With the progress of technology and the development of new methods, the success rate of today’s obesity surgeries is very high. Compared to the old obesity surgeries, the complications after a surgery have decreased in great extent and the healing period has shortened.
Who is a candidate for bariatric surgery?
BMI ≥ 40, or more than 100 pounds overweight.
BMI ≥35 and at least one or more obesity-related co-morbidities such as type 2 diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
Inability to achieve a healthy weight loss sustained for a period with previous weight loss efforts.
Types of Bariatric Surgery
Gastric balloon is one of the methods used in obesity treatment. The balloon limits the amount of food the stomach can hold and creates thereby an early feeling of fullness and satiety. Less intake of food will result in weight loss.
The procedure includes a longitudinal resection of the stomach starting from the antrum at the point 5–6 cm from the pylorus and finishing at the fundus close to the cardia. The remaining gastric sleeve is calibrated with a bougie. Most surgeons prefer to use a bougie between 36-40 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 150 ml.
Mini Gastric Bypass
The mini-gastric bypass is an effective and well-established procedure which combines some of the properties of a gastric sleeve and a standard gastric bypass. The upper part of the stomach is divided into a tube, similar to the top three quarters of a sleeve, and then joined to a loop of intestine.
Roux-en-Y Gastric Bypass
Laparoscopic Roux-en-Y gastric bypass has become the most common bariatric procedure for morbid obesity.
In this operation, the stomach is stapled or divided to form a small pouch, which empties into a roux limb of the jejunum of varying length.
Transit bipartition surgery is a metabolic surgical procedure. Metabolic surgeries are applied to people with diseases such as diabetes, obesity, high cholesterol and hypertension.
In this procedure, 100 or 120 cm starting from the connection point between the small bowel and the large bowel is measured and marked. The choice between 100 or 120 cm is determined according to patient’s body characteristics.
Afterwards, another 150 cm is measured, and small bowel is dissected at 250 cm distance to the connection between the small bowel and the large bowel.