What is bariatric surgery ?
The term “bariatric surgery” refers to surgical procedures performed to reduce body weight. It has been proved to be the only effective treatment for morbid obesity.
In 1991, the National Institute of Health (NIH) Consensus established the guidelines for bariatric surgery for patients with BMI> 35 kg/m2 with severe obesity related comorbidity and for BMI > 40 kg/m2 with or without comorbidity.
For Asian patients, these guidelines are more stringent since it has been observed that Asian (including Indians) have a greater proportion of body fat as compared to their Caucasian counterparts and are more prone to metabolic disorders associated with obesity.
For Asians,the guidelines for bariatric surgery for patients with BMI> 32.5 kg/m2 with severe obesity related comorbidity and for BMI > 37.5 kg/m2 with or without comorbidity.
There are basically two types of bariatric surgical procedures â€“ Restrictive and malabsorptive.
Restrictive procedures reduce the amount of food intake by decreasing the reservoir capacity of stomach whereas malabsorptive procedures decrease the amount of food being absorbed by the intestine. Some procedures have both these effects and are known as combined procedures.
There is a rapid loss of body weight after bariatric surgery during the first six months with a more gradual weight loss which can continue up to 2 years. The percentage of excess weight loss varies with the type of procedure performed and can vary from 50% to 80%.
In the present day scenario, all these operations are performed laparoscopically by the minimal access technique. This reduces the trauma to the abdominal wall and provides ease of access to the organs inside the abdomen. The other advantages of this approach include less pain, superior cosmesis and faster postoperative recovery.