[L42]Laparoscopic Weight Loss Surgery

Weight loss surgery, also known as bariatric surgery in medical terminology, refers to a group of gastrointestinal surgical procedures carried out on patients suffering from chronic morbid obesity (i.e., at least 100 lbs overweight, or a body mass index, BMI, of 40 or greater, for more than 5 years). It is used to facilitate weight loss and avoid the risk to life-threatening diseases associated with morbid obesity, such as type II diabetes, heart disease, sleep apnea, degenerative arthritis, etc.

Weight loss surgery is normally resorted to as a last measure when an all other conventional weight loss methods, such as diet control, exercise and weight loss medications, have failed in treating the person for morbid obesity. It may be pointed out that weight loss surgery is distinct from liposuction in that the latter is more of a cosmetic procedure rather than a medical procedure.

What does weight loss surgery involve?
According to The American Society for Bariatric Surgery, there are basically two approaches to weight loss surgery:

1. Restrictive procedures, which help reduce the capacity for food intake in a single meal but do not interfere with the normal absorption (digestion) of food.

2. Malabsorptive procedures, which help reduce absorption of calories from food by altering the process of digestion.

Restrictive procedures are mainly of two types:
1. Lap band surgery, which involves placing laproscopically a silicone gastric band around the top of the stomach in order to create a very small stomach pouch. As a result, the person starts feeling full with just a small portion of food. Food will then slowly empty from the smaller pouch into the lower part of the stomach and into the rest of the digestive tract.

2. Gastric bypass surgery, which involves stapling of the smaller, upper part of the stomach to separate it from the rest of the stomach and rerouting the small intestine to connect it to the smaller stomach pouch.

Lap band surgery is a relatively simple and less risky procedure compared to gastric bypass surgery. It requires just 1 to 3 days of hospital stay as opposed to 5 to 8 days in the latter case. Moreover, there is no malabsorption of vitamins and minerals after lap band surgery, which is not always the case with gastric bypass surgery. However, the expected weight loss over a period of 18 months is lesser (50 to 60% of the excess weight) compared to gastric bypass surgery (70 to75%). Both the procedures are reversible, but lap band surgery is much more easily reversible.

There is a third type of restrictive procedure too, called sleeve gastrectomy, that is less commonly used. In this the surgeon removes approximately 60% of the stomach laparoscopically so that the stomach takes the shape of a tube or "sleeve".

Malabsorptive procedures are rarely used these days due to the problems of malnutrition and nutritional deficiencies caused by them.

Any risks?
In addition to general risks associated with any kind of major surgery, weight loss surgery can pose its own complications. Discomforting symptoms such as nausea, vomiting, weakness, hernia, gallstones and nutritional deficiencies can crop up after weight loss surgery.

Is it for you?
Though the ultimate answer to the question whether you qualify as a candidate for weight loss surgery or not rests entirely with your bariatric surgeon, here are some pointers that can help you in your decision-making process. If you have been more than 100 lbs overweight for more than 5 years, if your body has failed to respond to the conventional weight loss methods, and if you are not suffering from any major disorder that makes surgery difficult, you can seriously consider weight loss surgery as a feasible option. Consult your doctor for detailed information in order to weigh the risks against benefits of weight loss surgery.

Finally, remember that even if you keep realistic goals in mind, the real success of weight loss surgery is strongly dependent on your making long-term changes in your diet and lifestyle.