Bariatric Surgeries: Gastric Bypass & Gastric Sleeve Surgery
Obesity is a growing health problem worldwide. The prevalence of obesity in India has been increasing at an alarming rate and is likely to increase further with time. Being overweight or obese means that your body weight is above normal which can be harmful to your health. Besides this, it is associated with numerous health problems that can lead to a poor quality of life and potential effects on life expectancy and premature death. The Body Mass Index (BMI) is a measure used to estimate body fat and determine obesity based on both height and weight of an individual. In other words, it determines whether a person’s weight is healthy for them or not and determine whether weight-loss surgery is needed or not. People whose body mass index (BMI) is 37.5 or more are considered as having morbid obesity. Such people are more likely to have other life-threatening weight-related health conditions, namely type 2 diabetes, high blood pressure, high cholesterol, heart disease and sleep apnea. However, these serious health problems can be remedied or treated through weight loss.
Bariatric surgery is a procedure performed to help people lose excess weight and treat or prevent the risk of other health conditions. The surgery basically makes changes to the digestive system, just restricts food intake and reduces food absorption in the stomach and intestines. There are numerous bariatric surgery procedures. These surgeries are recommended and considered for those who have serious health problems related to obesity and for those, for whom other options such as diet and exercise have not worked in losing weight. Consequently, these surgeries enable people to enjoy a better quality of life and a longer life span.
The two most common bariatric procedures performed in India are gastric sleeve surgery and gastric bypass surgery. Since each surgery has its own advantages and drawbacks, let us take a closer look at them in order to consider which option is best for you. Your surgeon will also look at your health record and help you determine the best option for you.
The sleeve gastrectomy is also called vertical sleeve gastrectomy or vertical gastric sleeve. This is a one-step procedure where about three-quarters of the stomach is removed and a new tube-shaped stomach is created with a banana like shape and size. This restricts the amount of food intake as well as prevents one from feeling hungry due to the reduced level of ghrelin or the hunger hormone that boosts your appetite. It is a purely restrictive procedure because it leads to weight loss by restricting the amount of food one can consume at a time and absorption of calories. A permanent or non-reversible procedure, it can be performed in patients with high risk medical conditions.
A patient who undergoes this surgery generally loses 50 to 60% of excess weight within 6 months to a year after the surgery on an average. A short time procedure, it generally takes around 1-2 hours depending on the body’s condition. The procedure is performed laparoscopically which is minimally invasive requiring a few small cuts or incisions on the stomach. Depending on the recovery, if the patient does not experience postoperative pain and nausea, s/he can leave hospital or go home in 1-2 nights after the surgery.
The immediate complications of the stomach reduction surgery which are rare may include infection of the surgical wound site, bleeding and a leak along the staple line. These can be prevented by experienced and skilled bariatric surgeons performing the surgery. The long term complication that may affect less than 5% of the patients is the development of reflux and heartburn which may require taking antacids for a long time to relief oneself. Overall, this procedure ensures an effective weight loss and improvement of obesity related conditions. However, it requires maintaining a healthier lifestyle including eating healthy, exercising, taking vitamins and supplements as instructed, and following up with the surgeon and dietician.
Gastric Bypass Surgery
This weight loss procedure is also called Roux-en-Y gastric surgery, a two-step procedure. It re-routes part of the digestive system by stapling part of the stomach together or by vertical banding to limit the food intake. Firstly, the surgery shrinks the size of the stomach by dividing it into a smaller upper part or pouch with a size of a walnut, and a larger bottom part called the gastric remnant which is bypassed and no longer stores or absorbs food. Secondly, the newly created smaller upper part or pouch is connected to a Y-shaped part of the small intestine that creates a bypass for food, skipping a large part of the digestive system. Consequently, the body will absorb fewer calories and nutrients. Since it limits the digestion and absorption of the calories’ intake of the body, it is a combination of the restrictive and malabsorptive procedure.
A patient who undergoes this surgery generally loses 60 to 75% of the excess weight within the first year to a year and a half after the surgery on an average, which is slightly more than the typical sleeve gastrectomy surgery. The procedure generally takes around 2-3 hours to complete. This procedure can also be performed laparoscopically which is minimally invasive, requiring a few small cuts or incisions on the stomach. After the surgery, the patient may need to stay in the hospital for 2-3 nights or longer so that the medical staff can monitor any complications post-surgery.
This surgery is not for everyone with morbid obesity as one needs to meet certain medical guidelines to qualify for the weight-loss surgery and is generally reserved for patients who need to lose a significant amount of weight or are suffering from medical conditions such as diabetes mellitus and hypertension. Patients with diabetes mellitus who undergo this procedure show great progress as compared to sleeve gastrectomy procedure because the re-routing of the digestive system can lead to changes in the hormones which regulate insulin and its resistance. The complications of this surgery may include risk of developing dumping syndrome which can cause abdominal cramping, nausea and dizziness triggered by eating sugary or high carbohydrate foods. There is also a possible risk of developing ulcers in the stomach adjacent to the bypass triggered by the tobacco use. However, the risk of complications reduces if the procedure is performed by an experienced and skilled team of surgeons.
Both bariatric surgeries are effective in losing excess weight. To ensure their long-term success, they should be accompanied by following a rigorous and lifelong diet and exercise plan to prevent any complications or recurrent weight gain even after the surgery.
If considering bariatric surgery, our team of experienced and skilled bariatric surgeons can help you determine the best option. Our surgeons perform a variety of bariatric procedures which are minimally invasive bariatric surgeries. Talk to our experts to develop a personalized weight loss plan.
Meet the best bariatric surgeon only at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad
Dr. Ashish Gautam is a very renowned and highly experienced bariatric, gastrointestinal and trauma surgeon. After completing his surgical training from S.N. Medical College, Maulana Azad Medical College, Lok Nayak Hospital, and Sushruta Trauma Centre, he pursued his fellowship in minimal access and bariatric surgery. He possesses enormous experience, having performed more than 20,000 laparoscopic procedures including advanced laparoscopic procedures like lap colorectal, lap bariatric, laparoscopic common bile duct surgeries, and video-assisted thoracoscopic surgeries. Dr. Gautam has been a pioneer in establishing world-class bariatric (weight loss) surgery services in Ghaziabad, Uttar Pradesh.