The surgeries for weight loss are of many types and are collectively called bariatric surgery. The basic criteria for undergoing a bariatric surgery is when you have failed losing weight with the help of strict diet and exercise and this excessive weight is responsible for development of serious health complications. Weight loss surgeries utilise one of the following two mechanisms or a combination of both. The idea is based either on reducing the size of stomach or limiting the amount of nutrient absorption. Based on this category the three types of weight loss surgeries are as follows;
This mainly shrinks or reduces the size of stomach which eventually reduces the amount of food the stomach can hold. The net effect is feeling full early and therefore eating less food.
This type of surgery focuses on limiting the amount of nutrition that gets absorbed in the body. The basic idea is to eliminate a part of the digestive part which is mainly responsible for absorption of calories. These surgeries are complex to perform and pose a higher rate of risk.
The Combination Approach
The type of surgery which involves basics of restrictive as well as mal-absorption, come under the combination class of surgery. Now having understood the underlying mechanism behind different classes of weight loss surgeries, let us go glance through the various established types of weight loss surgeries also called bariatric surgeries.
Gastric By-Pass Surgery
Gastric by-pass surgery is also called the Roux-en-Y gastric bypass (RNY). As the name suggests it involves bypassing the main portion of the stomach by creating a small pouch at the top (restrictive surgery) which is connected to the farther end of small intestine. This means the food entering from food pipe enters the small pouch and directly proceeds into the farther end of small intestine (mal-absorptive approach). In addition the by-passed portion of stomach is also attached to the small intestine which ensures the flow and mixing of gastric juices with the food. The approximate cost of a gastric by-pass surgery is 5-5.5 lakh INR.
Lap Band Or The Gastric Band Surgery
The gastric band surgery is restrictive type of surgery. It is laparoscopic and minimally invasive in nature. A silicone or silastic band is placed on the top portion of stomach. Now this band has an inflatable balloon surrounding its lower surface which is similar to a bicycle tyre in appearance. Now this balloon is connected to a port placed in the abdominal muscles. With the help of saline solution the band can be made tight or loose as per need. The result of this surgery is limited food intake and subsequent weight loss. The approximate expenditure for gastric banding in India ranges from 3.5-3.8 lakh INR.
Gastric Sleeve Surgery Or The Sleeve Gastrectomy
This again is a restrictive surgery where a vertical portion of stomach is separated from the stomach and removed. The procedure is laparoscopic and involves reducing the stomach size by about 25% of its original size by removing a portion of the organ. Post-removal the open surface is stapled and sealed so the stomach looks like a sleeve or a banana shaped organ. The result of sleeve gastrectomy is reduced food intake and therefore less eating. The average expenditure for gastric sleeve surgery in India is about 4.5 – 5 lakh INR.
This is comparatively a complex type of surgery. The first step involves removal of a major part of stomach which is similar to the sleeve gastrectomy. Next, the small intestine is cut and re-joined in such a way that the food enters the lower portion of small intestine (known as the duodenum switch) resulting in less absorption of calories and nutrition. It is also ensured that the bile and other gastric juices mix with the food in lower portion of small intestine. Therefore the reduced size of stomach (also reduces release of hunger generating hormone called ghrelin) and less absorption of nutrients and calories results in weight loss. The cost for performing a bilio-pancreatic surgery in India is about 6-7 lakh INR but is variable depending on number of patient related factors.
Although many new techniques and surgical procedures for weight loss have come up, a decision to undergo any kind of bariatric surgery must be taken only after consulting experts. The entire medical history of the patient must be taken into account along with the benefit-to-risk ratio. Only when the benefits greatly exceed the risk must the surgery be performed. The primary measure to lose weight always is a balance of good diet and healthy lifestyle which no surgery can replace.