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Bariatric surgery, also called weigh loss surgery, is used as a treatment for obesity. Obesity refers to abnormal and excessive accumulation of body fat that may impair health. It is a chronic and progressive disease that can reduce life expectancy if not treated early. Obesity is usually caused by imbalance between the consumption of calories and the excess energy that is stored as fat. Obesity has become a major health concern across the world and the number of bariatric surgeries is growing year on year.
Obesity is a major risk factor in the development of:
• metabolic syndrome, which is associated with elevated blood sugar (diabetes)
• elevated blood pressure (hypertension)
• elevated blood cholesterol and lipids (dyslipidemia) that can lead to heart disease and stroke
Bariatric surgery involves making changes to the digestive system by restricting how much you eat in one sitting or how nutrients are absorbed by the body or both. It is a safe and effective procedure but it is not a treatment for obesity unless you change your habits. For the best and long-term results you will need to adjust your diet, lifestyle and life conditions. Bariatric surgery is generally recommended when other weight-loss measures and treatments, such as diet and exercise, have failed.
Who is it suitable for
✔ A gastric bypass is often prescribed for those with a BMI of over 40
✔ May also be recommended for patients with a BMI of 30 and above, who suffer from conditions such as high blood pressure and/or type 2 diabetes
✔ If you have weight-related metabolic syndrome, surgery is recommended for those with BMI > 27
✔ Bariatric surgery usually takes 1-4 hours but may take longer
✔ Most patients need to stay in hospital overnight for 1-4 days
✔ The complexity and duration of operation vary from patient to patient, depending on their individual situation
✔ 1 to 2 weeks pre-operative diet may be prescribed
✔ Initial hospital stays following gastric bypass surgery last from 1-4 days
✔ Patients generally return to full fitness within 3-5 weeks
Bariatric surgery types
These weight loss surgeries can be performed by either conventional open surgery (as we used to do in the past) or by minimally invasive laparoscopic surgery.
The most common bariatric surgery procedures are:
• Gastric bypass
• Sleeve gastrectomy
• Adjustable gastric band
• Biliopancreatic diversion with duodenal switch
Before The Treatment
Before the treatment, you will need to meet with a doctor to discuss your surgery objectives and to perform an examination:
• Goals and expectations - Be ready to discuss you goals and expectations. Your doctor should explain you different types of methods, potential risks, recovery and expected outcomes.
• Medical history - Doctor will ask you to provide a complete medical history including your past and current medical conditions, and medications that you are taking, and any previous surgeries.
• Examination, diagnostics - Your doctor will perform physical examinations and diagnostics such as blood test, endoscopy, ultrasound and ECG, to determine the best treatment approach for you.
You will be advised by your doctor how to prepare for the procedure which may include dietary and medication requirements. You may need to stop taking certain medications such as contraceptive pill and anti-inflammatory drugs.
It's recommended that you arrange for help during recovery and drive you home from a hospital.
What does it involve?
There are different types of bariatric surgery, but generally the following is involved:
• This procedure is generally performed under general anaesthetic
• The procedure will start with making small incisions
• Parts of your stomach will be cut and connected to the bowel making new route to your digestive system.
• Special staplers and harmonic scissors will be used during procedure.
• During the surgery gallblader operation or hernia(umbilical hernia) procedure can be done.
• Drain tubes may be placed through the incision to drain any excess fluid and blood
• At the end, sutures are applied to close the incisions
• A bandage may be applied to reduce swelling and bruising.
Bariatric operations usually takes from 1 to 4 hours but can take longer. Most patients need to stay in hospital overnight for 1-4 days.
After the treatment
Your recovery and how quickly you can return to work largely depends on your treatment type and complexity of the operation. You will need to take at least 2 weeks time-off for your recovery. After bariatric operation it is common to experience some discomfort and:
After weight-loss surgery, you will need to follow a prescribed dies which usually involves:
• first fews days you can have water and fluids only
• next 4 weeks you will eat pureed and soft food
• after 6 weeks and onwards you can eventually return to regular food
After surgery it is likely that you will have a bandage or support corset to reduce swelling and bruising. You may need to wear bandage for couple of months after the treatment. You may need to take antibiotics after the operation to reduce the risk of infection. Bruising and swelling normally is visible for 2 weeks. It normally takes at least 6 weeks to resume strenuous exercise. Recovery usually takes around 4-6 weeks.
As with any major surgery, gallbladder surgery carries risks such as:
• wound infection
• blood clots
• dumping syndrome (when certain foods pass too quickly through the gastric tract, leading to nausea and diarrhoea)
More serious complications can include internal infections, gastric leakage and blood clots, which occur in roughly 1% of cases
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