Bariatric surgery: gastric band, resection or by-pass

Bariatric operations are conducted in order to minimize the need for food intake (by reducing the capacity of the stomach) or limiting the absorption of consumed products (by shortening the path of food through the intestines).

Three types of surgery

Most often three types of surgery are performed. The first one involves the implantation of an adjustable gastric band. The band is placed around the upper part of the stomach and divides the stomach into two parts, a smaller one at the top and a larger one at the bottom. The narrow isthmus between them makes the food pass more slowly and gives a feeling of satiety which lasts longer.

The second type of surgery is gastric resection. It involves the removal of 80% of that part of the stomach where ghrelin, the hormone responsible for appetite, is produced.

The third type of surgery is called gastric bypass. The stomach is divided into two parts, the smaller of which is only 10% of its capacity, and is connected to the small intestine (where food is absorbed). The larger part of the stomach, duodenum and part of the small intestine are excluded from digestion, but are involved in the production of enzymes and hormones.

Most of the operations are performed laparoscopically with the use of minimally invasive methods. This procedure involves the introduction of instruments through short incisions (5 to 15 mm) in the abdominal wall. Some treatments, however, must be performed with the use of the classical open technique (open abdominal cavity).

A chance for a normal life

Professor Mariusz Wyleżoł from the Military Institute of Aviation Medicine says that the indications for surgical treatment of obesity concern approximately 1.5 million Poles, however, only 1,500 bariatric surgeries are performed every year in Poland.

"We don't see people with this type of obesity every day. They don't leave their homes and can’t function normally. In many cases, there's not even a chance to provide them with the same kind of health and medical care as the other patients. The stretchers in ambulances are designed for patients who weigh up to 135 kg, while patients with pathological obesity may, in many cases, greatly exceed this limit," Professor Wyleżoł explains.

According to the experts, bariatric procedures give these people a great opportunity for leading normal lives. As shown by an analysis of 1421 operations which have been carried out in the UK, people with morbid obesity lose 60% of excessive weigh within one year as a result of the operation. What's more, the risk of death decreases by almost a half over the next 7-8 years.

Operation safety

The operations are relatively safe. The research carried out by the specialists of the University of Michigan has shown that only 7 patients out of 100 develop any kind of complications. The most common cause of their problems are hard-to-heal wounds.

Lethal complications are much less frequent; they occur once in every thousand patients. The main causes are pulmonary embolism and leakage of intestinal content that requires immediate reoperation and, if detected too late, may lead to death.

The experts point out that it is much more dangerous to leave extremely obese people without any proper help. According to the calculations provided by Professor Wyleżoł, every year in Poland approximately 5,000 people with morbid obesity die as a result of being treated improperly or not treated at all, forgotten and frequently suffering humiliation.