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) 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.

Weight loss surgery, also known as bariatic surgery, changes the anatomy of an individual’s digestive system to limit the intake of food.  Since being obese holds with it other serious medical conditions, surgery can prove to be helpful in lowering the risk associated with these conditions.

The most common and favored bariatric surgery in the United States is gastric bypass. Surgeons prefer this type of weight loss system because it is generally safer and has fewer complications.  The effects of a gastric bypass are also long-term and can lead to continual weight loss when behavioral adjustments are made. However, gastric bypass is not for everyone who is dealing with obesity. Before considering undergoing the surgery, you must be able to know what the things are involved during and after the procedure.

Gastric bypass surgury is done by creating a small pouch on top of your stomach. The surgeon will then bypass the route of the food from this pouch directly to the small intestine. Usually, the size of this pouch resembles that of a walnut and can only hold an ounce of food.  Bypassing the lower portion of the stomach will not lead to any disruption of the digestive process since it continues to secrete digestive juices which mix with the food in the small intestine. By having the food bypass directly to the second section of the small intestine, your ability to absorb calories is reduced significantly. Traditionally, this operation is done by “opening” the stomach but recent development in technology allows a less invasive procedure to be done through the aid of a laparoscope, a small camera which is inserted in your abdomen to see around the area. Typically, this surgery is done under general anesthesia and takes four hours to complete.  You may be required to stay in the hospital for three to five days post-surgery so that the hospital staff can monitor you for any complications.

Recovery after the surgery involves not being allowed to eat one to three days post-operation to allow your stomach to heal.  A specific diet will also be planned out for you for the next twelve weeks, starting with liquids and slowly, moving to pureed foods, and finally to regular foods. Since your stomach is reduced to such a small size, you have to expect to eat very small meals each day.  You have to anticipate that eating too much or too fast in the first six months after surgery will make you vomit or feel intense pain on the upper part of your abdomen. Your food intake will eventually increase but rest is assured that you won’t go back to your normal eating habits. Other changes that you might experience due to rapid weight loss caused by the surgery can include drier skin, hair thinning, mood changes, and body aches.

Undergoing this weight loss surgery has several benefits including a good 50% – 60 % weight loss which can be long term if dietary and exercise recommendations are met. It can also improve or cure medical conditions like high blood pressure, sleep apnea, and type 2 diabetes. Gastric by pass surgery is now considered a common procedure, but it is surgery and as such shouldn’t be taken lightly as there are major risks.