Tag: bariatric surgeon

Combined Restrictive & Malabsorptive Procedure

Posted by admin – October 21, 2008

Combined Restrictive & Malabsorptive Procedure is a type of weight loss surgery that does not only focus on limiting food intake but also in limiting the amount of nutritional intake happening in the small intestine. This procedure was only recently introduced to the public yet has proven to increase the choices of weight loss surgery options for patients needing help in weight management department.

Combined Restrictive & Malabsorptive Procedure delays the process of combining food with the gastric juices resulting to the early feeling of satiety.  This effect will then reduce the desire to eat thus will lead to less consumption of food. The Combined Restrictive & Malabsorptive Procedure typically is a gastric bypass procedure yet has some modifications to add the malabsorptive effect.

The surgery is done by stapling the stomach using gastric staples to form a small pouch which can approximately hold 15 to 20 cc.  Unlike other procedures, the rest of the stomach is not removed.  It is only stapled shut which serves as its division from the newly created stomach pouch. An outlet is then made from the pouch which is directly emptied to the lower portion of the jejunum.  This is achieved by dividing the small intestine beyond the duodenum to bring it up forming a connection with the newly created pouch. By doing this, the process of calorie absorption is bypassed, thus lessening the nutritional elements that are absorbed by the body. Length adjustments of the connection channel can be made by the bariatric surgeon to increase or decrease the level of malabsorption as the patient requires.

Risks of this particular procedure include poor absorption of iron and calcium, which can lead to anemia and osteoporosis. Metabolic bone diseases resulting in height loss, fractures, bone pain and humped back has also been reported as a side effect of the procedure. The dumping syndrome, or the rapid emptying of the stomach contents into the intestine, can happen post-operation which can lead to nausea, sweating, and diarrhea.  Also, ulcers and bleedings in the bypassed portion of the stomach cannot be diagnosed with an X-ray or an endoscopy.

Recovery plan to avoid excessive malnutrition related to the malabsorptive effect of the surgery is to follow strictly the nutritional plan set forth by a dietician, which usually consists of having liquid diet first and slowly progressing to soft foods, then later to normal food. Nutritional supplements should also be taken to answer the body’s need of several essential nutrients.

Several advantages can be benefited from having a Combined Restrictive & Malabsorptive Procedure done.  The most basic one is the higher amount of weight loss when compared to a strictly restrictive procedure. Approximately 77% of excess body weight is also lost after a year post-surgery. Long-term benefits and weight loss have also been reported, with patients maintaining a consistent weight loss of 50% – 60%.  Also, health conditions associated with weight problems have significantly been resolved or improved as the case may be after having a Combined Restrictive & Malabsorptive Procedure done.

Biliopancreatic Diversion (BPD) Surgery

Posted by admin – August 26, 2008

Biliopancreatic Diversion (BPD) is a type of weight loss surgery that is not commonly done today as surgeons prefer the gastric bypass more. Despite this, there are people that prefer having this operation done since the amount of weight loss with this type of surgery is greater than the most common types of weight loss surgeries. While other surgeries have a range of 50% – 70% weight loss after the surgery, the biliopancreatic diversion surgery can achieve weight loss at the range of 60% – 80%.

Also known as the Scopinaro procedure, BPD is used to cure severe obesity. The surgery is done by removing a part of the stomach and bypassing the duodenum and jejunum of the small intestine.  Removing part of the stomach is necessary so that the food intake is limited, while the bypass is done so that absorption of nutrients is lessened. The malabsorptive element of the operation is the factor responsible for the very high rate of weight loss.

During a BPD operation, a surgeon staples a portion of the upper stomach to create a pouch which can hold approximately 6 ounces of food.  The lower part of the stomach will then be removed from the body. After doing this procedure, the surgeon will then connect the pouch to the final section of the small intestine, called the ileum.  By doing this, the patient will be unable to digest the food they eat fully which leads to a lesser intake of nutrients. Yet, the duodenum will still be connected to the lower portion of the intestine so that the digestive juices produced by the small intestine will still mix with the food to be digested.   The bariatric surgeon can adjust the size of the stomach and the length of the channel as needed by the patient’s condition.   This surgery can be done either through the use of a laparoscope or through the traditional open type of surgery.

Not all people can be candidates of a biliopancreatic diversion surgery because the procedure carries with it perioperative and postoperative risks.  Individuals who have a high body mass index with complications, a history of weight loss failure, and are emotionally stable to undergo the surgery can be qualify for a biliopancreatic diversion surgery.

The most common problem that can be faced after having a BPD bypass is malnutrition. Malnutrition is a lifelong health risk and can only be remedied by following strict nutritional plans and taking vitamin supplements. Because of the malabsorptive effect of the operation, malnutrition cannot be avoided so maintenance has to be followed in order to avoid nutritional complications like anemia and osteoporosis.

Before deciding if this is the right weight loss system for you, make sure that you coordinate with your medical practitioner so that he will be able to guide you in your decision making.  Surgeries, in general, carries with it risks, including that of severe complications and even death, which is why it will still be best to get appropriate medical advice before deciding.