Weight Loss Surgery

Weight Loss Surgery Related Terms:
Bariatric Surgery, Bariatric Surgery, Body Procedures, Bypass Surgery, Cosmetic Surgery, Gastric Banding, Gastric Banding, Gastric Bypass, Lap Band, Obesity Surgery, Plastic Surgery, Surgeon

Plastic Surgery Your Procedure Procedure Animation

Weight Loss (cosmetic) surgery

Next to smoking, obesity is the most common death from behavioural risk in the USA.
In Western’s societies, “being fat”, or “looking fat”, is indeed a problem. However, the health risks associated with overweight are significant.
There are several ways to address the problem:
• Diet
• Weight loss programs
• Exercise (gym)
• Medications
• Surgery for weight loss

In this article we shall not deal with or criticize the first options, but rather present the surgical option.

Bariatric surgery (weight loss) is in many cases the preferred solution for the severely obese (fat). The basic idea behind such surgeries is to limit the amount of food that is absorbed in the stomach and intestines.

Bariatric surgery procedures are very effective and result in average reduction of 60%-70% of the excess weight. Problems related to over-weight usually go away, or significantly diminish, after surgery. Such include diabetes, high blood fat, high blood pressure, sleep apnoea (temporary incapability of breathing). Such successful effects are usually still present 10 years after surgery.
 
The most common surgical procedures are:
• Gastric bypass
• Gastric banding (“Lap banding”)
• Gastric pacemaker

In 1993, there were 20,000 bariatric surgery procedures performed in the USA. In 2006 the number was near 200,000.

Gastric bypass
This surgery re-routes the plumbing of the stomach and intestines. It creates a smaller stomach, which results in lesser absorption of food in the body.
The operation involves incisions, which can large or small, depending on the specific patient, and the use of laparoscope (a tiny camera).
The expected average result is a loss of 50 kg within 12 months.
There are risks and side effects involved, such as vitamin deficiency. Significant complications after surgery are estimated at a rate of 5%, with a death rate of 1 in 200.

Gastric banding (Lap band)
This procedure is less invasive and less dangerous than bypass. It restricts the size of the stomach; however, it does not limit the absorption of food.
This technique uses silicon bands placed around the top part of the stomach, which can be tightened after surgery. By such, the limiting of food passing may be controlled.
The death rate in this procedure is around 1 in 2,000, though it involves the same complication rate as with bypass.
The excess weight is lost within the first 24 months, and then the body continues losing weight in a slower pace.
Expert plastic surgeons specializing in this gastric procedure in the USA believe that this procedure will be the leading one in the next few years.
Usually, expert surgeons can perform it in 30-60 minutes.

Gastric Pacemaker
This procedure is still experimental in the USA (2007), but is available in Europe. This procedure involves an electric pacemaker that stimulates the stomach. The electric pulses “tell” the brain when the stomach is full.

The need for related procedures
Though health benefits associated with the loss of weight are life saving, the cosmetic aspect is significant. Cosmetic changes due to gastric surgery may be irreversible.
The skin of an overweight person is overstretched. There is difference in overstretching between the skin layers. The procedure leaves stretch marks which are inflamed and red for a long period of time.
Therefore, additional procedures to treat the effects of massive weight loss may be needed. A patient undergoing weight loss surgery may need afterwards cosmetic corrections: tummy tucks, thigh lifts, arm lifts, breast lifts, face lifts, body lifts.

Plastic Surgery Your Procedure Procedure Animation


 

weight loss surgery - News update:
Following a report from an observational study that the activity of clopidogrel on platelets, tested by vasodilator-stimulated phosphoprotein (VASP) phosphorylation was diminished in patients receiving PPI treatment, the OCLA (Omeprazole CLopidogrel Aspirin) study examined the influence of omeprazole on the antiplatelet activity of clopidogrel. This double-blind placebo-controlled trial involved 124 consecutive patients undergoing coronary artery stent implantation, who received aspirin (75mg/day) and clopidogrel (loading dose, followed by 75mg/day). They were randomised to either omeprazole (20 mg/day) or placebo for 7 days. The effect of clopidogrel was tested on days 1 and 7 in both groups by measuring platelet phosphorylated-VASP expressed as a platelet reactivity index (PRI). The main end point was PRI value at the 7-day treatment period in the 2 groups. The study found that: • On day 1, mean PRI was 83.2% and 83.9%, respectively, in the placebo and omeprazole groups (p = NS). • On day 7, mean PRI was 39.8% and 51.4%, respectively, in the placebo and omeprazole groups (p < 0.0001). The researchers conclude from these findings that omeprazole decreased the antiplatelet effect of clopidogrel as assessed by the VASP phosphorylation test. They note that as aspirin-clopidogrel antiplatelet dual therapy is widely prescribed, with PPIs frequently added to prevent GI bleeding, their findings require further evaluation, as the clinical impact of these results remains uncertain. According to an accompanying editorial, this is a hypothesis-generating study. It adds that “improved patient selection and pharmokinetic/pharmacodynamic investigations are needed before any clinical significance can be attributed to this reported drug–drug interaction or any suggestions are made that cardiologists should delete omeprazole therapy when clinically indicated in patients treated with dual antiplatelet therapy.” More...

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