Types of Weight Loss Surgeries
Adjustable Gastric Banding
It is a variant of restrictive type of weight loss surgery.
The surgeon inserts an inflatable band around the stomach compressing it into two sections; upper portion is smaller and the lower portion is larger. The two portions are interconnected by a small opening causing slow emptying of the upper portion. The capacity is reduced to half or full cup of soft and well-chewed food.
- Advantages: It is simpler and safer than gastric bypass with small surgical scar, speedy recovery and it is a reversible surgery.
The band can be easily adjusted in an out-patient setting and can be tightened by injecting more saline into the band. Similarly, saline can be ejected out to reduce the compression.
- Disadvantages: There is not significant weight loss in gastric banding as compared to other variants of weight reduction surgeries. The weight regaining has been reported over the years.
- Risks: Most commonly occurring adverse effect of banding is vomiting after ingestion of meal. Complications of banding include slipping, loosening or leaking of the band. There is a risk of infection as well and some individuals may need repeated surgeries. Life-threatening complications are also reported very rarely.
This is another type of weight loss surgery. In this surgery, 75% of the stomach is removed and converted into a narrow sleeve or tube connected with the intestine.
Depending on the case, sleeve gastrectomy could be the only intervention needed. Otherwise in other cases, it could be the first surgery in a series of operations.
- Advantages: patients who are obese or have other disease are suitable for this surgery because of low risk involved operative procedure to reduce weight. Depending upon the need, the gastric bypass can be done after a year considering the patient is fit and has lost weight.
There is no risk of developing malnutrition because intestines remain intact.
- Disadvantages: this operation can’t be reversed unlike gastric banding. Also, this is a new procedure therefore its risk and outcomes are still being evaluated.
Complications of the surgery are leakage of the sleeve, infection or blood clots.
Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)
It is a combined approach weight reduction surgery of malabsorptive and restrictive surgeries and is the most practiced type.
The surgeon splits the stomach into two parts, separately sealing both of them. The upper part is then taken and joined with the small intestine.
A shortcut is made that bypasses some part of stomach and intestine both. This skipping allows the body to waste few calories without absorbing them.
- Advantages: there is sudden and drastic weight loss with reduction to 50% from the original weight in just six months. The weight keeps on losing till 2 years after surgery. This sudden weight helps significantly with other coexistent diseases like diabetes, hypertension, high cholesterol, arthritis, heart burn and sleep apnea.
- Disadvantages: the normal absorption of the food is disturbed that makes you prone to develop nutritional deficiencies. Iron and calcium loss can cause anemia and osteoporosis, respectively. Vitamins and supplements will be prescribed to be taken life-long.
The other side effect of gastric bypass is dumping syndrome in which the food does not stay in the stomach for sufficient time to be digested properly. It may cause nausea, pain, bloating lethargy, diarrhea and sweating. The condition can get worse by ingesting carbohydrate rich diet and can get better by attenuating the diet.
This surgery is also irreversible generally but in a very few cases, it had been reversed.
The complexity of this procedure makes it a risky operation. Like in any other surgery, infection and blood clots are a complication. Also, it predisposes a patient to develop hernias which are to be corrected surgically and due to weight loss, patient my get gall stones.
It is a modified version of gastric bypass in which 70 % of the stomach is removed and is bypassed with intestine from farther.
Biliopancreatic diversion is a relatively less risky procedure with a duodenal switch. Although it is a more extensive procedure than gastric bypass but lesser portions of stomach and intestines are bypassed. Biliopancreatic diversion without the switch is more destructive comparatively. It decreases the chances of developing ulcers or dumping syndrome.
- Advantages: it helps reducing weight much faster than gastric bypass and even after removal of the stomach, the leftover part is bigger than what is left in gastric bypass. The larger capacity enables you to eat more.
- Disadvantages: it is less common than gastric bypass because it has a higher risk of developing nutritional deficiencies. Except in case of duodenal switch, other risks are same as gastric bypass surgery.
This is the most risky and complicated procedure. As compared to gastric bypass, chances of hernias are much higher in this modality which can only be corrected surgically. If laparoscopic or minimally invasive technique is used, chances of hernia decreases.
In a Nut Shell
The suitable surgery depends up on the condition and body size of the patient.
Like in obese patients with history of prior abdominal surgery, it is difficult to perform simple procedure. Physicians will help understanding the advantages and disadvantages of various procedures.
Specialized weight reduction surgical centre should be preferred to minimize the occurrence of complications.
Regardless, choose a surgeon with a vast experience in performing weight reduction surgeries.