Bariatric surgery helps patients lose weight and thereby lowers the risk associated with high-weight. There are two ways in which this surgery is done -
•Restriction - Using surgery, the amount of food the stomach can hold is limited. Thus, the number of calories which an individual can eat is kept in check
•Malabsorption - A part of the small intestine is shortened which reduces the number of calories and nutrients which is absorbed by the body
There are four types of weight-loss or bariatric surgery in India which are -
•Roux-en-Y gastric bypass
•Laparoscopic adjustable gastric banding
•Duodenal switch with biliopancreatic diversion
Roux-en-Y Gastric Bypass bariatric surgery
This is a gastric bypass surgery in which a trained surgeon makes a small pouch at the top of the stomach. This is because the pouch is the only part of the stomach which receives food and thus, once created, limits the amount of food a person can eat at any given point of time.
Once the pouch has been created, the small intestine is cut from below the stomach and attached to the pouch. As a result, the food so ingested now moves directly from the pouch to the intestine.
The main part of the stomach, however, continues to create digestive juices. The portion of the small intestine which is still attached allows these digestive juices to flow to the small intestine. However, fewer calories and nutrients are absorbed as compared to earlier as the food is now bypassed.
Laparoscopic Adjustable Gastric Banding
In this procedure, a band made up of an inflatable balloon is fixed in the upper part of the stomach. This, in turn, creates a small pouch in the stomach above the band but with a narrow opening to the stomach.
Under the skin of the abdomen, a port is placed which is connected to a tube which connects the port and the band. Through the port, fluid is injected or removed by which the balloon is inflated to adjust the size of the band.
Laparoscopic adjustable gastric binding aids in restricting the amount of food which can be contained in the stomach.
As a result, the person feels full very quickly but does not reduce the absorption of calories.
In this process, a part of the stomach is either separated or removed entirely. The remaining portion of the stomach is turned into a tubular structure. As the stomach has now become smaller, it now cannot help as much food as it used to earlier. This also leads to the lesser production of the appetite-regulating hormone ghrelin. This reduces the desire to eat.
This entire process, however, does not affect the absorption rate of nutrients and calories in the intestines.
Biliopancreatic Diversion with Duodenal Switch
This is similar to sleeve gastronomy wherein a large portion of the stomach is removed. The portions that remain are the valve which releases food into the small intestine and a portion of the small intestine which is also known as the duodenum.
A surgeon closes the middle section of the intestine and attaches the last part directly to the duodenum. This is also known as duodenal switch. The separated section of the intestine is reattached to the end of the intestine which allows bile and pancreatic digestive juices to flow into this part of the intestine, a process known as biliopancreatic diversion.
Once these changes have been made, the food so ingested bypasses most of the small intestine and thereby limits the absorption of nutrients and calories. This coupled with the smaller size of the stomach results in loss of weight.
So these are all the options for bariatric surgery in india