What are Different Types of Bariatric Surgeries? 

Bariatric Surgery is one of the most popular options for obese people looking for a way to control their weight. To get bariatric surgery, one has to qualify for certain criteria like BMI (Body Mass Index), associated comorbidities like Diabetes, Hypertension, sleep apnea, infertility, hypercholesterolemia etc. There are many kinds of bariatric surgeries or weight loss surgeries, different surgeries work differently in order to give the desired effect, which is why it is important to understand these surgeries thoroughly. 

Weight loss surgeries are divided into different categories like - 

  Restrictive surgeries: Some bariatric surgeries are focused on limiting the amount of food that can be stored in the stomach. This allows a person to eat less than they used to, because of the limited capacity of the stomach. Sleeve gastrectomy, Adjustable gastric banding, Gastric imbrication, Gastric balloon surgery are examples of restrictive procedures. In sleeve gastrectomy, the stomach is divided into two halves first, then one half of the stomach is completely removed. The remaining part of the stomach is formed into a tube-like structure. This tube-like structure cannot hold enough food and restricts excessive food intake. It also limits the secretion of an appetite hormone called Ghrelin which limits the desire of a person to eat. 

  Malabsorptive procedures: In this procedure, a large segment of the small intestine is bypassed i.e the food is not allowed to enter a large segment of the small intestine and hence malabsorption will be there. Duodenal switch is a malabsorbtive surgery. 

To Summarize: The weight loss procedures that suit our Indian population are the Roux en Y gastric bypass and the sleeve gastrectomy. We do not come across any sign of malnutrition in patients who have undergone these procedures. For successful outcomes, vitamin, calcium and protein supplements are required. 

There are certain myths about bariatric surgery --- life will never be normal after the surgery, pregnancy is a problem after this surgery, one will never be able to eat after this surgery, marriage is a problem after this surgery etc. All these are incorrect as one live a better life after the surgery as one has shed the extra kilos, one is cured of existing problems like diabetes, high cholesterol, hypertension, obesity induced infertility and sleep apnea extra. IN FACT, the quality of life is phenomenal after this surgery. CHOICE of surgery depends on the existing BMI, existing associated problems and results of the investigations that are done prior to the surgery. Your surgeon is the best to decide the right procedure for you. As the procedure which your friend has undergone might not be good for you. Choice of procedure and proper follow up are the key points for a successful surgical outcome. 

  Combination of restrictive and Malabsorptive surgeries: In these procedures, the surgery is done on the stomach as well as the small intestine. It involves creating a small stomach pouch which is attached to the small intestine, thus bypassing a small segment of the small intestine to get the desired effect if the person has diabetes associated. The rest of the stomach produces important digestive juices and is also connected to the intestine so that it can transfer these digestive juices in it. As a part of the stomach and few centimetres of the small intestine are bypassed i.e food does not enter this part, the surgery is called the gastric bypass. The Roux en Y gastric bypass and the Mini Gastric bypass surgeries are examples of these combination procedures.

Bariatric Surgeries - Know Forms Of Them!

Obesity is a major problem across the world. In India, fast foods and an unhealthy lifestyle have led to widespread obesity as well. While following a proper diet and leading a healthy life can help manage obesity and weight gain in most cases, severely obese people require surgeries to lose weight.

Weight loss surgery, known as bariatric surgery, aims to reduce hunger and appetite in extremely obese people. However, simply undergoing surgery does not guarantee positive results. In fact, the lifestyle changes post-surgery is the most important factor to keep the extra weight off your body.

Recovery post bariatric surgery:

If you undergo a bariatric surgery, your lifestyle changes will depend on the procedure of the surgery. For instance, in laparoscopic bariatric surgery, the recovery period is short. In this surgery, the doctor will make 5-6 very small incisions on your stomach. He will then insert a tube-like equipment with a camera in your stomach and carry out the surgery.

Since very small incisions are made instead of a large cut, you will be discharged within a week. Furthermore, you can return to your normal routine within a month.

Lifestyle changes to follow:

1. Eating healthy: Post the surgery, you will need to follow a low sugar and low-fat diet. If this is a break from your usual diet then you need to get used to this diet, since you will need to stick to it for a long time. Immediately after the surgery, you will need to stick to a liquid diet, so that your stomach can adjust to the food.

