Each surgery has pros and cons. There are different average weight loss results and potential side effects or risks, says Morrow.
“In general, it seems like the risk of a procedure sort of parallels the benefits,” she adds. A sleeve gastrectomy, for example, may have a little bit less risk in some ways but results in a little bit less weight loss, while a duodenal switch has been shown to have potentially more long-term complications but also has the biggest weight loss results.
If you’re considering bariatric surgery, you’ll want to go over each with your doctor to determine which of these three types is the best option for you.
Sleeve Gastrectomy
This option is the most popular kind of bariatric surgery. “Sleeve gastrectomy is currently the most commonly performed procedure nationwide,” says Morrow.
In general, bariatric procedures work in one of two ways — or sometimes both, explains Morrow. “The first way is with restriction. All bariatric procedures have altered the stomach to try and make people have a smaller stomach and feel more full,” says Morrow.
“A sleeve gastrectomy works purely through restriction, so we’re creating a smaller stomach by removing about two-thirds of the stomach, so conceptually it’s pretty simple.”
A sleeve gastrectomy is the simplest of the procedures and doesn’t require as much time on the operating table. “It takes approximately an hour to perform,” says Morrow.
Gastric Bypass
A Roux-en-Y gastric bypass is also known simply as a gastric bypass. “Roux-en-Y” is French for “in the form of a Y.” Like sleeve gastrectomy, this procedure is a common choice in the United States.
“I personally and my colleagues here at the University of Utah perform Roux-en-Y gastric bypass the most, which is kind of considered the gold standard,” says Morrow.
In this procedure, the surgeon separates the stomach into a top and bottom section.
The top section — also called a pouch — is roughly the size of an egg and the bottom section no longer digests food. The surgeon then connects a part of the small intestine called the Roux limb to the new stomach pouch.
“The Roux-en-Y gastric bypass works through malabsorption, so for this procedure, there is some intestinal rearrangement as well to basically alter your body’s hormonal response to food, which is important,” says Morrow.
Malabsorption is where the body is unable to absorb nutrients from food properly. For a healthy person, malabsorption isn’t something that’s desirable, but in terms of bariatric surgery, it can be a benefit for weight loss, adds Morrow.
Limiting the digestion and absorption of nutrients reduces your calorie intake, allowing for weight loss.
Because your body absorbs fewer vitamins and trace nutrients, it’s particularly important to follow the recommended diet after surgery to prevent unwanted side effects.
Duodenal Switch
Biliopancreatic diversion with duodenal switch is often referred to as simply a duodenal switch.
“A duodenal switch involves a bit more malabsorption [compared with the Roux-en-Y gastric bypass],” says Morrow.
The second step is to connect the end of the intestine to the duodenum, a tiny portion of the small intestine that connects to the stomach. This bypasses far more of the intestine than a gastric bypass. The result is that you’re unable to eat as much and or absorb as many nutrients.
While a specific diet is crucial for everyone who undergoes bariatric surgery, for people who have a duodenal switch, following eating guidelines closely is absolutely necessary.
“They have to be really careful about eating enough protein, or else they can become protein deficient, and drinking enough water, so they don’t get dehydrated, and they have to take vitamins every day, often more than once a day depending on which vitamin supplements they choose,” says Morrow.
Source link
