cms are needed to carry out the surgery.

Gastric Banding:

gastric-band

This is a surgery in which an adjustable band is placed in the upper portion of the stomach in a laparoscopic procedure. The band is made of silicone which can be tightened by filling saline in the band using a pump. This band is connected to a port under the skin near the abdomen which is used to introduce or remove saline thereby inflating or deflating the band. This banding reduces the size of the stomach and gives a feeling of fullness when only a small quantity of food is eaten. This procedure is generally carried out in adults only.

Gastric Sleeve:

In this surgery which can be carried out in the conventional open surgery procedure or as a laparoscopic procedure, more than half of the stomach of the patient is removed. Only a sleeve or tube of the size of a banana will be left after the surgery. The open portion of the stomach after removing a good portion as stated above are closed using staples. As a portion of the stomach is removed permanently this is a non reversible surgery. During the first month after the surgery the patient will be allowed to have soft food consisting of liquids and easily digestible components. Your bowel movements may also be restricted during the first few days after the surgery.

Intra Gastric Balloon Placement

In this surgical procedure a soft silicone balloon filled with sterile saline solution is placed inside the stomach so that the volume of the stomach is reduced and this helps in controlling the volume of food consumed. This procedure is recommended for patients who needs weight reduction before undergoing a surgery for some other purpose. This can also be done as a stand alone weight reduction surgery.

Gastric Baloon
After giving sedation the balloon is inserted through the mouth and the esophagus. Once the balloon reaches the stomach, it is filled with a liquid so that it partially fills the stomach. The balloon will remain in the stomach for about six months. After that it will be removed. Since the stomach is half filled with the balloon, the patient may not feel hungry and will be satisfied with lesser food. This helps to reduce the accumulation of calories through food intake, Insertion of balloon combined with properly planned diet and behavioral modifications have been found to be externally useful in reducing the BMI of obese people.

 

View Video