Bariatric Surgery Treatment Procedures in India at Aastha Healthcare Hospital

There are several different types of Bariatric weight loss surgical procedures, but they are known collectively as 'Bariatric surgery'. To understand this, the procedures can be grouped in three main categories below). The three types are:

Malabsorptive procedures: This surgery does focus at reducing the stomach size but they mainly aim on creating malabsorption. i.e. Biliopancreatic Diversion (Scopinaro procedure - rare)

Restrictive procedures: This kind of surgery primarily reduces the stomach size. There are three ways of doing this:

Vertical Banded Gastroplasty (Mason procedure, stomach stapling)

Adjustable gastric band (or "Lap Band")

Sleeve gastrectomy

Hybrid procedures: In this type, both the techniques of restriction and malabsorption are applied simultaneously. i.e. Gastric bypass surgery, like Roux-en-Y gastric bypass
In this section, we will discuss all the procedures but only a surgeon can decide which one is suited the best for patient. Infact he is the only person who can tell whether the case could be handled laparoscopically or should be carried out as open surgery. This section is dedicated to providing you with the information to help you get familiar with Bariatric surgery

Malabsorptive procedures

This surgery focuses to reduce the stomach size but they mainly aim on creating malabsorption. So if the stomach pouch is smaller in size and if there is signifcant malabsorption, this will lead to impairment of nutrition absorption and assimilation. In other words Malabsorptive procedures alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

Biliopancreatic Diversion: (BPD)

The original version of this procedure (without the duodenal switch) was developed by Dr. Scopinaro in Italy. This operation creates an impairment of nutrient absorption (called "malabsorption") as the primary factor in weight loss. This is done by removing about 2/3 of the stomach, and arranging the small intestine so that the section where food mixes with digestive juices is fairly short. This surgery is rare now because of problems with malnourishment. These operations may be more effective in achieving excellent weight loss in the extremely obese, but bring with them a higher rate of true malnutrition (malnutrition is very rare for those who undergo standard gastric bypass).

HYBRID PROCEDURES

There are several different types of Bariatric weight loss surgical procedures, but Hybrid procedures are most commonly performed. In this type, both the techniques of restriction and malabsorption are applied simultaneously. I.e. Gastric bypass surgery, like Roux-en-Y gastric bypass. Now let us see this procedure in details.

The third step in the procedure involves the reconnection of the bowel (the first 50-100 cm of the jejunum and the duodenum containing the juices from the stomach, pancreas, and liver and called the biliopancreatic limb) to the segment of small bowel that was connected to the gastric pouch (the Roux limb). It is the distance between the gastric pouch and the place where the biliopancreatic limb is connected that determines the length of the bypass and the degree of malabsorption created by the operation. This distance is selected based on the patients BMI. The average length of the small bowel before surgery is thought to be approximately 18 ft. with the jejunum accounting for the first 2/5 of the small bowel. The length of the Roux limb that is created ranges from 75 cm to 180 cm (3-6 ft). The average time it takes to complete the Laparoscopic Roux-en-Y Gastric Bypass is approximately 2 hours. If the patient has gallstones, the surgeon may choose to remove the gallbladder as a preventative measure since there is a high incidence of gallstone formation upon weight loss.

This surgery reduces the amount of food eaten as well as decreases absorption of the food and calories consumed. So one will feel full more quickly than when their stomach was its original size, which reduces the amount of food the person will eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss. There is very little interference with normal absorption of food since the operation works by reducing food intake, and reducing the feeling of hunger. The result is a very early sense of fullness, followed by a very profound sense of satisfaction. Even though the portion size may be small, there is no hunger, and no feeling of having been deprived: when truly satisfied, you feel indifferent to even the choicest of foods. Patients continue to enjoy eating - but they enjoy eating a lot less. Ingestion of concentrated sugar is also essentially prohibited because doing so results in "dumping." Dumping is a group of unpleasant symptoms that resembles food poisoning (nausea, vomiting, diarrhea, abdominal cramps, flushing, and palpitations) that occurs when simple sugars enter the small intestine without first being properly digested by the stomach. Many people also report diminished appetite after Roux-en-Y gastric bypass, as well as a change in the taste of food. These are additional ways the gastric bypass causes weight loss. Following RNY surgery, patients are at risk for developing anemia because of poor absorption of iron and vitamin B12. Therefore, dietary supplementation of these nutrients is required. Poor absorption of calcium may also occur. Thus, calcium supplements must also be taken postoperatively.

For more information on Bariatric Surgery Treatment Procedures, kindly visit :
http://www.aasthahealthcare.com/Bariatric-Surgery-Procedures.htm

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