Forty years ago, the number of obese people in the world was much lower than that of underweight people. This situation has been reversed, and today the number of obese people is double the number of underweight people. If the trend continues, by 2030, more than 40% of the planet’s population will be overweight, and more than a fifth will be obese. Being overweight and obese can increase the risk of developing certain health problems and can be linked to some emotional and social problems. For this reason, surgical methods, such as gastric band surgery or gastric bypass surgery, have been developed to help treat obesity issues by helping to achieve the feeling of being satisfied with less food.
Gastric Band Surgery
Gastric band surgery uses a silicone ring that is placed around the pit of the stomach and can be adjusted by reducing the space so that more or less food enters the stomach. In this way, the patient will eat food more slowly and will have the feeling of a “full stomach” much quicker, and as a result, they will lose weight.
The intervention is carried out by laparoscopy, a minimally invasive procedure that will only need five incisions in the abdomen area to be carried out. The surgeon will insert the necessary instruments and place the ring around the stomach. This is filled with saline, leaving the appropriate stomach size for each patient.
After its placement, the diameter of the elastic band (the degree of compression it exerts on the stomach) can be adjusted by the doctor by adding or removing saline solution. A catheter is left in the abdomen area for this function.
Inflammatory obstructions of the tissues within the ring have rarely been seen, but they heal on their own. However, after gastric band surgery, the patient must develop new eating habits and exercise to be as successful as possible.
Gastric Bypass Surgery
This method can cause the loss of up to 70% of the initial weight and consists of reducing the stomach and altering the intestine, causing the person to reduce the amount of food they eat, thus favoring weight loss.
Gastric bypass surgery differs a great deal from gastric band surgery. As it is a type of surgery that causes many alterations in the digestive system, a bypass is only indicated in people with a BMI greater than 40 kg / m². A person with a BMI greater than 35 kg / m² with one or more diseases associated with excess weight, including hypertension, dyslipidemia, fatty liver, obstructive sleep apnea, asthma, gastroesophageal reflux, among others, will also be considered for this surgery.
Gastric bypass surgery is a complex surgery that is performed under general anesthesia and takes an average of 2 hours. The hospitalization time varies from one person to another, between 3 to 5 days. To perform the bypass correctly, the doctor must follow specific procedures:
- Cut the stomach and intestine: a cut is made in the stomach that divides it into two parts, leaving a smaller portion in the form of a bag that has a reservoir of approximately 30 cm3 and a large portion that corresponds to the rest of the stomach which is sutured and stops storing food. In addition to this, a cut is made in the second portion of the intestine called the jejunum.
- Attach the jejunum to the smaller stomach: this creates a direct tube-shaped passage of food from the stomach to the intestine.
- Join the part of the intestine that remained connected to the large part of the stomach to the tube, forming a Y: this configuration allows the food, which comes from the connection created previously, to mix with the bile and digestive enzymes and then, digestion occurs.
Recovery from gastric bypass surgery is slower than gastric band surgery and can take between 6 months to 1 year, with the most intense weight loss taking place during the first three months.
One of today’s most successful weight loss methods is the gastric balloon (intragastric balloon). Its implantation is minimally invasive and relatively painless.
This treatment consists of inserting a medical silicone balloon endoscopically into the stomach. Before inserting it, the stomach is examined through the endoscope to ensure no ulcers or other disease that contraindicates its placement. When inserted the balloon is filled with a saline solution so that it can cause a limitation in stomach capacity and help the patient to modify their eating habits and, therefore, to change their lifestyle.
By placing the intragastric balloon, the feeling of hunger decreases, and satiety increases. As a consequence, there is a considerable weight reduction in a very short time. The success of the intragastric balloon is based on this.
For placement, after medical personnel verifies that there are no abnormalities in the stomach, the patient is sedated, and the deflated intragastric balloon is inserted into the stomach via endoscopy.
After the balloon is in the stomach, it is filled with saline solution, and its valve is closed. The balloon will be filled according to the weight and height of the patient but usually occupies between 30-40% of the total volume of the stomach.
The success rate of bariatric surgery is 90%, and patients lose between 30 and 50% of their weight. Still, despite the high success rate, the best results are obtained by complementing the surgery with a change in eating habits, an exercise routine, and in general, leading a healthy life.
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