Bariatric surgery is the surgical modification of the stomach, intestines, or both to cause weight loss.
Bariatric surgery is indicated for patients who have:
- Failed attempts at all non-surgical methods of weight reduction,
- Body mass index (BMI) > 40 kg/m2 or BMI > 35 kg/m2 and complications (e.g. diabetes, hypertension, obstructive sleep apnea, high-risk blood lipid profile),
- Acceptable risk of surgical intervention,
- Sufficient awareness and motivation.
Bariatric surgery should be considered for patients with type II diabetes who have a BMI of 30 to 34.9 and whose blood glucose levels are not controlled despite adequate drug therapy and the most favorable lifestyle․
Contraindications to bariatric surgery are:
- Depression as a mental disorder,
- Drug addiction and alcoholism,
- Oncological diseases that are not in remission,
- Due to the inability to follow the necessary diet, the obligation to constant intake of vitamins,
- Other severe contraindications to surgical treatment.
Currently, Sleeve gastrectomy is one of the effective and widely used bariatric surgery methods with fewer complications, during which about 80% of the stomach is removed, and a tubular stomach with a margin of about 2-3 cm and a volume of 150-200 ml is formed, which leads to a reduction in the amount of food intake․ Weight reduction with this method is done mostly at the expense of reducing the amount of food intake, but it should be noted that it also has a hormonal factor; in the removed part of the stomach, the hormone ghrelin is produced, which is responsible for hunger, and in its absence, the feeling of hunger decreases remarkably. Through this operation, patients get rid of about 60% of excess weight.
The method of bariatric surgery is chosen by the surgeon based on the data of the patient's clinical-laboratory, instrumental examinations and specialist consultations.