Medical Reasons For Bariatric Surgery?
medical reasons for bariatric surgery: bariatric surgery types and risks
In this article medical reasons for bariatric surgery, Read about types of bariatric surgery, its benefits, and risks.
Bariatric Surgery, Weight loss surgery, also known as obesity surgery, is a series of medical treatments for the purpose of weight loss for severely obese humans.
In the United States, the gastric volume is usually controlled by implanted devices, such as gastric banding, intragastric water polo, or physical reduction of gastric volume, gastric reduction surgery, or shortening of the small intestine, gastric bypass surgery, and the like. Long-term studies have shown that bariatric surgery can reduce weight and not rebound for a long time, cure type 2 diabetes, and improve heart disease symptoms.
The National Institutes of Health defines obesity as having a BMI of 40 or higher, or BMI 35-40 and at least one obesity-related disease such as heart disease, type 2 diabetes, and sleep-disordered breathing. However, this standard is being revised to A person with a BMI of 35 or higher, or a BMI 30-35 with a serious disease associated with obesity, can be defined as an obese patient. Because bariatric surgery belongs to the national medical insurance category, the original standard is suspected of raising the threshold for reimbursement of bariatric surgery and has been repeatedly criticized.
There are several approaches to bariatric surgery, but all procedures are malabsorptive, restrictive or a combination of the two.
(medical reasons for bariatric surgery: bariatric surgery types and risks)
Malabsorptive procedures change the way the digestive system works. Food is redirected without going through a large portion of the stomach and small intestine that absorbs some calories and nutrients. These procedures are known as “bypass” procedures or gastric bypass.
The restrictive procedures:
The restrictive procedures greatly reduce the size of the stomach to contain less food, but the rest of the digestive functions remain intact. The bariatric surgeon inserts specialized miniature instruments into the patient through small incisions made in the abdominal wall. Compared with a large incision surgery, the laparoscopic technique.
The Laparoscopic Technique:
(medical reasons for bariatric surgery: bariatric surgery types and risks)
- Promotes faster healing and recovery
- Reduces pain
- Reduces the possibility of an infection
- The procedure takes 1 to 3 hours, and patients usually stay in the hospital for 2 to 4 days after the operation. Most patients can return to work in 2 to 6 weeks.
Two Type Of Laparoscopic Bariatric Procedures In Adolescents:
Methods: Keep the gastric antrum above the pylorus 2-6cm along the direction of the big curve of the stomach, remove most of the stomach along the long axis of the stomach, and remove all the fundus, so that the residual stomach is “banana”, the volume is about 60-80ml.
Principle: Reduce gastric volume and reduce hormone secretion that stimulates hunger
Advantages: do not change the physiological state of the gastrointestinal tract, do not interfere with the normal digestion and absorption process of food
Evaluation: Sleeve-type gastrectomy has a good therapeutic effect on type 2 diabetes, and is widely used in the European Cup for weight loss and diabetes surgery.
Laparoscopic surgery, also known as Laparoscopic Sleeve Gastroectomy, is a hot topic in the field of weight loss surgery, and its popularity has increased significantly. The principle of stomach reduction surgery is to use a laparoscope to cut the large curvature of the stomach vertically so that the stomach forms a small stomach pouch of about 150cc, which can hold about 4-5 ounces of food.
Its advantage is that it does not need to be built into the body, and the weight loss of the surgery is remarkable. Because the surgery will cut off 80% of the stomach volume, in addition to reducing the amount of food, it will also reduce the amount of hormone ghrelin that stimulates appetite, so the appetite will also decrease. About 10-15 BMI or 70% excess body weight can be subtracted within two years after surgery. For those with a high BMI (more than 40) and difficulty reducing their food intake, stomach-reducing surgery can achieve the desired weight loss.
The effect of stomach-reducing surgery is between the gastric bypass and the gastric band, and the safety is also between the two, so it is a fairly “moderate” operation. If compared with the gastric bypass, there is no intestinal reconstruction after the stomach reduction surgery, so there will be no sequelae such as anemia and osteoporosis caused by vitamin deficiency. In addition, the incidence of gastric cancer in Asians is high.
After undergoing gastric reduction surgery, the stomach can still be regularly examined by gastroscopy, which is different from gastric bypass surgery. Compared with gastric banding surgery, both are limited surgery, but the stomach surgery does not place any foreign objects in the human body, so there is no need to worry about potential problems caused by the inside and outside of the abdomen.
