Obese patients undergo bariatric surgery (also known as weight loss surgery) to lose weight and alleviate co-morbidities such as diabetes, hypertension, and obstructive sleep apnea. This weight loss is usually accomplished by minimizing the size of the stomach with an implanted surgical device (gastric banding), removing part of the stomach (sleeve gastrectomy), or resecting and rerouting the small intestines to a stomach pouch (Roux en y gastric bypass/Mini gastric bypass surgery). Dr. Samrat Jankar, one of the best gastroenterologists in Pune, will discuss the most popular bariatric surgery procedures in this article.
Bariatric Surgery Types
Laparoscopic Sleeve Gastrectomy:
Laparoscopic Sleeve Gastrectomy, also known as Gastric Sleeve, is a surgical weight-loss restricting and permanent procedure under which an outsized part of the stomach is surgically removed, following the main curve, to minimize the size of the stomach to around 15% of its original size. Surgical staples or sutures are then used to secure the open edges together. The operation is irreversible, which means it decreases the size of the stomach indefinitely. It’s possible that the gastric sleeve is just a restrictive operation. There is no bypass of the small intestines with the gastric sleeve, unlike the roux-en-y gastric bypass or the duodenal transfer, because all nutrients are absorbed, and unlike gastric banding operations, no foreign items are left inside the body during the operation. According to Dr. Samrat Jankar, the patient will be able to lose 60 to 70% of their excess weight.
Roux-en-Y Gastric Bypass:
The Roux-en-Y gastric bypass is a common form of gastric bypass surgery. A small stomach pouch (25-30 mL) is created and attached to the intestine using a stapler system. In a Y-shaped configuration, the upper portion of the small intestine is then reattached. Around 70 to 80 percent of the patient’s excess weight can be lost. Patients will require vitamin, mineral, and iron supplements for a prolonged period of time (sometimes lifelong). Dumping Syndrome, as well as mineral and vitamin deficiencies, are only a few of the risks associated with this practice.
Laparoscopic Adjustable Gastric Banding:
The adjustable gastric band is nothing more than a reversible and restrictive operation. This operation has no effect on the small intestine. The silicone ring is wrapped around the stomach and positioned 1-2 cm below the oesophagus. This port is located in the middle of the abdomen, just under the surface. This is frequently how the surgeon makes the band smaller or larger by adding or subtracting water. Weight loss occurs as a result of the nutrient limitation imposed by the small gastric pouch and, as a result, the narrow outlet. In the first year after surgery, gastric bands were changed an average of 4 to 6 times. This are done to make sure the band isn’t too tight or too loose, as well as to promote weight loss. Adjusting the band is painless. According to the experts, the average patient will lose 40 to 50 percent of their excess weight.
Laparoscopic Mini Gastric Bypass:
It involves creating an expanded gastric tube and connecting it to the small bowel with a single anastomosis. The downside is bile reflux, which is stated but rarely experienced by patients.
Bariatric Surgery- Frequently Asked Questions
What is Keyhole Surgery or Minimal Access Surgery?
Laparoscopic surgery, also known as minimal access surgery, is a difficult method for performing a variety of surgical procedures. Via tiny incisions, a thin telescope known as a laparoscope and dealing instruments are inserted (3-12mm). The laparoscope is attached to a small video camera that projects a high-resolution image of the inside of the patient’s body. These incisions are normally sealed with surgical glue/sutures and are scarcely visible after a few weeks, eliminating the need for a follow-up appointment for suture removal.
Most of the bariatric surgeons & gastroenterologist in Pune, India uses this method to eliminate the chances of risks & visible scars.
Who would benefit from bariatric/weight-loss surgery?
According to Dr. Samrat Jankar who is one of the best gastroenterologist in Pune, following points are to be considered to decide if you are the right candidate for bariatric surgery.
- BMI greater than 37.5 kg/m2.
- BMI greater than 32.5 kg/m2, as well as other conditions such as hypertension, diabetes, and so on.
- A medically controlled weight-loss program that failed.
- Between the ages of 18 and 65.
- Dedicated and guided.
- If you’re in good enough shape to undergo surgery and anesthesia.
When will I be able to walk again after surgery?
When you have completely recovered from anesthesia, your doctor will ask you to get up and move the next day.
What about the scars from the surgery?
Scars, like those from other laparoscopic surgeries, are almost undetectable in patients who recover well, and there is no need to remove stitches because absorbable sutures are used.
Is it possible for me to become pregnant after surgery?
Yes, but it is highly recommended that pregnancy be delayed for at least one year after surgery, and that you meet your surgeon and get tested before proceeding.
When will I be able to resume normal sexual activities?
As soon as you’re pain-free and can resume your regular activities. Vigorous sexual activity should be prevented for at least two months after surgery.