Bariatric Surgery

Bariatric surgery or obesity surgery is performed in those patients who suffer from severe or morbid obesity, those who have not been able to lose weight with diets or classic treatments also unable to keep an achieved weight. This technique has been used for more than 40 years.

The techniques that are currently used are almost non-invasive or with laparoscopy, with small incisions in the abdominal area (smaller to 1 cm) allowing little surgical discomfort and post-surgical pain and it also allows a recovery with a quick return to normal life activities.

Our medical staff has a wide experience in bariatric techniques commonly used in the world to achieve effective weight lost and its long run maintenance.

There are two types of deviating surgeries or bypass

Y roux bypass: with a restrictive effect of 90%

Biliopancreatic deviation: its main characteristic is to produce a poor absortion of fats.

Y roux bypass or restrictive

It is the most widely used technique in the United States since the 1980’s. It involves creating a small gastric reservoir (15-20ml) that communicates with the small intestine and skips the rest of the stomach, duodenum and the first portions of the small intestine.

Its is based on a diminished gastric capacity (gastric restriction) and a small effect of poor absortion of fats and carbohidrates. It allows a weight loss of 70% of the excess and keeping it long term in a 65-70% .

ADVANTAGES

Intake restriction and poor absortion

No prosthesis is required

No adjustments needed

DISADVANTAGES

The weight achieved is not kept totally and patients tend to gain some kilos.

Stomach and small intestine must be sectioned and joined to skip a portion of the digestive tube.

Non-reversible or adjustable

By means of the placing of a gastric band, a small gastric reservoir is created that restricts the intake and allows only small portions of food, a quick feeling of fullness and decreased hunger in between meals.

The adjustable gastric band was designed to be placed aroung the upper region of the stomach like a ring creating a small reservoir of 15ml capacity, with it we restrict food intake to a ¼ of the normal intake.

It is a completely restrictive techniques that achieves a feeling of permanent fullness with a minimal intake.

The speed of food passage through the band is controlled with a small compartment under the skin. This is not noticeable from the outside.

It causes a weight loss of 65-70% of the excess and it keep it long term in 65% of cases.

ADVANTAGES of the adjustable gastric band

It is inserted with a non-invasive surgery

No gastric tissue or digestive tube sector is sectioned

The capacity and speed of gastric emptiness is controlled from the outside.

It is a reversible technique and the band can be remowed when the patients considers it,

DISADVANTAGES

Risk of intragastric displacement or migration (depending on the surgical technique)

Infection of the adjustment compartment

Patient unable to get used to food restriction

It does not prevent from high calorie liquid intake

All these disadvantages occur in only less than 5% of patients

The bypass produces a short circuit between a new and small stomach and a distal sector of the intestine with which it blocks the abortion of approximately 1,50 m of the digestive tube producing a poor absortion of nutrients.

Bariatric techniques

ADJUSTABLE GASTRIC BANDING

GASTRIC BYPASS

BILIOPANCREATIC DEVIATION

The biliopancreatic deviation or poor absortion bypass is a deviating surgery very popular in Europe and it is called mixed technique.

It is a procedure to cause poor absortion. It blocks most sectors of the small intestine so fats and carbohidrates are partially absorbed. Gastric capacity is not fully reduces and the patient can eat normally, but the excess of fat and carbohidrates will be eliminated because only one portion of the intestine will perform this function.

It allows a weight loss of 80% of the excess and it keeps it permanently on the long run.

ADVANTAGES

The patient suffers no food restriction and may eat the portion she wishes.

The excess of fat and carbohidrates will be eliminated

No adjustments should be done

DISADVANTAGES

Small intestine and stomach must be sectioned

It is non-reversible or adjustable

In many cases meals should be supplemented with iron and vitamins.

Sleeve gastrectomy consists of the removal of 80-90%of the stomach, reducing food capacity.

Intake capacity is reduced to 100cc and the patient eats only small portions

It causes a weght loss of 60-70%

ADVANTAGES

It allows a by-pass procedure in a 2nd oppotunity

Safer sutures than the ones in a by-pass

There is no poor absorption, food follows its normal circuit

DISADVANTAGES

Non- reversible and non-adjustable

The intragastric balloon involves placing a small balloon with saline solution via laparoscopy ( no surgery ) causing fullness with smaller portions.

The placement of a 500-700cc volume balloon reduces gastric capacity. This causes small volume intakes.

This is a temporal procedure, it lasts 6 months and it is indicated for low overweight patients or those with high surgical risks.