To reduce excess weight, there are many methods: a therapeutic diet, drugs for the treatment of obesity, the use of massage and specially designed sets of exercises, fasting. These methods are indicated for those who have gained excess weight as a result of an improperly formulated diet, neglect of physical activity, hormonal surges as a result of pregnancy and childbirth. In such people, the body mass index (BMI) usually does not exceed 30-35 kg / m2.
BMI is calculated using a very simple formula: a person’s weight (in kg) must be divided by the height (in meters) squared. For example, with a height of 1,7 m and a weight of 80 kg, the body mass index will be 80: 1,72=27,6. The upper limit of the norm is 25 kg / m2, the farther away from this figure the BMI values, the higher the degree of obesity.
Gastric reduction surgery is required for those with a BMI of 40 kg/m2 and above (“marbid obesity”). In addition, people with health problems will not be able to lose weight on their own:
Diabetes;
Pathologies of the endocrine system;
Violations of metabolic processes in the body.
Further maintenance of excess weight is fraught for such patients with an increased risk of hypertension, ischemia, stroke and joint diseases. With such indications, surgical methods are used to reduce the size of the stomach.
Gastric ballooning
The predicted effectiveness of this manipulation is a loss of 40% of the initial body weight. The operation consists in installing a balloon inside the stomach to temporarily reduce its volume. Indications for intervention – BMI over 30-35 units. This manipulation is performed under anesthesia by analogy with gastroscopy. An elastic container made of thin silicone is introduced into the stomach through the mouth. It is filled with water tinted blue. Such a precaution is necessary so that, if the integrity of the bladder is violated, the patient can determine this unfortunate circumstance by the color of his urine.
However, patients almost never have to go to the doctor with such complaints, since the likelihood of such incidents is too small. To prevent the destruction of the walls of the silicone container by the aggressive environment of gastric juice, patients take medications that reduce the acidity of the stomach.
After withdrawal from medication sleep, the patient can leave the hospital.
Possible symptoms in the first few days after ballooning:
Nausea,
Vomit,
burp,
Taste of rubber in the mouth.
After 5-7 days, adaptation to a foreign body in the stomach ends and discomfort is no longer felt. The term of stay in the stomach of the balloon is six months. During this time, the patient gets used to doing small portions of food, body weight is reduced by 40%. The next and final stage is the removal of the balloon from the stomach. Manipulation is carried out under anesthesia, under the control of a gastroscope. The container is pierced, the liquid is pumped out of it and the balloon is taken out of the stomach. The main task of the patient after ballooning is not to return to the previous eating habits, to maintain the achieved results.
Banding of the stomach
The effectiveness of this surgical manipulation is the ability to lose 50% of the original weight. Indications for a bandage on the stomach – BMI above 30 units. The patient must be over 18 years of age.
Contraindications for manipulation:
Childhood and adolescence;
Elevated hell;
Pregnancy;
Alcohol addiction;
The use of hormonal drugs;
Autoimmune pathologies in history.
Sequence of laparoscopic bandaging operation:
The patient is given general anesthesia, 5 punctures are made in the abdominal wall.
Under the control of special equipment (a miniature camera and a special monitor), a bandage ring is mounted around the stomach and fastened.
A tube is passed from the bandage with access to the adjustment port on the anterior wall of the chest under the ribs.
After 2 months, a saline solution is injected through the port into the bandage, thereby reducing the size of the stomach. After surgery to reduce the stomach, you need to eat mostly soft food, in small portions, do not drink water with food.
After 6 months, the bandage is blown off, removing the liquid through the port to the outside.
When returning excess weight, the procedure is repeated.
The ring must be removed to alleviate the psychological state of the patient, forced to live with a miniature stomach. Not everyone can eat meager portions of food, not feel hungry and maintain their former self-awareness. Even preliminary work with a specialist psychologist does not always help to overcome such a test.
Unfortunately, not all patients are able to keep the results. After returning to the previous size of the stomach, some operated patients add the volume of their portions and gain weight again.
gastrectomy
This major surgical intervention is performed with a BMI over 40 kg/m2. It is performed as a result of laparoscopic surgery under general anesthesia and radically changes the anatomy of the stomach. Briefly, this operation can be described as the complete removal of the stomach. From it remains a small tube no more than one and a half centimeters in diameter. After 5-6 days, the patient can return home.
Nutrition rules in the postoperative period:
Within 2 weeks, you should eat liquid food: broths, juices;
After this time, the patient switches to yoghurts and pureed vegetable purees;
After 5 weeks, they switch to the usual diet;
All food should be chewed thoroughly;
To replenish useful minerals and vitamins, complex preparations should be taken;
You may need to take medication to help digest food.
This intervention radically changes not only eating habits, but the whole way of life of a person. The former weight is reduced by half, but it will not be possible to return the usual volume of the stomach. This psychological discomfort can not be overcome immediately, the help of a specialist will be required.
Gastric bypass
The indications for shunting are the same as for gastrectomy. Bypass surgery is the creation of a new additional pathway around the stomach using a shunt system. During this operation, the cavity of the digestive organ is divided into 2 parts, one of which is connected to the small intestine, where most of the nutrients are absorbed.
Thanks to this tactic, most of the stomach is not involved in the process of digestion, and saturation occurs much faster than before.
The operation takes place in 2 stages:
After performing 8 punctures in the abdominal wall, the surgeon performs a resection of the stomach and cutting out a new digestive organ with a volume of up to 30 ml.
A part of the small intestine is shortened, intensively absorbing nutrients, and the remaining segment of the intestine is sutured to the truncated new stomach.
Thus, 2 goals are achieved at once – the volume of food consumed is reduced and fewer calories are absorbed.
Possible Complications of Gastric Bypass:
Inflammation of the peritoneum due to poor-quality suture and leakage of the liquid fraction of food. Peritonitis threatens the patient with a fatal outcome.
The appearance of scar tissue in the intestinal lumen, decreased patency. To treat this complication, a special balloon is inserted into the intestinal lumen.
Violation of the blood supply to the sutured part of the stomach and the formation of ulcers on it, occurs due to smoking, stress, high acidity.
The appearance of dumping syndrome due to the excess of the allowable amount of carbohydrates in the diet. Symptoms: pain in the epigastric region, cold sweat, tachycardia.
Such complications are extremely rare, since such operations are performed by highly qualified specialists. After shunting, as well as after gastrectomy, the volume of minerals and vitamins should be replenished by additional intake of special means. The peculiarity of this type of surgical intervention is a long postoperative period.
Surgery to reduce the stomach surgically is carried out after a thorough examination of the patient and in the absence of contraindications. They are used only in cases where other means are found to be ineffective. To maintain the results achieved, to avoid the appearance of flabby skin and muscles, you need to use physical activity, take vitamin and mineral complexes.