Weight-loss surgery (aka bariatric surgery) consists of a group of surgical operations designed to achieve both meaningful and sustainable weight loss. These procedures involve surgically manipulating the stomach (and sometimes the small intestines) to reduce food intake, and, in some cases, to reduce the absorption of calories into the body. The procedures include:
* Adjustable gastric banding: This common surgery achieves weight loss solely by restricting how much food one can eat.
* Gastric bypass: This common surgery achieves weight loss not only by restricting how much food one can eat, but also through hormonal changes, appetite reduction, food intolerances and mild malabsorption, in which the body absorbs fewer calories and nutrients.
* Biliopancreatic diversion: A less commonly performed operation, in which the intestines are bypassed, this achieves weight loss predominantly by limiting the absorption of calories consumed.
* Vertical sleeve gastrectomy: Also less common, this procedure involves removing part of the stomach. It is a new procedure and the exact mechanism of action has not yet been determined.
Currently, all of these procedures can be and are performed laparoscopically, meaning that surgeons operate through several small incisions with the aid of a video camera rather than through a long incision. This means less risk of complications, quicker healing, and less scarring.
The surgery has direct benefits, too. First, people can sustain a long-term eating pattern of caloric restriction (usually around 1,000 to 1,500 calories a day), with increased contentment and no deprivation. When hunger signals kick in, a moderate amount of food can now satisfy. Second, the likelihood of keeping most of the weight off is very high, so while 100-plus pounds of weight loss can be accomplished without surgery, the operation helps tremendously with preventing weight regain.
Here are some statistics for weight loss surgery risks:
* The adjustable gastric band has the best safety record with a mortality rate of only 0.1 percent (one in a thousand). Most of the complications occur over time and not at the time of surgery. The most common: problems with the implanted port that enables doctors to adjust the band, which occurs in four percent of cases; poor alignment of the band (called a prolapse), three percent; the band penetrating the wall of the stomach (called an erosion), two percent.
* Gastric bypass has a mortality rate of 0.2 to 0.5 percent (two to five out of a thousand). Postoperative complications include hemorrhages, in three to four percent of cases; leaks along the staple line in the stomach or at the connection between the stomach and bowels, two-and-a-half percent; intestinal obstruction, one to two percent of the time. Long-term complications include vitamin deficiencies, protein malnutrition, intestinal obstructions, marginal ulcers , strictures of the gastric pouch to intestinal leakage, and internal hernias.
* The biliopancreatic diversion procedures have slightly greater postoperative complications than the gastric bypass. Long term complications are similar to those of the gastric bypass, but the risks of protein malnutrition and vitamin deficiencies are greater.
* All of the procedures also have the risk of weight loss failure or weight regain.
Answered by
alok
, an ibibo Master,
at
4:13 PM on August 19, 2008