Which weight loss surgery ?
It is not difficult to answer whether you are or not a good candidate for obesity surgery, but is more difficult to answer “Which weight loss surgery is best for you?”
A lot of information is available about the types of obesity surgery, who is the best surgeon for weight loss surgery, which is the best facility, but little has been written about how to choose the best bariatric surgery option for you.
Though it is your personal choice and your surgeon’s experience in doing a particular surgery, here are a few points that would help you easily compare various bariatric surgery options and help you choose the best option for you.
Laparoscopic Gastric Banding
|Lap Band tied around stomach |
to limit the food intake
Laparoscopicgastric banding, also known as Lap band or gastric band surgery is being performed since 1993 and was approved by FDA in United States in 2001. Lap band is a reversible and least invasive of all the weight loss surgery procedures, thus making it the safest of all procedures. There are hardly any chances of post operative complication and absolutely no chances of leakage.
The procedure entails inserting an adjustable band around the stomach and an adjustment port under the skin. The band can be adjusted according to the speed at which you lose weight by injecting a saline solution through the port.
The weight loss is upto 50% of the excess weight, weight loss being slower initially. There are no risks of malnutrition and no dumping syndromes associated with lap band.
Why and Who should choose Lap Band surgery
If you are motivated enough and are sure that you can follow the dietary instructions to the point, Lap band surgery is good for you. This is the safest, least invasive, easiest to perform, reversible surgery. There are no changes in the anatomy of your body, no long stay at the hospital is required. There is not much requirement for vitamins, food supplements and blood tests.
You must understand that weight loss would be slower than other procedures, but is sustainable and can last longer. You should also know and understand that many people feel that enjoyment of food is curtailed.
The flip side is that the Lap band requires frequent adjusting and a lot of tweaking even to get it right and keep it that way. So, if you are thinking of travelling abroad for weight loss surgery, other procedures might work better for you, though you can get the adjustments done locally.
Vertical Sleeve Gastrectomy
|Vertical Sleeve Gastrectomy removes a |
large part of stomach which produces
hunger stimulating hormone
Verticalsleeve gastrectomy, also known as gastric sleeve or laparoscopic sleeve gastrectomy was first performed in Australia in early 1990s and started in US in 2001. The surgery has emerged to be most popular of all the bariatric surgery procedures among patients and surgeons equally. Sleeve gastrectomy is invasive and irreversible.
The surgery entails removing a large part of the stomach, leaving behind a small stomach similar to that of a banana. The greater curvature of the stomach is removed, which produces the hormone ghrelin responsible for the stimulation of hunger. The surgery works by two mechanisms- limiting the food intake and suppressing the hunger
The weight loss with sleeve gastrectomy is fast and sustainable. Upto 70% of the excess weight is lost in 1-2 years.
Why and Who should choose Sleeve Gastrectomy
Though all weight loss surgery procedure requires following dietary instructions for success, it is easier in sleeve gastrectomy as you feel full very early because one, the size of stomach is too small and second, the hunger stimulating hormone is no longer there.
So if you feel that is hard for you to curb your taste buds, sleeve gastrectomy is best for you. Weight loss is drastic and sustainable.
If you are travelling abroad for weight loss surgery, sleeve gastrectomy works best because it does not require adjustments at all and there are not many follow ups required.
The only flip side is, since it is a new procedure, long term results are still unknown.
Gastric Bypass Surgery
|Gastric Bypass creates a small stomach pouch|
and bypasses large part of small intestine
GastricBypass is still the gold standard in bariatric surgery and medical community has the longest experience in witnessing the surgery and results. The surgery is invasive and non reversible.
The procedure entails creating a small stomach pouch in the upper part of the stomach which is joined to the lower part of the small intestine, thereby bypassing a large portion of the small intestine, which is responsible for absorption of food. The surgery thus works by two mechanisms. One, it makes the stomach small thus making you feel full even with small meals and much of that is not absorbed by the body, because small intestine has been bypassed.
The technique is very effective and you can expect to lose about 75-80% of your excess weight. Weight loss is much rapid during the first year and slows down later. There is no need for regular follow ups or adjustments.
The surgery carries more risk than other procedures for clots (DVT and PE) and leakage of internal joins where cuts have been made. The surgery takes longer than other procedures, recovery is longer and time taken off the work as well.
Why and Who should choose Gastric Bypass surgery
Usually preferred by people with very high BMIs and with co-morbidities like diabetes and hypertension etc, because gastric bypass has proved to be best technique to treat diabetes in obese people.
If you have very high BMI, gastric bypass can work best for you because weight loss is fast and dramatic.
The flip side is that it may result in nutritional deficiencies because the intestines are bypassed. If you are a female and planning to have a baby in future, you must be cautious in choosing the procedure. The surgery can also cause dumping syndrome. Although dumping syndrome happens to less than 20% of the people and usually happens with specific foods and can be horrible, it sometimes gives extra motivation to the patient to avoid high carb diet or refined foods.
All weight loss surgery procedures have some positive and some negative sides to them. It is important to know about the procedure well and discuss with your treating surgeon to decide the best weight loss surgery procedure for you.
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Imp: The information provided is for general reference and cannot be construed as medical advice.