Weight reduction surgery is stepwise procedure that is done to correct obesity in persons that are struggling with excess weight. It is also termed bariatric surgery. During the procedure, it is often necessary to reduce the size of the stomach as well through a number of techniques. This may be done either by use of sleeve gastrectomy or by use of a special gastric band. The former cuts off some portion whereas the latter only shrinks the volume. The bariatric procedure greatly benefits people struggling with conditions such as hypertension and diabetes.
Bariatric surgery is most helpful in persons that have a body mass index, BMI, of more than 40. It is also recommended for those that have medical conditions that are likely to be worsened by obesity. These include among others, glucose intolerance, hyperlipidaemia and diabetes. Surgical options are reserved for cases that are unresponsive to medical therapy.
Pros and cons of such a procedure should be taken into account before the procedure is done. Certain post-operative complications such as gall bladder disease and malabsorption may arise. Psychiatric screening should also be done as there is possibility of patients falling in to depression after the operation.
There are three main categories of surgery to consider. They broadly include the restrictive, malabsorptive and mixed. The malabsorptive technique is one that results in a malabsorption state of the gut. An example here is what is referred to as billiopancreatic diversion with duodenal stitch or BDS/DS. What this means is that a portion of the stomach is cut and removed and the remaining is fashioned into a smaller pouch that is connected to the small intestine bypassing the jejunum and duodenum. Side effects are mainly related to vitamin and mineral deficiency.
Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
The diet of the patient after surgery becomes restricted to liquid foods such as broth, fruit juice and gelatin desserts that are sugar free. This kind of diet is maintained until the alimentary canal recovers from the surgery. The next diet is composed of blended substances which are sugar free, consisting of foods such as cream soup, skimmed milk, protein drinks among others.
As happens with any surgical operation, there are a number of risks that should be anticipated both in the short term and long term. In these patients calcium absorption is often compromised leading to metabolic bone diseases. Osteopenia and secondary hyperparathyroidism are some clinical features that may be encountered. Rapid loss of weight is a predisposing factor for gall stone formation and one will therefore need to have this at the back of their mind. Other complications of weight reduction surgery include decreased absorption of nutrients such as vitamin B12, thiamine, iron and folate.
Bariatric surgery is most helpful in persons that have a body mass index, BMI, of more than 40. It is also recommended for those that have medical conditions that are likely to be worsened by obesity. These include among others, glucose intolerance, hyperlipidaemia and diabetes. Surgical options are reserved for cases that are unresponsive to medical therapy.
Pros and cons of such a procedure should be taken into account before the procedure is done. Certain post-operative complications such as gall bladder disease and malabsorption may arise. Psychiatric screening should also be done as there is possibility of patients falling in to depression after the operation.
There are three main categories of surgery to consider. They broadly include the restrictive, malabsorptive and mixed. The malabsorptive technique is one that results in a malabsorption state of the gut. An example here is what is referred to as billiopancreatic diversion with duodenal stitch or BDS/DS. What this means is that a portion of the stomach is cut and removed and the remaining is fashioned into a smaller pouch that is connected to the small intestine bypassing the jejunum and duodenum. Side effects are mainly related to vitamin and mineral deficiency.
Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.
In sleeve gastrectomy, the stomach is reduced to 85% its original size. A huge portion of the stomach following the greater curvature is removed. This makes the stomach look more like a tube or shaped like a banana. It is a permanent procedure done under laparoscopy. Although the volume of the stomach is reduced, it still works normally and the patient can be able to take in small amounts of food at a time.
The diet of the patient after surgery becomes restricted to liquid foods such as broth, fruit juice and gelatin desserts that are sugar free. This kind of diet is maintained until the alimentary canal recovers from the surgery. The next diet is composed of blended substances which are sugar free, consisting of foods such as cream soup, skimmed milk, protein drinks among others.
As happens with any surgical operation, there are a number of risks that should be anticipated both in the short term and long term. In these patients calcium absorption is often compromised leading to metabolic bone diseases. Osteopenia and secondary hyperparathyroidism are some clinical features that may be encountered. Rapid loss of weight is a predisposing factor for gall stone formation and one will therefore need to have this at the back of their mind. Other complications of weight reduction surgery include decreased absorption of nutrients such as vitamin B12, thiamine, iron and folate.
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