Bariatric surgery is an exceptionally effective method to tackle obesity in patients for whom attempts to change diet and lifestyle did not bring desired results. Surgical treatment of obesity is commonly performed all over the world. It enables morbidly obese patients to significantly reduce their body weight.
There are many types of bariatric surgery available, which lets doctors choose a method tailored to the needs of individual patients. Despite this, some people still wonder: is the surgical treatment of obesity always effective? What determines the success of the procedure? Are there any postoperative complications that patients should beware of?
When is bariatric surgery effective?
Conservative treatment of obesity, namely dieting and exercising, is very safe, but often ineffective. In severely overweight people, surgical treatment produces much better results and is often the only way to permanently reduce the excess body mass.
Bariatric surgery causes the capacity of the stomach to shrink, which means that all the foodstuff passes through the digestive tract much quicker and the body can obtain fewer nutrients. After those procedures weight loss occurs relatively quickly and, depending on the chosen method, it can be as big as 60 kilograms within a year after the operation. However, for such a surgery to be safe, certain criteria must be met, and the patient should be properly prepared for the treatment.
During the bariatric consultation, which aims at qualifying the patient for surgery or suggesting him a better-suited method, it is necessary to carry out a general examination of the overweight person’s health condition and to check for any possible diseases associated with severe obesity that could lead to complications after the surgery.
Some of the health problems that might disqualify the patient from undergoing the procedure are peptic ulcer disease, portal hypertension, Cushing’s disease and cancer.
The effectiveness of bariatric surgery depends to a large extent on the attitude of the patient. Even before starting the surgical treatment, it is necessary to carry out a psychological consultation with the obese person. The consultation should also include a meeting with a dietician, during which it is checked whether the patient would be able to meet strict requirements imposed by the procedure.
After the operation, during recovery and in later stages of life, the patient has to adapt to new dietary recommendations, often limiting his food intake from several thousand kilocalories to as little as eight hundred kilocalories per day.
Moreover, after the surgery, the patient is only able to consume very small portions of food. Learning to include all the right nutrients in those tiny meals might be quite difficult at times. Willingness to work with a dietitian is, therefore, a key to success after undergoing bariatric treatment.
What to watch out for during surgical treatment of obesity?
Regardless of the type of surgery performed, the risk of complications will be higher for patients with higher initial body weight. Adipose tissue of a morbidly obese person is massively overgrown, which makes it difficult for the doctor to reach key operative points, even using laparoscopy. Because of the increased risk, only experienced and extremely precise bariatric surgeons can treat the heaviest patients.
Possible complications after bariatric surgery
Surgical treatment of obesity comes with a risk of complications, and although many operations are now performed using a relatively safe laparoscopic method, there still are some adverse effects of the procedure that must be properly monitored in the first weeks after the surgery. The probability of those issues occurring depends primarily on the chosen method, the skill and precision of the operator, and the patient’s individual predispositions and general health.
Complications during bariatric surgery are associated with the risk of damaging other organs that might stand in the way of the stomach and make it difficult for the surgeon to manoeuvre his instruments. Those are most commonly the spleen and the liver.
An experienced surgeon always takes the utmost care not to damage any nerves and blood vessels, but the risk of small and often unnoticed incisions must be explained to the patient. As a result of the operation, internal haemorrhages may occur.
A rare but possible postoperative complication is gastric leakage, often resulting from suture breakage or suture line leaks. Depending on the size of the leak and the surgeon’s decision, the patient may undergo a second operation or, in the case of small leaks, the stomach may be left to heal on its own during the hospital stay.
Serious complications after bariatric surgery occur in only about 2.5% of patients, so in most cases, this kind of treatment of obesity is quite safe, especially when using the minimally invasive laparoscopic method.
The most common complications following surgery are malabsorption, vomiting and diarrhoea. These issues occur because the body has some difficulties adapting to the new gastrointestinal tract system. They are only temporary and tend to pass on their own. In addition to the physical symptoms, it might not be easy for the patients to change their eating habits. Some people feel depressed when they can’t meet the desired outcome after the surgery.
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