Bariatric Surgery Essay

1625 Words Mar 22nd, 2013 7 Pages
Bariatric Surgery

Indication:
No studies evaluate the commonly used indications for bariatric surgery. Consensus guidelines suggest that the surgical treatment of obesity should be reserved for patients with a body-mass index (BMI) >40 kg/m(2) or with BMI >35 kg/m(2) and 1 or more significant co morbid conditions, when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity and mortality (strength of recommendation: C, based on consensus guidelines).
Types:
There are two basic types of weight loss surgery -- restrictive surgeries and malabsorptive/restrictive surgeries. They help with weight loss in different ways.
Restrictive surgeries: work by physically restricting
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A sleeve gastrectomy is a simpler operation that allows them a lower-risk way to lose weight. If needed, once they've lost weight and their health has improved -- usually after 12 months to 18 months -- they can go on to have a second surgery, such as gastric bypass. In people with high BMIs, sleeve gastrectomies result in an average weight loss of greater than 50% of excess weight.

Because the intestines aren't affected, a sleeve gastrectomy doesn't affect the absorption of food, so nutritional deficiencies are not a problem.
The Cons. Unlike gastric banding procedures, a sleeve gastrectomy is irreversible. Most importantly, since it's relatively new, the long-term benefits and risks are still being evaluated.
The Risks. Typical surgical risks include infection, leaking of the sleeve, and blood clots.

Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)
Gastric bypass is the most common type of weight loss surgery. It combines both restrictive and malabsorptive approaches. It can be done as either a minimally invasive or open surgery.

In the operation, the surgeon divides the stomach into two parts, sealing off the upper section from the lower. The surgeon then connects the upper stomach directly to the lower section of the small intestine. Essentially, the surgeon is creating a shortcut for the food, bypassing a section of the stomach and the small intestine. Skipping these parts of the digestive tract means that

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