Once your stomach starts adjusting to the sudden change, consume soft proteins. You will be able to return to solid foods around six months after your surgery. In the initial six months, it is essential to avoid foods such as white bread, pasta, and potatoes. Furthermore, you need to consult your doctor before consuming certain medicines such as painkillers.

2. Exercise daily:

Exercise becomes vital in your long-term goal of losing excess weight after the surgery. Your doctor will first need to clear you to take part in light activities, which will help enhance your body s metabolism. Joining a gym is helpful in this regard   you will have access to trainers and training equipment to help you exercise correctly. However, make sure to inform your instructor of your surgery before beginning an exercise regimen.

Most people fail to understand that you do not magically lose weight after bariatric surgery. You will need to maintain a healthy lifestyle if you want to achieve an ideal body mass and stay in shape. Therefore, you need to be committed to the procedure for the rest of your life.

Lifestyle After Bariatric Surgery!

Abdominoplasty, also known as  tummy tuck  is a surgical procedure aimed at removing excessive skin from the abdomen. This surgery removes the extra fat and skin, thus making the abdomen flatter, resulting in tighter muscles near the walls or border of your abdomen. You should consult your doctor and strictly follow prescribed procedures before and after the surgical process. It must not be confused with liposuction i.e. the cosmetic surgery which removes excessive fat deposits in the body. 

Abdominoplasty or tummy tuck is beneficial to you, 

If you possess good physical health. 
If you are a non-smoker or have recently quit smoking. 
If you have a stable health and realistic expectations about the outcome of the surgery. 
If you have been pregnant previously and now need to lose weight and fat deposits. 
The surgery is not suitable for the following cases: 

If you are planning to get pregnant, then it is recommended to perform the surgery after delivery. This is due to the fact that your muscles can be stretched again after the surgery. 
If the appearance of scars after tummy tuck is a problem, consult your doctor about the scar replacement procedure. 
If you still smoke or are absolutely unable to quit. 
Types: 

There are two procedures of tummy tuck. These are decided by the surgeon during your consultation and some pre-surgery medical tests. The procedures are: a) Complete Abdominoplasty and b) Partial or mini abdominoplasty. 

In Complete Abdominoplasty, the surgeon cuts the abdomen from hipbone to hipbone and your skin, tissue and muscle will be operated. In the case of partial or mini abdominoplasty procedure, the fat deposits are usually located below the navel region and the surgeon may not move your belly button. The entire procedure may take around two to three hours. 

Aftercare: 
Proper nutrition and healthy meals are required for this surgery. You must follow a balanced diet and focus on post-operative care.

Tummy Tuck Surgery - Abdominoplasty!

When dieting and exercising fail to help an obese person manage their weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within 12-18 months.

A gastric sleeve surgery is a relatively safe, straightforward and short surgery. Prior to surgery, few patients would have been given a special diet.  This surgery is always  performed laparoscopically popularly known as keyhole route. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. 

Though recovery from any surgery varies from person to person, most patients are able to walk and allowed sips of water by evening. Though certain amount of pain and discomfort is expected, this remains in bearable range with pain killers. Usually liquid diet is advised for 2 weeks followed by soft foods for 4 weeks.

You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. It is essential to drink plenty of water to remain adequately hydrated and to prevent constipation.

On an average, this surgery can help people lose up to 70% - 100%% of their excess body weight. However, this depends largely on your understanding and compliance of post operative dietary changes. A dietician can also help you make right food choices, decide meal portions and address the right number of meals needed by your body. For long term weight maintenance it is important not to fall back to your earlier lifestyle and to maintain a positive attitude.

Gastric Sleeve Surgery - What Is The Process Of It?

Obesity can make life miserable. From unhealthy eating habits to unhealthy lifestyles and medical conditions, obesity can be an amalgamation of many factors. Obese people are a greater risk of suffering from many serious health complications like type-2 diabetes, mood swings, and depression, cardiac problems, high blood pressure and high cholesterol, to name a few. It does not stop there. More alarming is the fact that obese people are an increased risk of suffering from different types of cancer.

