Bariatric surgery: what it is, effectiveness, advantages and disadvantages of the method
Bariatric surgery is a branch of medicine that deals with the study of the origin of and the treatment of obesity.
This definition was called not the simple elimination of overweight, but specific surgical interventions.
In recent years, this method is ranked as the most effective ways to eliminate morbid obesity (a complicated form, when the body mass index equals 40 or more).
Advantages of such measures to combat obesity extreme degree boil down to one thing: targeted weight loss.
What it is
Measures to correct the initial weight act in two directions: reduce the amount of food for a single dose by adjusting the size of the stomach and reduce the level of substances necessary for the body entering the small intestine.
In particular, the following types of bariatric practice in surgery are the classic list:
- The introduction of intragastric balloon.
- Gastric banding.
- Shunting of the stomach.
According to the requests of the 21st century, all the above procedures are required to be done exclusively laparoscopically (in the absence of wide body incisions), because this safe technology greatly facilitates the recovery period and reduces the risk of further complications. Each of the operations has its own advantages, so the question of what specific technique will be appropriate on an individual basis is decided by an experienced doctor based on the results of a medical examination.
Specifications on indications
The main solution to the use of bariatric surgery is BMI: for problems associated with diabetes (type 2) or arthritis, intervention is possible in the age group of 35 to 40. Professionals emphasize that this method of reducing metabolic weight is the last measure, other options (diet, exercise) in the early stages were unsuccessful. And in the practice of foreign medical institutions, when a patient requests for the use of such surgery, it is necessary to prove the fact that a person has previously tried all other methods and has not achieved the desired result.
Benefits of Obesity Treatment with Surgery
The mentioned method is ideal for those who perfectly helps those who do not independently have the will power to bring their bodies in order. Moreover, the most important advantage of the proposed method is the irrevocable elimination of extra pounds. Also an additional argument is the fact that the weight is eliminated without effort from the patient.
No special dietary restrictions, no exhausting workouts, and a strict regime, often leading to breakdowns. In parallel, the work of the whole organism is improved, the load is significantly reduced, the metabolic processes are normalized. The former mobility, ease, desire for an active and healthy lifestyle also returns and the inferiority complex finally disappears. If we consider the general advice on the operation in question, the most important nuance is the psychological state, which remains normal due to a gentle approach to solving the problem.
Is there a real risk
The bariatric surgery technique overcame an impressive path of development: the proportion of operations used in the past was excluded from practice due to dangerous complications, and other approaches were significantly modified to increase their benefits. The operations themselves are not planned solely at the request of the patient in the clinic of plastic surgery, because this is not just a correction of appearance. Although such changes are also taking place, the treatment of particularly advanced cases of obesity remains the central task.
The disadvantages of the technique
Like any approach, there are not only advantages, but also disadvantages. One of the negative aspects is the need to continue in the form of plastic surgery (usually of high cost) in order to eliminate sagging skin.
Most often, the folds of the stomach, thighs and arms are affected, which is accompanied by problems from the inside. The mentioned condition needs a quick medical correction and a high percentage that it will be repeated throughout life: adaptation is observed very rarely. And patients who have undergone bariatric surgery need regular medical check-ups in order to see abnormalities in time. One way or another, you will have to use medication, control the course of vitamins. Gradually, the body adapts to new conditions and will get used to the low consumption of food. But doctors advise in parallel to adhere to the rules of nutrition and not to overload the body.
Bariatric surgery: types and principle of implementation
Interventions of this type are performed on the stomach and within the boundaries of the small intestine, after which nutrient intake decreases, and then body weight decreases. It affects not only the work of the gastrointestinal tract: the action of a specialist is much broader - the restoration of metabolism. Stimulation of weight loss can sometimes occur due to the merging of two principles - truncation of the volume of the stomach and partial removal of the small intestine. And after surgery, the patient receives a lot less calories.
Installation of intragastric silicone balloon
The principle of operation of this method is to reduce the volume of the gastric cavity, which provides a feeling of rapid satiety, thanks to the gradual entry of food into the stomach. The balloon , placed in the gastric cavity, has a spherical shape; it contains a special saline solution, due to which it moves easily inside.
It is possible to adjust the contents of the cylinder within 400 - 800 cm3, given that the self-closing valve makes it possible to isolate the agent from external catheters.
During the bariatric operation, this object is placed inside and connected to the deflated shell, and the second edge of the tube is connected to the filling system.
The maximum period of using the system is six months, after which it should be removed, and the next one can be set no earlier than in 1 month. The patient is administered a balloon under general anesthesia using a probe with a balloon fixed on it. This method of bariatric installation of the cylinder primarily helps to eliminate the obsessive feeling of hunger, which leads to weight loss. However, after the procedure, it is necessary to strictly adhere to a low-calorie diet (maximum 1200 kcal per day), as well as exercise.
Laparoscopic horizontal gastroplasty using a silicone bandage
This bariatric surgery is quite popular, which indicates its effectiveness. It uses a special bandage, which is a special retainer in the form of a ring with an adjacent flexible tube of half a meter. The cuff is fixed on top, which provides control over pumping of the zone on the inner surface.
After application, the tube is connected to the reservoir through which a special liquid is introduced, and the size of the anastomosis is adjusted by means of a cuff. The volume of fluid is adjusted using a professional needle inserted through the skin. The initial filling with fluid should be carried out no earlier than 6 weeks after the first operation. The main advantage of this technique is its saving principle: during the procedure, no GIT organs or parts of them are affected, low injuries and considerable safety are also an important factor compared to other surgical interventions.
Gastroshunti operation
This option is prescribed for particularly complex forms of obesity. It can be performed openly or laparoscopically. During the operation in the upper part of the stomach a small part is formed, which connects directly with the small intestine. At the same time, the second half of the organ cannot be removed, it simply does not function when eating. So, the food enters first into the esophagus, then into the adjusted small stomach and then into the small intestine. And the gastric juice, bile and pancreatic substances enter the neighboring (biliopancreatic) loop and are mixed with food here.
This method allows you to remove excess weight for 1 - 2 years. The decrease in body weight varies between 65 - 75% of the initial index. Another advantage of surgery is the positive effect on type 2 diabetes on the lipid content of the blood, which significantly reduces the risk of cardiovascular pathologies.
Bariatric interventions through operations often provoke hormonal changes in a patient, which after a certain period of time will return to normal metabolism: in individuals with problematic weight, it is almost always flawed. In addition, a new figure and reduced parameters of the stomach form a person's healthy habits in the usual diet: he eats much less and less, and even radically changes the quality of his usual diet.
