Each surgical operation may have its own advantages and risks. This applies to all surgeries. It’s the same with obesity surgeries.
By providing brief information about Gastric Sleeve Surgery, Gastric Bypass Surgery and Gastric Band procedure, we will provide detailed information about The Pros and Cons of Medical Weight Loss Procedures. Let’s start it!
Table of Contents
What is Gastric Sleeve Surgery?
Gastric Sleeve surgery is the most common method of bariatric surgery, especially recently. It is the process of starting from a distance of about 3-6 cm to the pylora, which is the end point of the stomach, and turning the stomach into a tube until the esophagus with the help of special tools.
After the procedure, which lasts about 45 minutes, about 75-80% of the stomach is removed. Gastric Sleeve surgery helps to lose weight with 3 mechanisms.
Gastric Sleeve Surgery Pros
In terms of weight loss, Gastric Sleeve surgery compared to other operations, Gastric Sleeve surgery provides effective weight loss. According to the criteria of the World Society of bariatric surgery, the percentage of excess weight loss in a year above 50 is considered a success.
For example, let’s assume that a person who is 160 centimeters tall and weighs 120 pounds has an excess of 60 kilograms. If this person loses 30 or more pounds in a year, it is considered a success. But such weight loss is not considered sufficient by many patients.
After surgery, it is usually observed that there is much more weight loss. As in the same example, most patients from 120 pounds drop to a weight of 60 pounds to 70 pounds. Excessive weight loss is almost never observed after Gastric Sleeve surgery.
Because the first month after surgery, a person who can eat two spoons of soup or 2 meatballs can eat half a bowl of soup or five or six meatballs when it is a year. This, in turn, allows the given weight to decrease in the process and stop when it reaches the ideal weight.
Another Gastric Sleeve Surgery Pros is that when you are at a young age, there are no problems with the small intestine in later periods. If surgery is performed at a young age, there will be no problems with pregnancy in the future. On the contrary, because excess weight is given, a healthier pregnancy will be passed.
Gastric Sleeve Surgery Cons
- Potentially insufficient weight gain or weight gain is slightly higher than Bypass surgeries.
- Irreversible
- It is still accepted by some surgeons and insurance companies at the research stage.
- It is seen as a temporary treatment if the second step is not passed in super morbid obese people.
- There is the potential for the gastric pouch to expand over time and affect weight control.
- Its long-term consequences of 20 years and more have not been evaluated.
In the last decade, with the improvement of surgical techniques and experience of Surgeons, the Gastric Sleeve has become a generally safe bariatric surgery procedure. However, there is a possibility that complications may occur during and after surgery.
The main Gastric Sleeve Surgery Cons are: over time, you may experience problems with the digestion of certain nutrients. Narrowing of the tube may develop. Some people may experience heartburn or reflux complaints after surgery.
If moderate or severe reflux is present, gastric sleeve surgery can make it worse. Against such a condition, you may want to consider gastric bypass surgery instead. Such operations are safer against reflux and heartburn. Constipation may occur in some people after Gastric Sleeve surgery due to digestive problems.
Depending on your health, you may have other risks. Before surgery, you should talk to your doctor about your concerns.
What is Gastric Bypass Surgery?
It is one of the oldest obesity and Metabolic Surgery surgeries. Unlike gastric sleeve surgery, the stomach is not removed, part of the intestines is disabled. It is an obesity surgery that both restricts eating and disrupts absorption.
Gastric Bypass is a type of gastric reduction surgery that is often used today. The operation is applied to people who cannot get results with diet and exercise, and whose weight begins to seriously affect their health. In surgery, the goal is different from that in Gastric Sleeve surgery.
In Gastric Sleeve surgery, the result is achieved by reducing the capacity of the stomach, while in gastric Bypass surgery, it is aimed to go to the result both by reducing the capacity and by reducing the absorption.
Gastric Bypass Surgery Pros
- Rapid realization of targeted weight loss for 18-24 months
- A decrease in diseases such as Type 2 diabetes, hypertension, sleep apnea, GERD that appear associated with obesity
- Noticeable increase in quality of life
Gastric Bypass Surgery Cons
Gastric Bypass surgery severely restricts volume. Because of this, its effectiveness can be seen immediately with small yawns in the volume of the stomach. Gastric bypass failure can be up to 40 percent, especially in patients with BMI values above 50 kg/m2.
For this reason, the most ideal surgical method can be obtained with Duodenal Switch surgery. In fact, the operation that should be compared to gastric Bypass surgery should actually be Sleeve gastrectomy. In other words, a patient considering gastric Bypass should conduct research on Sleeve gastrectomy or gastric surgery.
What is Gastric Band?
Gastric Band is a medical device made of silicone. The Band is a silicone material, like a thin long finger, up to a centimeter wide, up to 10 centimeters long, carrying an inflatable balloon along its inner face as needed.
An adjustable silicone gastric band, or commonly known as a gastric clamp, is usually placed laparoscopically just below the junction of the esophagus and stomach.
In surgery, the band, which is inserted into the abdomen in an open flat manner, is attached in an arch style by curling around the stomach tissue, a few centimeters below the junction of the esophagus and stomach.
As can be understood from its name, the biggest advantage of Gastric Band is that it can also be adjusted after surgery.
Thanks to an apparatus called a port, which is connected to the band with a connecting tube and placed under the skin, tightening or loosening can be done with just one injection, depending on the patient’s weight loss rate and whether a feeling of satiation occurs.
Gastric Band Pros
The gastric band method creates minimal trauma, so there is no bowel or stomach incision. 4-5 holes with a diameter of half – 1 inch are enough when performed laparoscopically. Hospital stay is short. It’s an application that has a return.
It can be performed laparoscopically without opening the abdomen at all. In this way, there are very few scars on the abdominal wall, the patient experiences little pain, and the duration of hospital stay is very short. The opening of the clamp can always be adjusted according to the patient’s weight loss rate.
If there is no problem, the clamp can remain for life. If a problem occurs, the problem can be easily fixed by removing the clamp; that is, it is a reversible operation. It definitely prevents the patient from taking foods such as solid food, bread, meat in excess.
The patient feels satiety by eating less and cannot eat more solid food. In the majority of obese patients in our country, the problem is a suitable surgical treatment, since there is a constant and excessive habit of eating solids. And it does not pose any obstacles to other operations. Here are some of the gastric band pros:
- Reduces the amount of food the stomach can hold
- It causes about 40 – 50 percent loss of excess weight
- Does not involve cutting the stomach or reorienting the intestines
- The patient is discharged on the same day as surgery, usually requiring a hospital stay of less than 24 hours
- Reversible and re-adjustable
- It has the lowest rate of early postoperative complications and mortality among approved bariatric procedures
- Has the lowest risk for Vitamin / mineral deficiencies
Gastric Band Cons
Because the Gastric band allows fluid passage, patients may fail to lose weight if they later switch to high-calorie liquids. In the consumption of high-calorie liquids such as ice cream, chocolate, cola, rice pudding, band surgery cannot achieve the desired result.
For this reason, this operation should not be recommended to patients of this type. You need close doctor control. Tightening and loosening of the clamp should be done completely under the supervision of a doctor.
Even if the rate at which the clamp slides and passes into the stomach in a long period is very low, it must be followed. In these cases, the clamp may need to be removed.
This surgery should be performed by surgeons who have received advanced laparoscopy training. Operating room conditions, material facilities and intensive care follow-up of the hospital where the operation is performed should be suitable for these operations.
References:
https://www.webmd.com/diet/obesity/is-weight-loss-surgery-right-for-you
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/
