Obesity Surgery
Nowadays obesity is a serious health threat. People who weigh twice their normal weight have a decreased life span and increased incidences of other diseases, such as high blood pressure, diabetes, bone and joint disease, heart failure, sleep disorders and sudden death.
Unfortunately, the non-operative therapy of morbid obesity, using special diets and medications, is rarely successful. Within five years, virtually all patients regain the weight lost through diets and/or medications.
Because of the futility of non-operative means for weight loss and other useless obesity treatment intervention methods, the interest in the surgical treatment of morbid obesity got high levels in the medical world. Using a surgical approach to obesity, together with dedicated support from dietitians, lung specialists, heart specialists and nursing specialists, hospitals tried healing America weight loss by enabling individuals with morbid obesity to sustain weight loss at a healthy level.
This special medical treatment for obesity always had some strict requirements for the patients. Gastric bypass success stories and gastric bypass before and after pictures were possible because of the large medical effort, sustained with good procedures and long practice professionals. The cost of gastric bypass surgery and the gastric bypass risks still frightens many patients, but again gastric bypass pictures before and after surgery and the information surgery for morbid obesity persuade them to do it.
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There are some relative indications for obesity surgery that are used as usual criteria that must be met by patients accepted for operation. For example, if you want to do such an intervention, you must have at least twice your ideal weight or 100 pounds above your ideal body weight. Or you should have a body mass index of 40 in those without co-morbidities or a body mass index of 35 for those with co-morbidities. Only patients between 20 years and 55 years old are preferred. Also, long-standing obesity and previous efforts at weight loss through organized, medically sound weight loss dietary plans are required. In some cases, exceptions to these guidelines are appropriate.
There are several operations available that are used in patients with morbid obesity. The preferred operation is the gastric bypass procedure. This operation balances risk of operation with long-term weight loss and long-term nutritional complications better than any of the alternatives.
Gastric bypass obesity surgery
The vertical banded gastroplasty is a relatively safe operation that restricts the amount one can eat. However, too many patients regain weight after the procedure and too many patients complain of vomiting.
Two other operations, the pancreaticobiliary bypass and the long-limb Roux-en-Y gastric bypass, combine restriction of the amount of food one can consume with malabsorption of calories and nutrients. Unfortunately, malabsorption of nutrients also means that essential vitamins are not absorbed properly. This results in dangerous complications, such as osteoporosis or weak bones in too many patients.
While eventual weight loss after the standard gastric bypass procedure may be less than after these two operations, the malabsorption of nutrients is significantly decreased and compensated with vitamin pill supplements.
Short-Term Risks of Obesity Surgery
There are risks with any major abdominal operation. Unfortunately, many of them are greater in people with morbid obesity. The most common and important risks are wound infection, pneumonia, thrombophlebitis (blood clots in the legs or lungs), leakage of the stomach, causing serious internal infection and even emergency reoperation, heart attack, breathing failure requiring ventilator support, or even death.
Wound infections occur in about two percent to 10 percent of patients and are managed easily without permanent effects. Usually, pneumonia and other breathing problems occur in smokers or in patients with pre-existing lung trouble. Thrombophlebitis is common after major surgery, especially in obese patients. You will have special stockings put on in the operating room in an effort to prevent this complication. Some patients also will receive low doses of a blood thinner, called heparin.
Major life-threatening complications, such as gastric leakage requiring an emergency operation are rare, occurring in about one percent of the cases. Death after operation should occur in less than one percent of cases.
Long-Term Risks of Obesity Surgery
Doctors divide the long-term risks into two categories: technical problems and nutritional problems.
The most common technical problem is a hernia of the scar, called an incisional hernia. This occurs in more than 10 percent of patients and is an unavoidable occurrence after abdominal surgery in morbidly obese individuals.
The most serious technical problem is a disruption of the staples or tearing of the staples, which then allows food to pass through into the remaining stomach. This occurs in three percent to five percent of patients and unfortunately results in considerable weight gain.
Other technical problems include stretching of the stomach reservoir or the connection to the bypass intestine, which also result in weight gain.
Finally, a small percentage of patients have too small a reservoir or connection, resulting in occasional vomiting and/or restriction of the kinds of food one can consume. This problem is unusual, occurring in less than five percent of patients.
The nutritional risks of the operation result from the fact that iron, vitamin B12, and perhaps fat-soluble vitamins are not absorbed normally. You will be requested to supplement your diet for the rest of your life with a multivitamin plus iron pill and an extra strength vitamin B12 pill. We may ask you to take extra calcium.
If patients take their vitamin pills and eat a balanced diet, we believe that no easily detectable nutritional complications exist from this operation.
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