Small cuts for different interventions

In some cases, obesity surgery, also called Bariatric surgery is a therapeutic option. 

Bariatric surgery is a therapeutic option if:

• you are  severely obese  with a body mass index (BMI)  of 40 or higher
• the BMI is between 35 and 39.9  but there is a so-called comorbidity, or a health problem related to weight, such as  diabetes or arterial hypertension
•  You are willing to make the lifestyle changes necessary for surgery to work.

Obesity surgery can help you lose up to 50% or more of your excess body weight, but it’s not a miracle cure. In fact, it does not guarantee either the loss of all excess weight or the long-term maintenance of the weight obtained. Success in weight loss after surgery also depends on the person’s commitment to long-term changes in eating habits and commitment to physical activity.

The most popular procedures in bariatric surgery

Laparoscopic Adjustable Gastric Band (LAGB):  In this operation the stomach is separated into two distinct portions (pockets) with the placement of an inflatable silicone ring (bandage). By narrowing the bandage, like a belt, the surgeon creates a narrow passageway between the two pockets, creating a sort of asymmetrical hourglass, with an upper gastric pocket and the remaining gastric body under the band. The bandage is generally designed to stay in place permanently. Laparoscopic Adjustable Gastric Band – LAGB is popular because it is the least aggressive procedure and at lower surgical risk, and usually cause slow but steady weight loss. The degree of closure of the bandage, if necessary, can be changed over time. Ultimately we can say that LAGB is the intervention with the lowest risk but also the one with the least results in terms of weight loss.

Sleeve Gastrectomy (SG, Vertical Gastric Resection): With Sleeve Gastrectomy, a vertical gastric resection is carried out (that is, a large part of the stomach is removed) with residual stomach tubulation. The profound change in the secretion of hormones produced by the digestive tract produces a sharp reduction in appetite and true early satiety. The food intake is therefore reduced spontaneously, due to reduced appetite and early satiety. SG is a fairly rapid intervention, it has almost no nutritional complications and, above all, it is noted for a good quality of postoperative life: for these reasons it is the fastest growing surgery, and is particularly recommended for people of advanced age, high-risk patients if undergoing prolonged operations, or even for people with BMI 40-50.

Gastric Bypass (RNYGBP):  Gastric bypass offers good long-term results, and is a powerful therapy for  type 2 diabetes  and  gastroesophageal reflux disease. With gastric bypass surgery – RNYGBP, the surgeon creates a small pocket in the upper part of the  stomach. The goal is to direct food flows directly into this part of the intestine, bypassing most of the stomach and the first intestinal tract. It works, like the Sleeve Gastrectomy, reducing appetite and giving early satiety; its results at 15 are known and are good, both in terms of weight loss and in the treatment of type-2 diabetes. However, it is a  more complex procedure than bandaging and Sleeve Gastrectomy.

Biliopancreatic diversion with or without duodenal switch (Standard BPD or BDP/DS): With this surgery, a large part of the stomach is removed. Weight is lost not for reduced income but for reduced absorption of food: in practice, those who undergo it are still free to eat large quantities of food. An operation, therefore, that offers  good weight loss  and, above all, good maintenance of the weight lost over the years: however, the biliopancreatic diversion – BPD exposes the person who undergoes it to a greater risk of deficiencies (calcium, iron,  vitamins and proteins), a situation that requires careful and continuous monitoring of his health conditions. Side effects on the frequency and smell of bowel movements are also unwelcome. 

Side effects of bariatric surgery

The first thing to underline is that anyone who undergoes  obesity surgery will then have to return for check-ups with the frequency scheduled by the Center: checks are in fact essential to obtain the best results with the lowest percentage of complications.

The first side effect of obesity surgery will therefore be the need to respect the check-up schedule, with blood tests to be performed on a scheduled basis: not everyone lives near the Center, therefore certain mobility in the months and months must be taken into account years following the intervention.

The second  side effect to take into consideration is that obesity surgery will bring great benefits to the endocrine system and to all systems of the human body ( respiratory ,  cardiovascular ,  locomotor ) except one, the digestive system , which may in fact be a victim more often than a beneficiary of bariatric surgery. Common side effects will be, depending on the surgery performed and obviously not all together,  nausea ,  vomiting ,  gastroesophageal reflux , dumping syndrome,  bloating ,  diarrhea ,  constipation .

Finally, a third group of side effects is related to nutrition. With big differences from one procedure to another, there will be possible deficits either from reduced intake or from reduced absorption. Impaired absorption deficiencies are usually more severe and require you to chronically take calcium, iron, and vitamin supplements.