While weight loss surgery is somewhat inexpensive around the world, this is not the case in most of the healthcare centers in the US. Here are the best options for bariatric surgery abroad.
Options for Weight Loss Procedures and Bariatric Surgery Abroad
Weight loss surgery or bariatric surgery is a procedure that aims to help control the appetite and food intake of morbidly obese individuals. Combined with regular exercise and strict compliance to a healthy lifestyle, bariatric surgery is proven to lead to tremendous weight loss. Accomplishing this result is also made possible by highly experienced bariatric surgeons through different types or techniques.
There are 3 Basic Types of Weight Loss Surgeries According to Their Method of Treatment or How They Affect the Individual’s Digestive System:
Restrictive Weight Loss Surgery – is a type of bariatric surgery that involves the restriction of the stomach volume and results in slowing down of digestion as well. The effects are diminished food intake through appetite control and decreased stomach capacity. This technique also leaves a continuity of the alimentary canal; thus, minimizing any complications due to metabolic causes.
Malabsorptive Weight Loss Surgery – this involves altering the anatomic and physiologic structures of the digestive system. This method also includes stomach volume reduction and results in decreased absorption of nutrients and calories from food.
Combination (Restrictive + Malabsorptive) – combines the techniques applied to restrictive and malabsorptive weight loss surgeries.
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There are at Least 3 Kinds of Procedures Under Each of the Basic Types of Weight Loss Surgery:
Predominantly Restrictive Bariatric Surgeries:
Vertical Banded Gastroplasty:
Vertical Banded Gastroplasty involves stapling of a part of the stomach. It is also known as the Mason procedure which leaves a “new stomach” by creating a small pre-stomach pouch. An approximately one centimeter hole is created under the pre-stomach pouch to serve as an aperture for food stuff to flow through the stomach proper and the rest of the digestive system. Food intake control is achieved by stomach volume reduction and food passage delay from the pouch to the stomach.
Adjustable Gastric Banding:
Lap-Band is a popular method under adjustable gastric banding. It uses an adjustable silicone ring placed around the upper part of the stomach that creates a narrow outlet between the new upper pouch and the lower stomach. Mostly, adjustable gastric banding is done laparoscopically and involves lesser incisions as compared to the more invasive types of surgeries. In Lap-Band, stomach volume reduction and food emptying is moderately controlled; thus, causing a feeling of satiety.
Also known as “gastric sleeve,” it involves stomach reduction up to 15% of its original size. This is done by resection of a portion of the stomach along the major curvature and stapling of the open edges creating a tube or banana-shaped stomach. Volume reduction of the stomach using this procedure can be done laparoscopically and is permanent. Sleeve gastrectomy doesn’t involve any intestinal bypass but it restricts the volume of food eaten without the malabsorption of essential nutrients.
It is one of the latest restrictive weight loss surgeries that uses the combination of vertical sleeve gastrectomy and Lap-Band. The stomach is reduced by sutures along the greater curvature without removal of stomach tissue. The procedure eliminates the use of bands, staples, fills or adjustments. It promises no complications from leaks and the achieved results are comparable to most restrictive type of weight loss surgeries.
This procedure uses an inflatable balloon that is placed into the stomach. The balloon is eventually inflated causing a decrease in gastric volume. A maximum of 6 months is allowed for the balloon to be left in the stomach. Intragastric balloon can be done as a “pre-bariatric” procedure for other weight loss surgeries. Morbidly obese patients can be prepared for other form of bariatrics using this procedure in order to attain a weight that is suitable for more invasive and aggressive surgery.
Predominantly Malabsorptive Bariatric Surgeries:
It is also known as the Scopinaro procedure and now replaced by a more modified form called duodenal switch (BPD/DS). BPD causes problems of malnourishment due to malabsorption and is now rarely performed. In this procedure, a portion of the stomach is removed and a smaller stomach is created. The duodenum and the jejunum are bypassed by connecting the distal portion of the small intestine to the gastric pouch. BPD is a complex procedure and is usually done with another procedure known as BPD/DS:
It is also called Biliopancreatic Diversion with Duodenal Switch (BDP/DS) or Gastric Reduction Duodenal Switch (GRDS). This modified form of surgery has both restrictive and malabsorptive stages. The restrictive stage involves the resection of about 70% of the stomach following the greater curvature; and the malabsorptive part involves the rerouting of a portion of the small intestine. The switch creates 2 pathways with one common channel: (a) the digestive loop – which takes in the food coming from the stomach delivering to the common channel; (b) the biliopancreatic loop – which carries liver bile to the common channel. This procedure allows the reduction of calorie absorption from the small intestine; moreover, this procedure limits the absorption of fats.
This procedure is rarely done because of many complications that develop after the operation. It involves the bypassing of most of the intestines to create a malabsoptive condition. JIB keeps the stomach unchanged and intact. JIB is no longer recommended due to permanent dangers of severe malabsorption after the procedure.
This is done by way mouth where the liner is implanted and removed. An impermeable sleeve is placed in the upper part of the small intestine (in the duodenum and in the first part of the jejunum). The mechanical bypass blocks the absorption of nutrients in those portions of the intestines mentioned.
Extended (Distal) Roux-en-Y Gastric Bypass (RYGBP-E):
A variation of the Roux-en-Y Gastric Bypass, it involves the creation of a larger stomach pouch. A considerable and longer portion of the small intestine is also bypassed in this type of procedure.
Combination (Restrictive + Malabsorptive) Bariatric Surgeries:
Roux-en-Y Gastric Bypass:
RNY gastric bypass is a procedure that creates a small gastric pouch by staples and where the distal small intestine is connected to the pouch. A Y-shaped configuration is formed by reconnecting the upper part of the small intestine to the distal part. This is one of the most common procedures done in the US for weight loss and is considered the gold standard. However, the procedure poses disadvantages with regard to malabsorption syndromes.
Sleeve Gastrectomy With Duodenal Switch:
Another modified form of the biliopancreatic diversion, sleeve gastrectomy with DS involves resection of the stomach along the greater curvature and the stomach is disconnected from the duodenum to be connected to the distal small intestine. The duodenum and the upper part of the small intestine are then reconnected to lower part of the small intestine connected to the colon.
Implantable Gastric Stimulation:
It uses electrical leads that stimulate the external surface of the stomach. The electrical stimulation is thought to cause a form of modified activity to the enteric nervous system. This is interpreted as a sense of satiety or fullness to the brain.
Weight loss surgery can also be offered as a laparoscopic or open surgery. Laparoscopic surgery is becoming more popular and makes use of small openings or incisions along the abdomen and the operation is aided with a video camera (laparoscope). Open surgery requires opening of the abdomen as usually done in major operations. Open surgery is associated with a longer recovery period while laparoscopy involves less extensive scarring and a shorter recovery period.
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