Bariatric surgery comes as a saviour for highly obese people (with a BMI over 40), who have tried every possible treatment under the sun to lose weight without any success. Bariatric surgery has helped many severely obese people attain a healthy weight. Bariatric surgery can be of three types;

Gastric bypass surgery (Roux-en-Y): This is one of the most common types of weight-loss surgery practised worldwide. The procedure involves rearranging (dividing) the stomach into a smaller upper pouch and a larger lower part. The smaller pouch is then connected to the small intestine. The food consumed will pass into the small intestine through the pouch. The idea is to rearrange the stomach in such a way that a person consumes a lesser quantity of food.
Gastric banding (Laparoscopic Adjustable Gastric Band): In this procedure, the surgeon creates a small pouch at the upper part of the stomach by placing a band (lap band or A-band) around it. The pouch, true to its name, is used to hold the food consumed. The purpose of placing a band around the stomach (upper part) is to reduce the intake of food.
Sleeve Gastrectomy (Gastric Sleeve surgery): In Sleeve Gastrectomy, surgeons remove a large portion of the stomach, leaving behind only a small sleeve-like pouch (hence the name). Like the other two surgeries, sleeve gastrectomy also aids in limiting the consumption of food.
Duodenal switch: The fourth type of bariatric surgery, Duodenal switch with biliopancreatic diversion, is not very commonly used. Bariatric surgery has several health benefits. In addition to the weight loss, it plays a pivotal role in lowering the incidences of Type-2 Diabetes, depression, anxiety, coronary artery problems, sleep apnea cardiovascular diseases.
Research also suggest that bariatric surgery has been instrumental in reducing the chances of cancer (especially colon and breast cancer) by as much as 60%. The correlation between weight loss and reduced cancer instances is still a debatable topic. Some researchers and oncologists believe that the weight loss (bariatric surgery) brings about a hormonal modification which prevents the growth of tumour cells. Another study links obesity with an increased inflammation. In many cases, inflammation acts as a catalyst, accelerating the growth of cancer cells. Research is still going on to understand this correlation (obesity and reduced cancer rates) better.

Bariatric surgery has its share of risks and demerits. Consult your physician and get yourself thoroughly examined before opting for the surgery.

Does Bariatric Surgery Reduces The Risk Of Cancer?

If you have taken the big decision to go ahead with bariatric surgery, one thing you need to prepare for well in advance is the additional effort that is required after the surgery to ensure it is a success. The results will be evident only after a few months post the surgery. This period requires your constant attention. 

Listed below are some after-care measures that are essential for the success of a bariatric surgery.

Hospital stay: Most patients are advised hospital stay for four days, during which the hospital staff will ensure the sleeve is working fine. No food is allowed for 48 hours. Diet is gradually advanced from water to clear liquids, about 50 ml to 100 ml and then to 150 ml.
Wound care: Depending on whether a laparoscopic or open surgery was done, the number and location of incisions will vary. However, the wound should be maintained clean and it should be ensured that there is no infection of the site. Wound care should be done by the nursing staff if required. Suture removal, if required, should be done as per doctor s advice.
Pain management: Finish the course of antibiotics and pain killers to ensure infection is completely gone. Pain would continue, if the infection is not completely controlled.
Diet: The first two weeks would be a completely liquid diet. The next two weeks will consist of a pureed diet. After these four weeks, solid foods will be introduced.
Foods to avoid after a bariatric surgery include anything with a higher protein content and anything that has too much oil as the stomach s ability to digest these is reduced. Refrain from:

Carbonated beverages
Hard meat
Nuts and seeds
Fried foods
Food items to include post bariatric surgery include those which are easy on the stomach, including:

Liquids such as soups, broth, juice, and milk
Pureed cooked vegetables and eggs
Soft mashed food including meat and vegetables
Adherence to this will reduce complications. While eating, the patient should also remember to chew nicely, eat and drink slowly, increase water intake throughout the day, and avoid fats and sugar. It is advisable to eat three proper meals a day and avoid snacking during the day.

Remember that the need for bariatric surgery arose in the first place due to uncontrolled eating of oily food. After undergoing a bariatric surgery, diet pattern is definitely going to move to a healthier side with reduced fat and sugars. It is not an easy shift, but definitely required, if the surgery is to be a success. Imagine the new you and you will be able to do it!

Bariatric Surgery - Aftercare Tips You Must Follow!

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