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June 10, 2022 In bariatric surgery By Dr. Vikas Singhal

What are the 4 types of bariatric surgery?

Bariatric surgery refers to surgical interventions that aid in weight loss by making structural changes to the digestive system and how it works. Read on to find out how it’s done, the 4 types of bariatric surgery, and their specific advantages. 

This type of surgery is performed in patients who are morbidly obese and must lose the extra weight to diminish the risk of severe and life-threatening conditions, including:

  • Cardiovascular disease
  • Stroke
  • Hypertension or high blood pressure
  • Liver disorders
  • Obstructive sleep apnea
  • Type 2 Diabetes Mellitus

Bariatric surgery is a good choice for you if: 

  • You have obesity-related conditions such as diabetes, asthma, high blood pressure, GERD, or sleep apnoea.
  • Your BMI is above 35.
  • Your body weight is about 45 kgs more than the ideal recommended range 
  • You are above the age of 18.
  • You have tried other non-surgical weight loss methods but with no desired results.
  • You are aware of the long-term commitment to lifestyle changes, including dietary, exercise, and medical requirements.
  • You are not pregnant and do not plan to get pregnant in the near future.

There are different types of bariatric surgery depending on your individual needs, concerns, and the technique used by the

surgeon.

Table of Content

  1. Sleeve Gastrectomy
  2. Roux-en-Y Gastric Bypass
  3. Adjustable Gastric Band
  4. Biliopancreatic Diversion with Duodenal Switch
  5. Other Types of bariatric surgery
  6. FAQ’s
  7. Take away

1. Sleeve Gastrectomy

This is a permanent procedure that employs staples to divide the stomach into sections.  The largest section constitutes about  85-90 percent of the stomach and is surgically removed. The remaining portion is long and narrow, resembling the shape of a sleeve, and will remain functional. In this method, the volume of food that the stomach can hold is considerably less. As a result, patients who undergo sleeve gastrectomy feel satiated more quickly and consume lesser food. On average, patients lose about half of their excess weight in about a year.

Advantages of sleeve gastrectomy

  • Reduces the capacity of the stomach but retains its normal function.
  • Patients who undergo the procedure can digest almost all types of foods.
  • The portion of the stomach responsible for the production of hormones related to hunger is removed.
  • This technique minimizes the chances of stomach ulcers. 
  • It is a very effective procedure for those with a very high body mass index.
  • This surgery may be the right choice for people who have conditions such as anaemia and Crohn’s disease.

2. Roux-en-Y Gastric Bypass

The surgery is performed using a laparoscope and is less invasive than traditional open surgery. Roux-en-Y is the most common type of gastric bypass surgery. The procedure involves stapling the stomach to create a small pouch that holds less food. We shape a portion of the small intestine into a “Y.” Roux-en-Y limits food absorption and intake and is very successful in bringing about weight loss.

In this surgery, the bariatric surgeon in gurgaon creates a shortcut and bypasses a part of the stomach and the small intestine. This causes skipping certain parts of the digestive tract, and the body absorbs lesser calories.

The advantages of this procedure are:

  • Weight loss tends to be faster, and about 50% of it shows in the first six months and may continue for up to 2 years after the operation.
  •  Rapid weight loss is beneficial in conditions affected by obesity, such as diabetes, high blood pressure, arthritis, and heartburn, which improve following the procedure.
  • Gastric bypass offers great long-term results, and many people keep their weight off for 10 years or longer.

3. Adjustable Gastric Band

Laparoscopic adjustable gastric banding (LAGB) is a type of laparoscopic weight-loss surgery.  The surgeon puts a band around the top part of the stomach that is adjustable, thus creating a small pouch. The pouch makes you feel fuller more quickly and help you lose weight.

Advantages of gastric banding:

  • This surgery does not require regions of the stomach to be stapled as with other bariatric procedures. 
  • So, absorption of the food takes place in the same way as it used to before the surgery.
  • It is a very safe procedure, and recovery is quicker.

4. Biliopancreatic Diversion with Duodenal Switch

Biliopancreatic diversion with duodenal switch (BPD/DS) is a type of bariatric surgery also known as the duodenal switch. This type of bariatric surgery will change the size of your stomach and the length of your small intestine. The procedure limits the amount of  food you can eat and causes weight loss.

Advantages :

  • The average weight loss with the duodenal switch procedure is more than with other procedures because it provides the highest level of malabsorption.
  • The weight loss resulting from the duodenal switch procedure helps resolve type 2 diabetes, high blood pressure, obstructive sleep apnea, etc.
  • After the procedure, there are no restrictions on what you can eat
  •  In fact, following the procedure, you can eat larger meals compared with other bariatric procedures because the stomach size is not much compromised.

5. Other Types of bariatric surgery

Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a new technique to treat morbid obesity. It is based on the biliopancreatic diversion concept in which a sleeve gastrectomy is followed by a duodeno-ileal diversion from the end to side.

Advantages:

The advantages of SADI include:

  • There is quicker weight loss with almost 80-100% of excess weight loss in a period of about  8 to 9 months.
  • Improvement in comorbidities such as diabetes, high cholesterol level, sleep apnea, etc.
  • Less postoperative pain as compared to other procedures.

6. FAQ’s

You will be able to return to work two to four weeks after the procedure. You may experience low energy levels due to the altered volume of food intake and once soft foods are resumed, resuming a routine becomes easier.

After the surgery, your appetite is different, and you feel fuller sooner. However, healthier food choices are important for the desired results, and most of our patients enjoy tasty food and treat themselves from time to time.

It is advisable to wait about  12-18 months after surgery before getting pregnant. Birth control pills are not very effective during the transition, and alternate methods such as an IUD or using condoms are recommended. Do I need to take vitamins and minerals after surgery?

You may require higher doses of certain vitamins or minerals, and it is advised to take them as per the doctor’s recommendation.

Takeaway

Bariatric surgery is a very effective weight way to weight loss, and your surgeon will determine if it is right for you. Understanding the 4 types of bariatric surgery, and following the instructions, with respect to your diet and exercise will make the results of the surgery last longer.

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