Bariatric Surgery

Surgical Obesity (Bariatric surgery) includes a number of surgeries performed on people with obesity. One loses weight by reducing the size of the stomach with a bandage or by removing part of it (stomach amputation) ) Or by dissecting the small intestine and converting its pathway (gastric bypass surgery) .

Long-term studies have shown that these surgeries lead to significant weight loss, diabetes mellitus (Type II), improvement in the risk index for cardiovascular disease, and a reduction in mortality from 23% to 40%. On VA patients in the United States of America found that there was no difference in survival rate in older patients and obese patients when comparing surgery and normal health care for at least seven years The US National Institutes of Health recommends these operations for obese people with a BMI of at least 40 kg / m 2 and for people with other serious illnesses such as diabetes with an BMI of 35 or more. However, some recent studies suggest that surgeries Weight loss may be appropriate for those who have a BMI of between 35-40 and no other disease, and those who have a BMI of 30 to 35 but have other serious diseases .

Operations can be classified into three main groups:

Malabsorption processes,
Restricted processes
Mixed operations

Since 2009, laparoscopic operations have been the preferred option in the United States of America and most industrialized countries around the world.

The malabsorption processes are primarily correct Although the malabsorption processes primarily reduce the size of the stomach, the effectiveness of these procedures is derived primarily from creating a physiological condition that leads to poor absorption of food.

Biliary biliary bypass :

This complex process is called Scopinaro. This procedure is rarely done in the original way because of the problems associated with it, especially because it causes poor absorption. A part of the stomach is removed to create a smaller stomach that connects the last part of the small intestine to the 12 and the fasting.

First restricted operations :

Restricted operations primarily reduce the amount of food consumed by mouth by reducing the size of the stomach, sweating feeling full, leaving the digestive tract to continue to work, and thus reduce the possibility of metabolic complications.

Gastric bypass with vertical ligament:

In the gastric bypass of a vertical ligament, or by another Mason procedure or stapling, a portion of the stomach is permanently stapled to form a smaller pre-gastric sac, to act as a new stomach .

Connect the stomach with adjustable strap :

Gastric restriction can also be done by using a silicone band, which can be modified by injecting it with a brine solution or by withdrawing its saline solution through an outlet placed directly under the skin. This laparoscopic operation can be done, usually called gastric binding. Weight loss is mainly by reducing the amount of food intake due to the small gastrointestinal sac and narrow outlet. This is one of the safest processes with a mortality rate of about 0.05%.

Gastric banding :

is an operation to lose weight, in which the size of the stomach is reduced to about 15% of its basic size, by removing a large part of the stomach surgically, in parallel with the arch of the larger stomach. The open parts are then joined together (usually using surgical staplers, stitches, or both) until the stomach becomes more like a tube or a banana-shaped amount. This process reduces the size of the stomach permanently. This process is carried out through the endoscope, and can not be canceled or reversed, and the process of what distinguishes them:

Although the size of the stomach is lower, it tends to function normally and can consume most types of food in small quantities. This process removes the responsible part of the stomach from the secretion of the hormone that stimulates the feeling of hunger (the hormone ghrelin), although the stability of this effect has not yet been verified. The possibility of rapid emptying or drowning is less likely to occur due to the retention of the pylorus (part of the stomach in the form of a tube opening up to the 12) (although this syndrome can occur if any stomach surgery is performed). Reduce intestinal ulcers. By avoiding intestinal bypass, the chances of intestinal.

Adjustable stomach balloon :

The gastric balloon process is done by placing a hollow balloon from the air inside the stomach, then filling it to shrink the area inside the stomach. The balloon can be left in the stomach for up to 6 months, leading to the loss of approximately 5-9 BMI in half a year.

The gastric balloon process is authorized in Australia, Canada, Mexico, India, the United States of America (where FDA has been approved by 2015) as well as a number of European and South American countries. The gastrointestinal balloon may be used prior to another procedure to help the patient lose weight to an appropriate weight of the process.

Bend the rectifier :

It is a form of the most famous process; Inhalation of the stomach, in which the stomach is quantified by stapling part of it in the form of sewing instead of cutting and removing the tissue of the stomach, which preserves their natural ability to absorb food. The stomach flexion reduces the size of the patient's stomach significantly, helping the patient to feel full of smaller amounts of food. This process has produced remarkable results published in a recent study in Bariatric Times, which was based on a postoperative study of 66 patients (44 females) who underwent the procedure between January 2007 and March 2010. The average age of patients was 34 years, Body mass 35. The clinic reviews were scheduled at regular postoperative intervals to measure and assess the safety and rate of weight loss in patients. No major complications were reported in any of the 66 patients. The weight loss rate is also close to the infectious process.

Gastric bypass surgery :

One of the most common methods is gastric bypass surgery, where a small gastric bag is created by a stapler machine and then connected to the intestine. The upper part of the small intestine is then connected to the Y shape.

Infectious gastric bypass surgery is the most common operation in the United States for weight loss. Approximately 140.00 gastric bypass surgery was performed in 2005. Since that time, its market share has declined. In 2011, it was thought that the rate of gastric bypass surgery was less than 50% Weight Loss Operations Market.

Strict adherence to healthy eating habits after the procedure is a success factor in any of the surgical obesity methods.

There are certain patients who can not tolerate bad absorption and dumping syndrome associated with infectious leave. For such patients - although they are thought to be irreversible - there are cases of infectious disease that can be partially reversed.

Gastric stenosis with transducer :

he conversion of the twelve is a type of surgery to change the course of pancreatic juice and bile ducts. In which part of the stomach and its largest arc are removed. The stomach is formed as a 150 ml tube. By reducing the size of the stomach in this way food consumption is also restricted in this process. This type of gastrectomy is anatomically and irreversibly functional. The stomach is then separated from the duodenum and connected to the lower part of the small intestine. The remaining 12 and the upper part of the small intestine are reconnected to the rest, 57-100 cm from the colon.

Stimulated gastric stimulation :

The surgeon in this science implants a device similar to a pacemaker, so that the electrical wires stimulate the outside surface of the stomach, and the process is still under study in the United States. It is believed that electrical stimulation modifies the signals of the intestinal nervous system, which the brain interprets as a feeling of satiety and fullness. Initial evidence suggests that the process is less effective than other types of obesity surgery .

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