About Bariatric (Weight-Loss) Surgery
Bariatric surgery is done to produce dramatic weight loss in patients.
Three common ways to achieve this include:
- Restrictive surgery which helps you feel full faster
- Malabsorptive surgery which causes food not to be absorbed completely
- Both restrictive and malabsorptive surgery: helps you feel full with very small amounts of food as well as causes food not to be absorbed completely
How is it performed?
There are several methods of performing bariatric surgery, all of which can be performed either Laparoscopically or through open surgery.
Laparoscopic Surgery: Laparoscopic surgery is also called minimally invasive surgery. This means that the surgeon makes 4 to 5 small incisions to do the surgery. This method creates minimal tissue damage, improves recovery time and has few complications.
Open Surgery: The open method means that a larger incision, about 15 cm (6 inches) or more long is made in the abdomen to do the surgery.
Roux-en-Y Gastric Bypass Surgery: This surgery is the most commonly performed restrictive and malabsorptive procedure done today. It is considered to be the “Gold Standard”.
Vertical Sleeve Gastrectomy:
Vertical sleeve gastrectomy (VSG) is a restrictive, laparoscopic surgery. During this surgery most of the stomach is removed. Since the stomach is smaller, you feel full sooner.
Adjustable or Laparoscopic Banding (Lap Band):
Adjustable or laparoscopic banding is restrictive surgery. This surgery involves placing a silicone and silastic band around the top of the stomach.
Is it right for me?
If you’re convinced that further attempts at losing weight on your own will be unsuccessful, professional help could be the answer. A study published in the Journal of the American Medical Association found that most patients are more open to losing weight under a doctor’s supervision.
What result can I expect?
Depending on the type of bariatric surgery you choose, your percentage of excess weight lost could be as high as 80% or more. You won’t see bariatric treatment results overnight, Often times your lowest weight will not be reached until 1-3 years out.
- Obesity-related health problems are far riskier than bariatric surgery: morbidly obese patients who receive bariatric surgery are 89% less likely to die than morbidly obese individuals who don’t have surgery
- Relationships with family and friends may change
- Unhealthy food cravings may or may not go away after surgery
After surgery is finished in the operating room you are taken to the recovery area. Nurses look after you here for 1 to 2 hours until you are stable and it is safe for you to move to a nursing unit or go home. The nurses monitor your heart, blood pressure and oxygen levels. If you use a CPAP machine at home, you may be on your CPAP machine when you wake up in the recovery area. The nurses also give you pain control medication and medication to control nausea when needed. When you are stable, you go back to the day surgery unit if you had day surgery or a hospital room if you are staying overnight or longer. Your length of stay in the hospital depends on the type of surgery you have and will be explained at your bariatric centre.
On the same day of surgery you will be encouraged to do deep breathing, coughing and circulation exercises every hour that you are awake. These exercises help prevent breathing problems such as pneumonia, blood clots and constipation. Exercise and activity are very important to help you recover. Getting up and moving helps keep muscles strong and prevents complications.
You may wear special stockings on your lower legs or feet. These are attached to a machine to help prevent blood clots. If your centre uses these stockings, you only wear them while you are in bed and not when you are up walking around.
You may have some pain from your incisions. You will also have pain from the air that is put into your abdomen to help the surgeon do the surgery. This pain usually decreases within the first 2 days. It is very important for you to be comfortable and control pain before it gets bad. When you are comfortable you are able to move around better, walk more and do your exercises to help you recover faster and prevent complications.
Some people have nausea after a general anesthetic. It is important to tell your nurse if you feel sick to your stomach. The nurse will give you medication to help the nausea.
You will be monitored closely for complications after surgery and be taught what to look for at home and during your path to recovery and weight loss.
Your diet while in the hospital will progress from having nothing to eat or drink then slowly increasing your fluids. The progression of your diet is reviewed with you and your family in detail at each Bariatric Centre. This depends on the type of surgery you have. You are also given written information to follow during these teaching sessions.
Remember that the nurses are specially trained in Bariatric Surgery and will answer any questions or concerns you may have. Your surgeon and assistants will also check on you. If you have any questions for any members of the health care team write them down when you think of them. You can ask any member of your health care your questions when you see them.
Limits & Risks
While bariatric treatment has become much safer over the last several years, the mortality rate is only 0.135%.
Anastomotic leaks: This happens when the surgical connection made during bariatric surgery leaks digestive contents into the abdomen which can cause infection and abscess.
Pulmonary embolism: as a result of bariatric surgery is usually caused by deep vein thrombosis (DVT).
Respiratory failure: is another rare, but serious complication. It occurs when oxygen and carbon dioxide levels fall too far outside of their normal ranges.