Bariatric surgery is a complex procedure that is intended to help patients lose weight and improve their overall health.
Surgeons have a duty to qualify patients as being suitable candidates for this complex and life-changing procedure.
Thorough pre-operative evaluation requires a close examination of a patient’s medical history including any factors which indicate against such procedure, current health status, and psychological health.
Such evaluation should inform the surgeon as to which of the following surgery procedures should be used for any particular patient:
Roux-en-Y Gastric Bypass.
This surgery involves creating a small pouch at the top of the stomach and then connecting it directly to the small intestine, bypassing a portion of the stomach and intestine. This procedure reduces the amount of food a person can eat and the amount of calories they absorb.
This procedure involves removing a large portion of the stomach, leaving a small tube-shaped stomach. This limits the amount of food a person can eat and helps them feel full more quickly.
Adjustable Gastric Banding.
This involves placing a band around the top of the stomach, creating a small pouch. The band can be adjusted to control the amount of food a person can eat.
Biliopancreatic Diversion with Duodenal Switch.
This is a more complex procedure that involves removing a portion of the stomach and rerouting the small intestine. This procedure results in more weight loss than other methods, but it also carries a higher risk of complications.
This is a non-surgical procedure in which a deflated balloon is placed into the stomach and then filled with saline solution. The balloon takes up space in the stomach, reducing the amount of food a person can eat.
Bariatric surgery comes with risks and potential complications that should be fully discussed with patients. Some of the mistakes that can occur during or after surgery include:
- Organ damage: The surgeon can inadvertently damage organs such as the liver, spleen, and other abdominal structures;
- Bleeding: Unrecognised tissue damage in the course of surgery can result in extensive abdominal bleeding;
- Wound infection: Infection can occur at the site of incision or in the abdomen which if not recognised quickly can lead to serious complications.
- Strictures: Narrowing of the opening between the stomach and intestine can cause nausea, vomiting and chronic pain.
- Nutritional deficiencies: if the surgery involves removal of part of the stomach organ, some patients may experience nutritional deficiencies.