Bariatric Surgery

What is Bariatric Surgery?

Bariatric surgery is an age-old procedure that involves making several changes to a patient’s digestive system. The aim of this procedure is to reduce the amount of food the stomach can hold. Today, reports are increasingly showing proof that it is to benefit to diabetic patients and people living with obesity.

The DIRECT study, (a primary care-based study done in Scotland and Tyneside), revealed that at 12 months, half of the bariatric surgery participants achieved remission to a non-diabetic state and off antidiabetic drugs.

Other studies have shown that patients lose up to 25 percent of their body weight compared with traditional weight-loss methods. In fact, more than three-quarters of type 2 diabetic patients have achieved better blood sugar control. Also, according to Diabetes UK and American Diabetes Association, Type 2 diabetes remission occurs in about 30 to 60 percent of patients following the surgery.

Thus, they have become popular weight loss means to people with extreme obesity to lose weight. Patients with serious health problems like heart disease, type 2 diabetes, and other ailment related to heavy weight also undertake this procedure. In type 2 diabetes, the surgery controls the condition without the need for diabetic medications.

Forms of bariatric surgeries are mostly carried out on body organs such as the stomach or intestines. This is meant to allow a person to eat and drink less at any given time. It is recommended for a person whose body mass index (BMI) is above 40 and had tried other weight loss interventions using both diet and exercise but had not been successful.

What are the types of bariatric surgeries?

For patients seeking to reduce weight, studies have shown that they achieve about two-thirds in weight loss. Doctors might prescribe different ways to do the surgeries to a patient. Generally, there are two ways;

• First is restrictive surgeries, this procedure reduces the size of the stomach and slows down the digestion of food.
• There is also a Malabsorptive/restrictive surgery which involves reducing the size of the stomach and also removing parts of the digestive system.

In more detail, most forms of bariatric surgery involve opening up the abdomen or by use of laparoscopy during which surgical instruments are guided into the abdomen through small 10 millimeter incisions. In recent years, the overall rate of complications during one month following surgery ranges from 7 percent for laparoscopic procedures to 14.5 percent for operations through open-cut surgery. So, laparoscopic procedures are preferred. The laparoscopic method of surgery causes relatively lesser tissue damage than open surgery during the procedure. There are four types of bariatric surgery operations:

1. Adjustable Gastric Banding (AGB)

This involves inserting an inflatable gastric band to the top of the stomach. This helps patients feel more “full” with less food. Unlike other bariatric surgeries, it does not involve removing part of the digestive system. This procedure can be reversed and it is adjustable in that the band can be adjusted or removed at any time. After surgery, a strict diet rich in vitamin B12 and calcium would need to be followed.

2. Roux-en-Y gastric bypass (RYGB)

This is one of the most common yet complex forms of bariatric surgery. It is estimated that 200,000 operations were carried out in the US in 2008 alone.  This surgery is performed using several incisions so as to insert a surgical telescope connected to a camera and specialized operating instruments. Benefits include shorter recovery stay and less scarring.

3. Vertical sleeve gastrectomy (VSG)

This involves carrying out a surgery that reduces the stomach to three or four ounces. During the procedure, a surgeon would make four to five small incisions of the size of a fingertip and insert surgical tools to reduce the stomach size. Recovery time in the hospital is two days at most. After this surgery, levels of hunger hormones drastically drop in turn reducing appetite.

4. Biliopancreatic diversion with a duodenal switch (BPD-DS)

BPD-DS involves surgical removal of approximately three quarters (70 percent) of the stomach and most of the duodenum – upper part of the small intestine whereby calorie absorption occurs. It leads to less calorie absorption and increased weight loss. Some studies say that it has had a 98 percent diabetes cure rate in some cases.