It seems that stomach surgery seems to be a relatively ideal surgery, but this surgery involves the removal of part of the stomach, which is irreversible after resection. Therefore, the patient must consider the surgery before he can be considered. In addition, gastric surgery also has metabolic effects. The medical profession has found that post-operative food increases into the intestines and helps to treat type 2 diabetes. The actual principle has been confirmed by further medical research.
Although this operation can help patients greatly reduce the amount of food, the weight does not necessarily decline naturally after surgery, if the diet is not controlled after surgery, the food intake can also rise, the patient also has the opportunity to compound fertilizer. Therefore, no matter which type of bariatric surgery is performed, patients should pay attention to diet and exercise to have the ideal effect of obesity treatment. Because the stomach is cut, the diet must be carried out in a gradual manner.
The basic principle is the same as the diet after gastric bypass. High-calorie beverages need to be completely avoided. In order to avoid weight loss is not ideal. The three meals are based on regular quantitative and balanced nutrition.
2. Gastric bypass surgery
Method: On the one hand, by setting a small stomach sac in the upper part of the stomach to limit the food intake, on the other hand, through the distal empty space small gastric sac anastomosis, the food bypasses the stomach, the duodenum, and the first segment. Jejunum, which greatly controls food intake and absorption
Principle: change the structure of the intestine, close most of the stomach function, reduce the space of the stomach and the length of the small intestine
Advantages: The weight loss effect is obvious, and the treatment effect is expected to be maintained for a long time.
Evaluation: Gastric bypass surgery is earlier and more frequent in weight loss and diabetes surgery, and it is best for patients with type 2 diabetes with obesity
Gastric bypass surgery refers to a series of similar surgical procedures for the treatment of obesity. The common feature is that the operation firstly divides the stomach into upper and lower parts, a smaller upper part, and a larger lower part, and then cuts off the small intestine. Rearrange the position of the small intestine, change the way food passes through the digestive tract, slow down the rate of gastric emptying, shorten the small intestine, and reduce absorption.
Surgeons have developed several different alignment schemes that form several branches of gastric bypass surgery. According to the National Health Center’s 2008 data, gastric bypass surgery has replaced stomach-reducing surgery since 2000, becoming the most popular weight-loss surgery in the United States, with about 100,000 cases a year. Gastric bypass surgery is gradually being replaced by gastric banding surgery.
The gastric band, full name laparoscopic adjustable stomach band weight loss surgery. It refers to the upper part of the stomach by laparoscopic surgery, and the elastic silicone binding band can be adjusted by water injection. The purpose of gastric banding surgery is to treat obesity. Adjustable gastric banding is one of the four best therapies for the treatment of obesity and is currently the most used therapy in the United States and Europe.
Intragastric water polo
Intragastric balloon (intragastric balloon), also known as a gastric balloon (gastric balloon), is a very effective medical therapy weight loss: weight loss principle it is to use a silicon gastroscope into the stomach balloon, then saline Inject into the water polo, fill the stomach, induce satiety to help control appetite. The stomach water polo was first used in Europe in the 1990s.
After 2000, it entered Asia. Japan, Hong Kong, and Taiwan have related medical institutions to carry out improvement and promotion. Asian gastric balloon for weight loss efficacy was significantly higher than Europeans, Asians more gastric balloon schematic diagram of obesity blood sugar causes and hereditary issues related to family control.
Gastric water polo regulates the secretion of insulin in the intestine while providing a feeling of fullness in the stomach. In addition to the efficacy of weight loss, the condition of Asian diabetic patients is significantly relieved. The specific mechanism is still under study.
The main medical methods for treating obesity are: gastric sleeve resection (surgical risk, complicated and serious complications, has been eliminated); laparoscopic gastric bypass surgery (surgical risk is high, complications are serious, only suitable for BMI45 The above-mentioned extremely obese patients or patients with BMI above 35 and other diseases caused by obesity, for example, diabetes, heart disease, etc.); Laparoscopic gastric banding surgery (popular, recommended for BMI35-45 patients) ; gastric balloon surgery (surgery is relatively risk-free, side effects, is recoverable, and is suitable for young people).
Risks of bariatric surgery:
Modern surgical techniques have been able to minimize complications. There is a certain misunderstanding of the risk of weight loss and diabetes surgery, and the risk of surgery is not as high as expected. In fact, the mortality rate of weight loss and diabetes surgery has been confirmed to be lower than other common operations, such as cholecystectomy.
As with any surgical procedure, there may be complications. Some possible complications include, as an example, the following:
- Intestinal Obstruction
- Nutritional Deficiencies
- Gastroesophageal Reflux
- Blood Clots
- Bleeding Ulcer