BARIATIC SURGERY (OBESITY SURGERY)



Bariatric surgery (weight loss surgery) includes a variety of procedures performed on people who have obesity. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestine to a small stomach pouch (gastric bypass surgery).



 



Surgery should be considered as a treatment option for patients with a BMI of 40 kg/m2 or greater who instituted but failed an adequate exercise and diet program (with or without adjunctive drug therapy) and who present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea. A doctor–patient discussion of surgical options should include the long-term side effects, such as a possible need for reoperation, gallbladder disease, and malabsorption.



 



Classification of surgical procedures:



 



Biliopancreatic diversion



Jejunoileal bypass



Endoluminal sleeve



Vertical banded gastroplasty



Adjustable gastric band



Sleeve gastrectomy



Intragastric balloon (gastric balloon)



Gastric plication



Gastric bypass surgery



Sleeve gastrectomy with duodenal switch



Implantable gastric stimulation