Obesity has profound health implications and affects your quality of life. Bariatric surgery offers a long-term solution to help you overcome obesity and achieve long-term weight loss.
Surgery for weight loss reduces your appetite and helps you develop new behaviors that support a healthy lifestyle as we advance. A statistician will extract outcomes from both surgical and non-surgical studies for pooling comparisons.
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Gastric Balloon
Intragastric balloons are effective because they encourage weight loss by occupying space in your stomach and serving as built-in portion control. They are also an effective tool to help you manage weight-related health issues, such as high blood pressure and type 2 diabetes.
The saline-filled, spherical silicone balloon is placed through a non-surgical outpatient endoscopic procedure under light sedation. The saline solution-filled balloon should remain in your stomach for six months.
At the International Workshop on Intragastric Balloons, held in Tarpon Springs, Florida, in 1987, experts established the characteristics of the ideal intragastric balloon (“IGB”). They defined a spherical balloon, made of a flexible, semi-rigid, and transparent material (silicone), saline-filled and having a diameter between 400 and 500 cc, with a radio-opaque marker. This site has been shown to reduce esophageal reflux symptoms, gastric ulcers, and migration rates.
ReShape Duo is an integrated dual balloon system consisting of two independently filled saline-filled silicone spheres and a short, non-communicating flexible silicone shaft. This design was intended to decrease the risk of balloon intestinal migration should one of the spheres accidentally deflate. This system has FDA and CE approval.
Endoscopic Sleeve Gastrectomy (ESG)
Bariatric surgery is a well-known treatment for severe obesity, but some people may not be able to qualify due to their age or medical history. Endoscopic Sleeve Gastroplasty (ESG) is a practical, non-surgical weight loss procedures option for patients not candidates for traditional bariatric surgery.
ESG is an outpatient procedure performed under sedation using an endoscope, allowing minimal discomfort. The physician creates a sleeve-like structure in the stomach by stitching the walls together during the procedure. It reduces stomach capacity and alters satiety-inducing hormones, encouraging weight loss and limiting overeating.
One study found that ESG patients lose between eighteen and twenty percent of their body weight a year after the procedure. This amount is comparable to surgical sleeve gastrectomy, but ESG is less invasive. In addition to the weight loss, the ESG and LSG cohorts improved their quality of life, decreased HbA1c, and reduced triglycerides.
Although this treatment is effective for many patients, there are some potential complications. One concern is that reducing stomach capacity can lead to nutrient deficiencies, which could require using vitamin supplements after the procedure. Additionally, a small percentage of patients experience new-onset gastroesophageal reflux disease. However, these symptoms typically improve with time and are often controlled with medication. For this reason, it is essential to discuss the benefits and risks of ESG with your doctor before undergoing the procedure.
Gastric Bypass
A gastric bypass is a restrictive-malabsorptive surgery used to treat obesity and related comorbidities. The procedure changes how the stomach and small intestine work, affecting food absorption and the gut-hormone levels that govern hunger. Various versions of this surgical procedure exist, with differences in the lengths of segments of the stomach and small bowel used and their effect on food absorption.
These endoscopic weight loss procedures are performed as outpatient procedures, which allow patients to return to their daily lives sooner and reduce the risk of complications. Additionally, they are less costly than surgical options and have fewer risks, such as infection or prolonged hospital stays.
Because these techniques do not involve making incisions, they also have a lower risk of complications such as blood loss, wound infections, and hernias. It is because they do not entail a lengthy recovery period that necessitates extended absences from work or the ability to perform physical activity.
One of the biggest concerns associated with bariatric surgical options is the increased likelihood of developing blood clots in the legs or pelvis due to decreased venous flow following surgery. A potentially fatal illness known as pulmonary embolism can develop when blood clots become loose and move to the lungs. It is a serious concern that requires immediate attention. Fortunately, blood thinners can significantly decrease the chances of this severe complication.
Gastric Sleeve
A gastric sleeve surgery reduces the stomach size by folding over a portion of the stomach. The stomach’s capacity is restricted, avoiding overeating and excessive weight gain. On average, patients lose 25% to 30% of their body weight within two years after the procedure.
The sleeve surgery can be an alternative to gastric bypass surgery for patients too heavy for that operation. During the procedure, surgeons make several minor cuts in your belly, insert a laparoscope (an instrument with a camera that sends pictures to a monitor) and then remove 3/4 of the stomach.
After surgery, patients eat sugar-free liquids for the first seven days and then gradually progress to pureed foods and solids. They must also take daily multivitamins and vitamin B-12 injections for life.
A gastric sleeve’s most common side effects include vitamin deficiencies, heartburn, and gallstones. The part of the stomach that’s removed during this operation partly absorbs vitamins, so if you don’t get enough from your diet, it can lead to vitamin deficiencies. The sleeve surgery can also cause or worsen heartburn, usually treated with over-the-counter medications. Additionally, rapid weight loss can make gallstones more likely. These can be diagnosed through a physical exam or with an ultrasound test.
