At RAK Hospital we regularly perform this kind of surgeries and have an experienced team at your service. We believe in a 360 degree solution including proper intensive preoperative counseling and postoperative care. Do not believe everything you read about bariatric surgery. Before taking any decisions, talk with patients who have undergone this form of weight loss surgery. Find out about the problems, issues and health risks involved. Listen carefully to the advice offered by your obesity clinic.
Bariatric surgery is a term derived from the Greek words: weight and treatment. In simple terms, bariatrics concerns the causes, prevention and treatment of severe overweight, a condition known as obesity. Bariatric operations are major gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision. Some bariatric surgeons also use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site. The two types of bariatric surgeries are (1) restrictive – like Lap Band and Sleeve Gastrectomy- and (2) combined restrictive and malabsorptive – such as Roux-en-Y Gastric Bypass. The first type of surgical procedure simply reduces the size of the stomach, using staples and/or a band, resulting in a drastic reduction in the quantity of food it can ingest. The second reduces stomach capacity and bypasses the upper part of the small intestine, causing a reduction in the number of calories and nutrients which the body absorbs. Stomach Bypass operations differ in both how the stomach is sectioned (stapling, banding or gastrectomy), and how much of the duodenum and jejunum are bypassed.
The new Consensus Conference, sponsored by the American Society for Bariatric Surgery (ASBS), was held in 2004, which updated the evidence and suggested that: (1) Bariatric surgery is the most effective treatment for severe clinical obesity. (2) Stomach bypass is one of four types of surgical treatment for morbid obesity. (3) Laparoscopic surgery is as effective and as safe as traditional open surgery. (4) Bariatric patients should receive comprehensive pre-op assessment, and multi-disciplinary post-op support, in order to achieve the best weight loss results.
The health dangers of severe obesity are well documented. Words like globesity and diabesity are evidence of the growing impact of this body-fat disease. Also, statistics show that severely obese patients have little chance of losing weight using conventional diets. However, this does not mean that bariatric surgery is a guaranteed solution for obesity. Long term studies of bariatric patients suggest that 1 in 2 fail to maintain any significant weight loss, and many patients regain all the weight they lose. Patients who have realistic expectations, a positive attitude and, above all, a genuine commitment to making lifelong changes in their attitude to food and exercise, typically achieve much better results.
Frequently asked questions:
How Does Bariatric Surgery Affect The Digestive Process?
Before Surgery: Food is chewed in the mouth, then swallowed, passing through the esophagus to the stomach, (roughly the size of a melon) where stomach acids dissolve it into smaller particles. The liquid (chyme) then passes into the small intestine where enzymes and bile continue the digestive process. The first section is the duodenum, the shortest section. Here, calcium, iron and a few vitamins are absorbed. The second and third sections are the jejunum and ileum, both about ten feet in length. Here, the bulk of food nutrients (vitamins and minerals) and calories are absorbed.
After Surgery: During both main types of obesity surgery, the size of the stomach is reduced by up to 90 percent, to the size of an egg or even the size of a thumb. Typically, its capacity is 3-4 tablespoons of food. This stomach reduction drastically reduces the quantity of food which can be consumed in one sitting and speeds up satiety. During bypass surgery, the digestive tract below the stomach is also altered. After leaving the small stomach pouch, food is re-routed to bypass most of the duodenum and is directed into the final part of the jejunum. Because the food passes along a much reduced length of small intestine, and comes into contact with smaller amounts of digestive enzymes, fewer calories and nutrients are absorbed.
Is Bariatric Surgery An Easy Solution for Weight Loss?
No. According to the American Society For Bariatric Surgery, gastric reduction surgery is not an easy option for obesity sufferers. It is a drastic step, and carries the usual pain and risks of any major gastrointestinal surgical operation.
Does Bariatric Surgery Involve New Eating Habits?
Yes. All types of gastrointestinal obesity surgery compel patients to change their eating habits radically, and make them very ill if they overeat. And after bariatric surgery is performed, patients remain at a lifelong risk of nutritional deficiencies.
Does Bariatric Surgery Typically Lead to Major Weight Loss?
Yes and No. Some patients who undergo bariatric gastrointestinal surgery lose more than 100 pounds in weight – some lose as much as 200 pounds weight. Typically, patients who undergo adjustable gastric banding procedures, such as Lap-Band lose less weight than those who have gastric bypass like Biliopancreatic Diversion or Duodenal Switch. Some patients reach a normal weight, while others remain overweight, although less overweight than before. However, in order to maintain this type of weight reduction, patients must follow carefully the post-operative guidelines relating to diet and exercise.
Who Is A Candidate for Bariatric Weight Loss Surgery?
Some bariatric surgeons accept patients in their 60′s, and some even operate on teenagers. But because bariatric surgery is a last-gasp treatment solution for obesity, to be used when conventional weight loss programs have been tried and failed, candidates must have severe obesity-related health problems. Typically, to qualify for bariatric surgery you must be ‘morbidly obese’, which usually means being overweight by 100 pounds (man) or 80 pounds (woman) with a Body Mass Index (BMI) of 40+.
Alternatively, bariatric surgery may be appropriate if you are 80 pounds overweight (BMI 35+) andhave a serious obesity-related condition like type 2 diabetes or life-threatening cardio-pulmonary problems such as severe sleep apnea or obesity-related heart disease.
Is Hospitalization Necessary Before Undergoing Bariatric Surgery?
Not usually, although patients with extremely severe obesity (End Stage obesity syndrome) may need to be hospitalized before undergoing weight loss surgery in order to lower the health risks of surgery.
Is Obesity Surgery Dangerous?
Yes. Both types of bariatric surgery (gastric banding and gastric bypass) involve major operations lasting one to two hours (longer if performed laparoscopically) and patients typically need three to five nights in hospital. The first night following the operation is usually spent in a high dependency unit or intensive care environment. (Note: After laparoscopic bariatric surgery, patients typically remain in hospital for 2-3 days, rather than the 4-5 days after open surgery. Patients typically return to work after 2-3 weeks, compared to 4-6 weeks after open surgery.) The level of health risk varies according to patient condition, type of procedure and the experience of the surgeon. But in general, bariatric surgeries carry all the possible health risks of any major medical operation.