Bariatric Surgery Definition-Tests & Procedures

Bariatric surgery aids in weight loss by altering the anatomy of the digestive system, it primarily limitsthe intake of food and the amount of food that can be digested.

Let’s take a look at the common types of bariatric surgery:

1. Roux-en-Y (roo-en-y). This is the most common gastric bypass surgery. This surgery is not reversible. The surgeon creates a small upper pouch using the upper part of the stomach and then cuts the small intestine and sews it to this newly created pouch.The small pouch can now hold a limited quantity of food and then the food bypasses the major part of the stomach and moves into the middle part of the small intestine. The food intake and nutrients absorbed is considerably reduced hence aiding in weight loss.

1. Biliopancreatic diversion with duodenal switch. This is a complex procedure. In this procedure about 80 percent of the stomach is removed. The valve (the pyloric valve) from the newly created stomach releases food to the small intestine that is connected to the stomach (duodenal switch and biliopancreatic diversion). This surgery both controls the quantity of food you can eat and reduces the absorption of nutrients. This procedure has a lot of risks associated with it. It's generally used for people who have a body mass index (BMI) greater than 50.

1. Laparoscopic adjustable gastric banding (LAGB). In this typeweight-loss procedure, the surgeon places an inflatable band around the topmost part of the stomach. The band is can be adjusted by varying the amount of saline solution in the band. The band compresses the upperpart of the stomach creating a very small upper pouch that connects with the rest of the stomach through the narrowpassage created by the band. The small upper pouch restricts the intake of food. LAGB is not as effective other weight loss procedures.

1. Vertical banded gastroplasty. This procedure uses staples to create a small upper pouch hence limiting the intake of food. The food from upper pouch is small and empties into the rest of your stomach. This weight loss surgery is not as popular as the others.

1. Sleeve gastrectomy. A sleeve gastrectomy, also called a vertical sleeve gastrectomy, is a more recent type of weight-loss surgery. In sleeve gastrectomy, the anatomy of your stomach is changed to be shaped like a banana using laparoscopic methods, which limits the amount of calories absorbed by the body.

The type of weight-loss surgery that is best for you depends on your medical condition.  Before conducting the procedure, your surgeon will have to consider many factors such asyour BMI, eating habits, health problems and the risks of each procedure.

 

Diagnostic Tests before a Weight Loss Surgery

 

Possible diagnostic tests that a patient might have to undergo before a weight loss surgery

• Body mass index, or BMI, is the basic test to determine your eligibility for weight loss surgery.The BMI will help identify the procedure thatbest suits your medical condition.

The various tests conducted before you are proven eligible for a surgery range from physical to psychological. Physical tests may include heart, lung and kidney function as well as an assessment of your overall health. Each of these tests helps the surgeon to ascertain the likely risks of surgery and how to minimize them. Some of the Physical tests are as below

• CXR ora chest X-ray is the most common imaging test or X-ray used to identify problems inside the chest.
• Electrocardiogram (EKG or ECG) is a test that helps identify problems with the electrical activity of your heart and check the overall health of the heart. This test is done  to determine unexplained chest pain, inflammation in the areas surrounding the heart .To identify the cause of symptoms  of heart disease such as palpitations ,shortness of breath and dizziness and also.
• Blood Work-A blood test , also known as blood work, is a laboratory analysis performed on a blood sample that is used to determine physiological and biochemical states, such as disease, mineral content, drug effectiveness, and organ function.
• CBC -A complete blood count (CBC) is a blood test used to assess your overall health and detect a wide range of diseases, including anemia, infection and leukemia. An unusual increase or decrease in cell counts as detected in a complete blood count may indicate that you have an underlying medical problem that needs further diagnosis.
• Complete metabolic panel including calcium and liver function tests -A complete metabolic panel is a blood test that analyses your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.This test can be used to check high blood pressure and diabetes.
• Thyroid function tests –A Thyroid function testis used to assess the thyroid's functioning and to diagnose and help determine the cause of thyroid diseases.
• Lipid panel –is a blood test to determine the level of bad cholesterol
• Fe Panel- is a blood test to determine the iron content in the blood; this is used to diagnose medical conditions such as anemia.
• B12-is a test to determine the amount of vitamin B12 in the blood.
• Folate tests are used to estimate the amount of folic acid in the blood and Thiamine tests help diagnose a deficiency in thiamine.
• Other tests include homocysteine, C-Reactive Protein, Lipoprotein a, Cardiac Echo Stress Test/Cardiac Catherization – abnormal cardiac echo, family hx, IDDM, HTN, >20-pack year history, age >50, other cardiac risk factors – elevated lipids etc.
• Greenfield Filter – To prevent the blood clots to travel from the legs to the lungs, your surgeon may place temporary filters. This is usually done for patients with a history of blood clots.

Your surgeon may also advise you to visit a psychologist and dietician to know more about what to expect after the surgery and to get a complete overview of your responsibilities in the long run. The dietician will assess whether you can accustom yourself to permanent lifestyle changes.