Bariatric Surgery

What is Bariatric Surgery, Why is it done?

Bariatric surgery, also called weight loss surgery, is a procedure that helps you lose weight. You may consider, or your health care provider may suggest, bariatric surgery if:

  • You are severely obese and have been unable to lose weight through diet and exercise.
  • You have health problems related to obesity, such as:
    • Type 2 diabetes.
    • Heart disease.
    • Lung disease.

How does bariatric surgery help me lose weight?

Bariatric surgery helps you lose weight by:

  • Decreasing how much food your body absorbs. This is done by closing off part of your stomach to make it smaller. This restricts the amount of food your stomach can hold.
  • Changing your body’s regular digestive process so that food bypasses the parts of your body that absorb calories and nutrients.

If you decide to have bariatric surgery, it is important to continue to eat a healthy diet and exercise regularly after the surgery.

What are the different kinds of bariatric surgery?

There are two kinds of bariatric surgeries:

  • Restrictive surgery. This procedure makes your stomach smaller. It does not change your digestive process. The smaller the size of your new stomach, the less food you can eat. There are different types of restrictive surgeries.
  • Malabsorptive surgery. This procedure makes your stomach smaller and alters your digestive process so that your body processes less calories and nutrients. These are the most common kind of bariatric surgery. There are different types of malabsorptive surgeries.

What are the different types of restrictive surgery?

Adjustable Gastric Banding

In this procedure, an inflatable band is placed around your stomach near the upper end. This makes the passageway for food into the rest of your stomach much smaller. The band can be adjusted, making it tighter or looser, by filling it with salt solution. Your surgeon can adjust the band based on how you are feeling and how much weight you are losing. The band can be removed in the future. This requires another surgery.

Vertical Banded Gastroplasty

In this procedure, staples are used to separate your stomach into two parts, a small upper pouch and a bigger lower pouch. This decreases how much food you can eat.

Sleeve Gastrectomy

In this procedure, your stomach is made smaller. This is done by surgically removing a large part of your stomach. When your stomach is smaller, you feel full more quickly and reduce how much you eat.

What are the different types of malabsorptive surgery?

Roux-en-Y Gastric Bypass (RGB)

This is the most common weight loss surgery. In this procedure, a small stomach pouch is created in the upper part of your stomach. Next, this small stomach pouch is attached directly to the middle part of your small intestine. The farther down your small intestine the new connection is made, the fewer calories and nutrients you will absorb. This surgery has the highest rate of complications.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

This is a multi-step procedure. First, a large part of your stomach is removed, making your stomach smaller. Next, this smaller stomach is attached to the lower part of your small intestine. Like the RGB surgery, you absorb fewer calories and nutrients the farther down your small intestine the attachment is made.

What are the risks of bariatric surgery?

As with any surgical procedure, each type of bariatric surgery has its own risks. These risks also depend on your age, your overall health, and any other medical conditions you may have. When deciding on bariatric surgery, it is very important to:

  • Talk to your health care provider and choose the surgery that is best for you.
  • Ask your health care provider about specific risks for the surgery you choose.

Generally, the risks of bariatric surgery include:

  • Infection.
  • Bleeding.
  • Not getting enough nutrients from food (nutritional deficiencies).
  • Failure of the device or procedure. This may require another surgery to correct the problem.

Where to find more information

Summary

  • Bariatric surgery, also called weight loss surgery, is a procedure that helps you lose weight.
  • This surgery may be recommended if you have diabetes, heart disease, or lung disease.
  • Generally, risks of bariatric surgery include infection, bleeding, and failure of the surgery or device, which may require another surgery to correct the problem.

Bariatric Surgery, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • Soreness.
  • Sluggishness.
  • Tiredness.
  • Moodiness.
  • Chilliness.
  • Dry skin.
  • Some hair loss.

Follow these instructions at home:

Eating and drinking

  • Follow instructions from your health care provider about:
    • What to eat and drink. He or she may recommend that you start by eating pureed foods and liquids at first. Then you may move on to soft foods. Over time, you may slowly resume a more normal, healthy diet.
    • How much to eat and drink. You should eat small meals often.
  • Eat slowly to avoid discomfort and vomiting. Take small bites, and chew thoroughly before swallowing.
  • Drink liquids between meals instead of during meal time.
  • Focus on eating high-protein foods. Avoid foods that are high in sugar and fat.
  • Take vitamin and mineral supplements as recommended by your health care provider.

Stop eating when you feel full.

Incision care

  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may need to take sponge baths until your health care provider tells you otherwise.

Activity

  • Do notdrive until your health care provider approves.
  • Do notdrive or use heavy machinery while taking prescription pain medicine.
  • Take short walks several times a day. Walking helps you recover, and helps to prevent blood clots. Ask your health care provider what other activities are safe for you.
  • Rest when you get tired. It may take several weeks for your normal energy levels to return.
  • Do notlift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.

Lifestyle

  • Do notdrink alcohol until your health care provider approves.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
    • Drink enough fluid to keep your urine clear or pale yellow.
    • Take over-the-counter or prescription medicines.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have pain or swelling in your thigh, behind your knee, or in your lower leg.
  • You have redness, swelling, or pain around your incision.
  • You have fluid or blood coming from your incision.
  • Your incision feels warm to the touch.
  • You have pus or a bad smell coming from your incision.
  • You have a fever.
  • Your incision opens after your sutures, skin glue, or adhesive strips have been removed.
  • You develop episodes of dizziness.
  • You faint.
  • You have shortness of breath.
  • You have nausea or vomiting that does not go away.
  • Your soreness gets worse instead of better.

Get help right away if:

  • You have sudden, severe abdominal pain or swelling.
  • You develop a rash.
  • You have difficulty breathing.

Summary

  • After your procedure, it is common to feel sore and to get tired easily.
  • Take short walks several times a day. Walking helps you recover, and helps to prevent blood clots after surgery.
  • Avoid lifting anything that is heavier than 10 lb (4.5 kg) for 6 weeks, or for as long as told by your health care provider.
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