Bariatrics

When weight increases to an extreme level, it is called morbid obesity. Obesity is associated with diabetes, heart disease, high blood pressure, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity. Bariatrics surgery is the term for operations to help promote weight loss. Bariatrics surgical procedures are only considered for people with severe obesity and not for individuals with a mild weight problem.

Types of Bariatrics Procedure

• Gastric Bypass Surgery :separates the stomach into two unequal compartments with less than 5% of the stomach remaining usable for food consumption. During digestion, the food empties from this tiny stomach pouch into the upper intestine.
• Biliopancreatic Diversion creates a smaller stomach (similar to gastric bypass surgery), but in addition there is less absorption of ingested food inside the intestine.
• LAP-BAND® (Adjustable Gastric Band) is a procedure in which the stomach is encircled with an inflatable plastic band that restricts food intake.
• Gastroplastyis a procedure in which the stomach is stapled close to the top with a small outlet or stoma leading to the remainder of the stomach and digestive tract.

Need Bariatrics Surgery?

The parameters that we use to indicate a Bariatrics surgery are the established ones worldwide by the National Institute of Health of the United States, the society of Gastrointestinal Surgeons and the American Society of Bariatrics Surgery.

• Age Between 18 and 55 years.
• To have an equal or higher BMI of 40.
• To have an equal or higher BMI of 35 with presence of two or more diseases associated to the obesity, the most common are the arterial hypertension, diabetes, hypercolesterolemy, hypertrigliceridemy, sleep apnea, etc.
• To have completed unsuccessfully other treatments supervised and documented to go down weight.
• Psychological and/or psychiatric evaluation that documents the absence of severe psychopathology.
• Other potentially corrigible reasons for obesity must be rejected (e.g. Endocrine).
• To suffer from obesity for almost 5 years.
• Consensus of the multidisciplinary team.

Gastric Banding

The gastric band (LAP-BAND), an FDA approved devise, is surgically implanted and adjusted around the stomach usually via laparoscopy. A new small stomach is created over the band with the majority of the stomach underneath the band. This reduces the area of food deposit in the new stomach to a small area. You will feel satisfied ("full") promptly and the sensation will remain for a long period of time.

Gastric Bypass

The Gastric Bypass surgery is ideal for patients with severe obesity and that have to loose a great amount of weight to attain ideal weight. The research shows a reduction of 40-50% of the excess weight in patients with gastric banding versus a 66-70% of weight loss with the gastric bypass after a year.

Vertical Gastrectomy Sleeve Type

Vertical Gastrectomy Sleeve type is a relatively new procedure that consists of removing 66% of the stomach decreasing considerably its capacity. This procedure is being recommended to patients that are extremely obese (BMI greater than 60 kg/mt²) and that perhaps might not resist a prolonged surgery.

How it Works?

During Bariatrics surgery, the stomach is closed off, leaving only a small pouch about the size of a thumb for food. As a result, patients feel full on fewer calories. However, the most common procedure -- gastric-bypass surgery -- goes one step further. Surgeons not only shrink the stomach but also reroute the small intestine to thwart the digestive process, thereby decreasing the number of calories absorbed.

This is achieved by making a direct connection between the stomach and a lower section of the small intestine. The first segment, the duodenum, is skipped entirely. The duodenum's chief responsibility is igniting the digestive process and absorbing iron and calcium from food. So in the end, patients eat less and absorb fewer calories.