Bariatric Surgery

Bariatric surgery is the term for surgery to help promote weight loss.

Millions of individuals around the world are overweight or obese.

When weight increases to an intense level, it is called morbid obesity.

The consequences of Obesity are related with heart disease, high blood pressure, diabetes, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity.

Bariatric surgery has slowly gained recognition as a weight loss option in a select group of extremely obese adolescents who have not been able to lose weight with less invasive conventional procedures.

In adults, bariatric surgery results in major and persistent weight loss, which has reversed or reduced the severity of many obesity related disorders, including obstructive sleep apnea.

Obsrtuctive Sleep Apnea Treamtment With Bariatric surgery

Most important factor contributing to the severity of obstructive sleep apnea (OSA) is considered as Being overweight. OSA is a disorder characterized by narrowing of the pharyngeal airway, resulting in repeated episodes of airflow cessation, oxygen desaturation, and sleep disruption.

For this reason, the treatment of OSA includes way to achieve substantial weight loss. The occurrence of OSA has been shown to be almost 90% in severely obese patients.

Therefore, it is strongly recommended to administer CPAP to these patients before surgery. So, until extensive weight reduction has been achieved, the patient should continue to receive CPAP.

Nineteen of 34 patients (55%) who underwent bariatric surgery were diagnosed with OSA. Following the surgery, 10 of these patients returned for polysomnographic testing. After significant weight loss, OSA severity markedly decreased in all patients.

Unfortunately, only a few patients with sleep-related breathing disorders succeed in maintaining their dietary-achieved weight reduction.

The Process Of Digestion

In order to understand how bariatric surgery results in weight loss, it is necessary to understand how food is digested

1. Food enters the stomach after swallowing, which performs to hold the food and then allow small amounts of the food to pass further into the digestive tract. The volume of the stomach is usually between 600 - 1000 cc.
2. In the first part of the small bowel (duodenum), food comes into contact with bile, secreted by the liver as well as enzymes from the pancreas. These secretions help in the digestion and amalgamation of food. The small bowel is where most of the absorption of food occurs and may reach a length of 6 - 7 meters. The proximal (closest to the mouth) two-fifths of the small bowel is called the jejunum and the distal (farthest from the mouth) three-fifths is called the ileum

Working Procedures Of Bariatric Surgery

Restrictive component and a malabsorptive component are the two methods through which most of the bariatric procedures work

• Restrictive component - a part of the stomach may be removed or bypassed so as to decrease the volume of the stomach. This procedure make the stomach smaller to limit the amount of food intake
• Malabsorptive component - Bile and pancreatic secretions, which are essential for digestion of food, are directed away from the food. This procedure reduce the amount of intestine that comes in contact with food so that the body absorbs fewer calories

Bariatric Surgery Complications include:

Any operation are associated with risks and complications. Bariatric surgery complications cannot be always prevented but the risks can be minimized.

• Marginal ulcers in the pouch
• Bowel obstruction, requiring further surgery
• Complications due to anesthesia and medications.
• Bleeding from a tear to the liver, spleen, or blood vessels
• Gastrointestinal dysfunction, such as long-term nausea or food intolerance.
• Cardiac problems. Greatest risk in patients who are mostly overweight, or who have cardiac disease
• Spleen damage or tear. Most in common in patients who have had a previous surgery.
• Stenosis or narrowing of the connection between stomach pouch and intestine, which may need a procedure to correct
• Infections of the wounds
• Blood clots in the large leg veins. They become serious when they float up into the blood vessels of the lungs.
• Pulmonary (lung) problems, such as pneumonia or fluid on the lungs. Getting the patient up and about as soon as possible can often prevent these.