Bariatric & Metabolic Surgery
Bariatric and Metabolic surgery is a term used to describe surgical procedures to treat morbid obesity and obesity related conditions such as diabetes, hypertension, hyperlipidemia, obstructive sleep apnea, cardiovascular diseases, joint problems and so on.
Bariatric and metabolic surgery is done when diet control and exercise haven’t worked for you or when you have serious health issues due to your body weight. Usually these procedures work by limiting how much you can eat. Others work by reducing the body’s ability to absorb fat and calories, while some do both. According to international guidelines, bariatric and metabolic surgery is now recommended for individuals with BMI>35 regardless of whether you have any obesity related conditions or BMI >30 and also suffering from 1 or more obesity related conditions such as hypertension, diabetes, hyperlipidemia, fatty liver, cardiovascular diseases or joint problems etc.
These procedures are now considered the most effective and long- lasting treatment for morbid obesity, leading to substantial weight loss, improvement, prevention or even cure of many obesity related diseases including diabetes, hypertension, hyperlipidemia, obstructive sleep apnea and heart diseases.
Patients can lose 60-80% of their excess weight 1 year after surgery and the majority of patients with diabetes, hyperlipidemia, hypertension, obstructive sleep apnea and heart diseases experience remission after surgery.
In terms of safety, bariatric and metabolic surgery is as safe as or even safer than many common surgeries performed such as cholecystectomy, appendicectomy and knee replacement surgery. The risk of death associated with bariatric surgery is around 0.1%, however the overall risks of suffering from major complications from morbid obesity is around 4%. Therefore the risk of severe obesity outweighs the risk of bariatric and metabolic surgery for many patients.
Intra-gastric Balloon
Intragastric balloon is a non- operative procedure in weight loss therapy. A balloon filled with about 500ml of normal saline is placed inside the stomach to partially fill the stomach to give a feeling of fullness.
However, the intragastric balloon is not as definitive and long-lasting as compared to other operative options. The balloon can be placed in the stomach from 4 months to one year, during which patients can expect to lose about 10-20% of excess weight.
Laparoscopic sleeve gastrectomy
Laparoscopic sleeve gastrectomy is a surgical procedure that removes around 70-80% of the stomach and shape it into a tube like structure of about 150ml.The operation usually takes around 90mins to complete and the average hospital stay is around 2-3 days. Since the operation removes appetite-inducing cells in the stomach, patients will generally have greatly reduced appetite and food intake. Patients will be able to lose 60-70% of their excess weight within 2 years. This surgery is the most commonly performed weight loss procedure in the world and the overall risks of complications is less than 1%.
Laparoscopic gastric bypass
Among the many bariatric and metabolic surgeries, gastric bypass has the longest history of use and is comparatively more effective in treating diabetes and morbid obesity. During this minimally invasive surgery, the stomach is split into two parts, where the smaller part will be connected to a distal portion of the small intestine. This assists in weight loss and diabetes control by controlling the amount of food ingested and undigested food bypasses a section of the small intestines that is responsible to absorb nutrients. As such, this operation is more definitive and longstanding compared to many other types of weight loss surgeries.