Obesity puts an individual at risk for many conditions, some of which can be life threatening. These conditions include high blood pressure, diabetes, joint pain and deterioration, stroke and heart attack. Many people are able to lose weight through good diet and exercise, but some people struggle to lose weight even when they are eating right and are physically active. Some of these people may consider one of the multiple forms of bariatric surgery to treat their obesity.
Definition
Bariatric surgery can be defined as surgery that modifies the gastrointestinal tract with the purpose of decreasing calorie consumption and therefore decreasing weight. There are several different types of bariatric surgery, including malabsorptive, restrictive and mixed. In malabsorptive bariatric surgery, the primary result is the inability to absorb as many calories, vitamins and minerals. Restrictive bariatric surgery achieves weight loss by restricting the physical size of the stomach and thus restricting the number of calories consumed. Mixed bariatric surgeries are a combination of malabsorptive and restrictive bariatric surgeries.
Biliopancreatic Diversion
Biliopancreatic diversion is a rare type of malabsorptive bariatric surgery. In this procedure, part of the stomach is resected, which creates a stomach that is smaller. This smaller stomach pouch is then connected to the small intestine.
Restrictive Surgeries
The two main types of restrictive bariatric surgery performed are vertical banded gastroplasty (aka stomach stapling) and adjustable gastric band (aka lap band). In vertical banded gastroplasty, the stomach is stapled to create a prestomach pouch that is smaller. Adjustable gastric band surgery is like stomach stapling, but a band is used in place of staples. The advantage of the band over the staples is that the band can be made larger or smaller based on the needs of the individual.
Mixed Surgeries
The two main types of mixed bariatric surgery are gastric bypass and sleeve gastrectomy with duodenal switch. In gastric bypass, stapling of the stomach is done, and the intestine is rerouted to the smaller pouch that is created. In the United States, this is the most popular form of bariatric surgery. Sleeve gastrectomy is similar to biliopancreatic diversion---the size of the stomach is decreased, the stomach is disconnected from the duodenum and the stomach is then reattached about 3 feet from the colon.
Considerations
Bariatric surgery is a serious procedure despite its commonality. Complications, such as bloating, infections, leaks at the site of incision and diarrhea, frequently occur.
