Individual decision – the choice of operation method
Despite the numerous interventions in recent years, no uniform standard method has been developed in bariatric-metabolic surgery. Every decision on the operation and the method used is a case-by-case decision. The most common restrictive procedures include the sleeve gastrectomy and gastric banding. The gastric band constricts the upper part of the stomach from the remaining part, so that the patient has only his stomach for food intake available. With a tubular stomach, the surgeon removes most of the stomach. Both methods thus provide for a reduction of the stomach, which have a massive reduction in weight result. In addition to the two variants, there are also different types of gastric bypass.
The gastric bypass and the omega loop
The gastric bypass is also called Roux-Y gastric bypass and refers to the complete transection of the stomach in the upper segment. The surgery forms a small stomach pocket, which then connects to the small intestine. Both the remaining part of the stomach and parts of the upper small intestine and the duodenum are completely excluded from digestion following the operation. Due to the delayed mixing of the digestive juices and food, a large part of all added calories is not utilized and excreted again unused by the stool. The omega loop is a smaller version of the gastric bypass. With this method no operational influence on the digestive tract is taken.
When talking about bariatric surgery, one rarely hears about metabolic surgery, which is also part of bariatric surgery. Derived from the Greek, metabolism means metabolic processes or metabolism. Metabolic surgery is already very old, without which it is especially common, because by definition metabolic surgery refers to operations on a functionally and anatomically correct organ system or single organ. The aim is to have a positive effect on health by having biological effects on the processes of metabolism. A good example of metabolic surgery is surgery for ulcer disease, a duodenal ulcer. For this purpose, for more than 100 years, surgeries have operated on completely intact stomachs, such as partial removal, pyloric interventions, and nerve tears, in order to cure this condition.
Metabolic Surgery in Bariatric Surgery
In a bariatric operation, there is also an intervention on a usually completely intact organ, namely the stomach. The consequences are not only a reduction in weight, but also a substantial improvement in the entire health area such as lipid metabolism, blood pressure and diabetes. For this reason, it can be said that metabolic surgery is not only associated with bariatric surgery, but also with diabetes surgery.