Bariatric Surgery Types
Mar 10, 2023 - Weight Loss Surgery in Delaware: Bariatric Friday - Bariatric Surgery Types
This Bariatric Friday, Kemal Erkan, Chairman of American Surgery Center, and Dr. Isaias Irgau of Christiana Institute of Advanced Surgery (CHRIAS) are together to discuss types of bariatric surgery. This surgery treats morbid obesity. An individual who is morbidly obese is defined as being 100 pounds over their ideal body weight. This is a life-threatening condition. Another way to classify an individual as being morbidly obese is if their body mass index (BMI) is greater than 40. One can also be a candidate for bariatric surgery if they have a BMI of 35 but also have related illnesses such as high blood pressure or sleep apnea.
Dr. Irgau goes into detail regarding the types of surgeries they perform at American Surgery Center. The most common procedures are a gastric sleeve, also known as gastrectomy, and gastric bypass. Other procedures that can be done, but are less common, are the duodenal switch and the gastric band. All of these procedures reduce the size of the stomach. Dr. Irgau explains, “with the gastric sleeve, the most common procedure… we cut the stomach so that a larger portion of the stomach, which is known as the greater curvature and fundus of the stomach, are removed completely.” This is a non-reversible procedure because it takes out a portion of the organ. This is done laparoscopically, which results in a quicker recovery time and less chance of infection. Because the stomach is reduced in size, the patient will not feel as hungry and prevents excess food from being consumed. This restriction results in the patient feeling fuller much earlier than prior to surgery.
Erkan asks Dr. Irgau to explain the gastric bypass. He states that with a gastric bypass they reroute the intestine and divide the stomach to create a smaller stomach. This is so the patient receives less food and will be processed by the body differently. The food bypasses the larger stomach. This surgery is most commonly offered to patients. There is a downside to rerouting the intestine, and this can be avoided by undergoing the gastric sleeve. Bariatric surgery is a major change to someone’s life. If one has severe acid reflux, this is the ideal surgery type for them. Dr. Irgau says, “the gastric bypass is better simply because it is going to be taking away the acid producing stomach from the food pipe.” The rerouting of the intestine can also reduce diabetes. The correlation between diabetes and the gastric bypass has been proven effective. It helps to regulate blood sugar even before weight loss. It prevents the food from going into that early portion of the intestine. Because that portion of the stomach is so critical in regulating blood sugar that when it is not exposed to food it leads to a better control of blood sugar.
As previously mentioned, gastric bands are being used less and less. The pair are seeing many patients come in to get the band removed and move forward with another surgery type. “In my view, you know I always say to patients that when they are faced with morbid obesity, the worst choice is to do nothing. There are clear advantages to the gastric sleeve or gastric bypass when you compare it to the band… from a patient’s point of view, there is an appeal to the gastric band, that is we are not rerouting any organs, we are not taking away any part of the organ, we are simply placing a device that can be removed,” Dr. Irgau states. The band size can be increased or decreased because it is filled with saline; it is adjustable to the patient’s needs. Patients may find discomfort with the gastric band. He continues, “it’s certainly not my first choice, at the moment, because we can achieve a lot more with a relatively safe procedure like the gastric sleeve.” Some patients do very well with the gastric band. Dr. Irgau explains he has had patients lose 150 pounds with the gastric band. It comes down to quality of life; ultimately, the patient has to make the best choice for themselves. “There are probably ninety 90 patients out of 100 who still do not want to have any type of surgery… if the only thing that they will
accept is the gastric band, then in the circumstances we have to educate them and work with them as well,” Dr. Irgau says.
The duodenal switch is a more complex procedure; it is like a combination of the sleeve and gastric bypass. The stomach is cut and a portion of it is removed leaving it as a slender stomach, and the intestines are rerouted as well. It shows much more significant weight loss compared to the sleeve and the bypass because of the drastic changes that are made. This has downsides, however. The ability to absorb nutrients is reduced and other intestinal issues can form. With any surgery, there are risks and benefits. This is why guidance is provided at American Surgery Center. Patients attend a number of consultations to ensure they are choosing the best option for them. Education and communication are key when making a life-changing decision.
The pair made an update to their communication channels. Erkan demonstrates how to schedule an appointment with three different options. Their website has been updated to make it significantly easier for patients to contact physicians and schedule appointments.