Bariatric Surgery Procedure

June 16, 2009 · Filed Under vertical sleeve surgery · Comment 

Bariatric is the branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatric was created around 1965, from the Greek root baro (“weight,” as in barometer), suffix -iatr (“treatment,” as in pediatrics), and suffix -ic (“pertaining to”). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Overweight and obesity are rising medical problems of pandemic proportions. There are many detrimental health effects of obesity: heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, etc. There is also a clear effect of obesity on mortality, though this is not so clear for those who are overweight

Although not a direct measure of body fat, the Body Mass Index is widely adopted and promoted as a marker for excess body weight. However, it is not flawless: a very muscular person may be assessed as obese, and an elderly person with low body weight but high body fat (this can happen due to low muscle mass and bone density) may be assessed as healthy. Other markers for the evaluation of obesity include waist circumference (associated with central obesity), and a patient’s risk factors for diseases and conditions associated with obesity. Besides these indirect methods, body fat can also be measured directly.

There are a number of surgical options available to treat obesity, each with their advantages and pitfalls. In general, weight reduction can be accomplished, but one must consider operative risk (including mortality) and side effects. Usually, these procedures can be carried out safely. Procedures can be grouped in three main categories:

predominantly malabsorptive procedures: although also reducing stomach size, these operations are based mainly on malabsorption.

Biliopancreatic Diversion (Scopinaro procedure – rare)

Jejuno-ileal bypass (no longer performed)

predominantly restrictive procedures: this kind of surgery primarily reduces stomach size

Vertical Banded Gastroplasty (Mason procedure, stomach stapling)

Laparoscopic Adjustable Gastric Band (LAGB)(REALIZE Band – Lap Band)

Sleeve gastrectomy

Mixed procedures: applying both techniques simultaneously

gastric bypass surgery, like Roux-en-Y gastric bypass

Sleeve gastrectomy with Duodenal Switch

Implantable Gastric Stimulation