Bariatric surgery in Ahmedabad,GujaratIn the starting era of weight loss surgery began with the intestinal bypass. This surgical procedure shortened the length of the small intestine. The intestines absorb calories and macro nutrients. And if this area was shortened then there would be less absorption of calories and macro nutrients as the food worked its way out of the patient’s body.

Most bariatric surgery procedures are now done laparoscopic. This is also called “minimally invasive surgery.” 3 to 6 smaller incisions are made and small instruments and a camera are inserted into the patient’s body. Recovery is quicker and patients experience less pain.

SO WHICH PROCEDURE IS BEST?

You would think that gastric balloon surgery is the latest and greatest procedure for weight loss. Or you may think that the Lap Band is the best because you’ve heard so much about it.

Everyone has a different relationship with food, different medical histories, and different lifestyles. One procedure does not fit all.

Open and honest conversations with your bariatric surgeon will help you choose the procedure that best fits your personality, level of risk aversion, and lifestyle.

Feel free to take our Bariatric Surgery Selector Test, but again, open and honest conversations with your bariatric surgeon will lead to the best procedure for you.

Key Points of surgries:

  • Not all bariatric surgeons perform every procedure.
  • There could be a strong bias towards gastric banding if your surgeon only performs the Lap Band procedure.
  • Ask your bariatric surgeon which procedures he or she performs and if he/she doesn’t perform a procedure, ask why.
  • The support and education from the bariatric program and your desire/ability to utilize the offered support is probably more important than the type of procedure you choose.
  • Gastric bypass surgery has been proven to be clinically effective for long-term weight loss. However, without the proper guidance before and after surgery, you may still fail.

RESTRICTIVE V/S MALAPSORPTIVE

Weight loss surgery works because of restriction and malabsorption. Some surgical procedures involve only restrictive elements, while others involve a combination of both.

Malabsorptive

Malabsorptive procedures alter the digestive tract so that a certain amount of the small intestine is bypassed. This allows for food to pass through the intestines quicker and less calories are absorbed.

Although there are some procedures that are purely malabsorptive, none of these types of surgeries are performed anymore.

Restrictive

  • Restrictive procedures reduce the size of the stomach so a patient feels full quicker. This is typically done with staples and the stapled stomach is either removed or bypassed depending on the procedure.
  • Reducing the size of the stomach may also reduce ghrelin production and reduce hunger.
  • Restrictive procedures can be restrictive only or combined with a malabsorptive aspect.

THE PROCEDURES

For each procedure we will give you the key benefits and risks and then provide you with a link for more information about that procedure if you want to learn more. As always, check with your doctor for his/her experience with each procedure and have an open an honest discussion about your lifestyle medical condition to determine the best procedure for you.

GASTRIC BYPASS SURGERY

  • Gastric bypass procedureAverage Excess Weight Loss: 60% to 80%
  • Serious Complication Rate: 1.25%
  • Average 30 Day Mortality Rate (Death Rate): 0.14%
  • Procedure Type: Restrictive and Malapsorptive

Key Benefits:

  • Long history of success and clinical studies to validate its effectiveness.
  • Average of 60% to 80% excess weight loss.
  • May reduce hunger.
  • Excellent rate of diabetes cessation after surgery.
  • May relieve heartburn and acid reflux.

Key Disadvantages:

  • It is a technically challenging procedure and typically requires a bit more time under anesthesia compared to other popular bariatric surgeries.
  • Vitamins and minerals are required daily or you’ll risk log-term nutritional deficiencies.
  • If you are prone to ulcers, discuss this with your doctor.

GASTRIC SLEEVE SURGERY

  • Gastric sleeve diagram.Average Excess Weight Loss: 57% to 70%
  • Serious Complication Rate: 0.96%
  • Average 30 Day Mortality Rate (Death Rate): .08%
  • Type of Procedure: Restrictive

Key Benefits: 

  • Average hospital stay of 2 nights but in some cases it is an outpatient procedure.
  • Average of 60% to 70% excess weight loss.
  • May reduce hunger.
  • No foreign objects like Lap Bands.
  • No re-routing of the intestines like gastric bypass.
  • Straightforward procedure that is relatively easy to replicate.

Key Disadvantages:

  • Vitamins and minerals are required for life. However, the risk of vitamin and mineral deficiencies is lower than duodenal switch and gastric bypass.
  • Does not improve heartburn or acid reflux and in some cases may worsen it.
  • Less long-term data compared to gastric bypass.

DUODENAL SWITCH SURGERY

  • Duodenal switch diagram. Average Excess Weight Loss: 80% to 90%
  • Serious Complication Rate: 2% to 3%
  • Average Mortality Rate (Death Rate): 0.29% to 2.7%
  • Procedure Type: Restrictive and Malapsorptive

Key Benefits:

  • The best weight loss profile, up to 85% excess weight loss.
  • The best long-term weight loss success rate (better than 50% excess weight loss) of 95%.
  • Best rate of comorbidity reduction.

Key Disadvantages:

  • Highest risk for malnutrition.
  • Strictest dietary guidelines.
  • The longest and most complex procedure of the 3 primary bariatric procedures (bypass, sleeve and duodenal switch).
  • Highest 30 day serious complication rate.
  • Strict adherence to vitamins and minerals and post-operative diet are required for success and to prevent malnurtition.

Gastric Balloons

  • Gastric Balloons are a new procedure for patients with a Body Mass Index (BMI) of 30 to 40 that want to lose weight but do not want to have surgery.
  • New options give the patient a pill to swallow and a balloon is then inflated and left in the stomach for 6 months. Hunger is reduced and satiety is increased.
  • These are not permanent. Lifestyle changes are very important for lasting weight loss. Patients can expect 10 to 30% excess weight loss from gastric balloons.