Index
- Obesity surgery, a necessary evil
- The different operations of obesity surgery
- Non-compliance with the standards observed in obesity surgery
- The various complications caused by obesity surgery
- Complications during the operation
- Post-operative complications
- The importance of follow-up after obesity surgery
Obesity surgery, a necessary evil
Obesity surgery is the set of surgical techniques used to treat severe obesity. The principle consists of reducing the ingestion or absorption of food. It is performed on a person with a body mass index higher than 40 or 35 depending on the case. The person must have a real desire to lose weight and be between 18 and 60 years old. Their weight must be stable over time. It is important that they have the will to change their eating habits after the operation, otherwise surgery would be useless.
The different operations of obesity surgery
The 4 main operations that can be performed on the patient in obesity surgery are :
- Le bypass gastrique : Offered to people with a BMI greater than 45, this operation consists of completely changing the morphology of the stomach. It is a complex operation in the sense that the entire upper part of the stomach will be sectioned. The patient will end up with a reduced stomach size, a small gastric pouch. The amount of food ingested will decrease considerably and it will pass directly into the middle part of the small intestine. The first metre of the small intestine and a large part of the stomach will no longer take part in digestion.
- L’anneau gastrique : It is an obesity surgery L’anneau gastrique : technique that allows you to lose weight. The surgeon will reduce the volume of the stomach with a ring whose diameter can be modified. The band will be placed around the upper part of the stomach. The stomach will decrease in volume to become a small gastric pouch. In the same way, very little food will be able to pass through and will be enough to fill this pouch. The feeling of satiety is rapid.
- La sleeve gastrectomie : The operation consists of removing two thirds of the left side of the stomach by ablation. It promotes a rapid feeling of satiety in the patient who loses weight considerably. The surgeon performs this surgical procedure on patients with a BMI greater than or equal to 40 (morbid obesity). The patient with severe obesity associated with comorbidities can also benefit from it. The co-morbidities may be high blood pressure or type 2 diabetes.
- Le ballon gastrique : The operation consists of the insertion of a temporary device, a gastric balloon, in order to change the patient's eating habits. The gastric volume will be temporarily reduced giving the patient a feeling of rapid satiety. It is particularly indicated for patients with non-morbid obesity (BMI > 27). The methods they have used to lose weight have also not given any results.
Non-compliance with the standards observed in obesity surgery
Obesity surgery, in order to be regulated, must comply with the recommendations of the HAS (High Authority for Health). However, more and more establishments are now performing these operations without complying with the standards. The consultation of several specialists is required before performing this operation. The patient must also be psychologically monitored and undergo a full medical check-up. This is not always the case and there are many reasons for this.
- The number of patients in a hurry to lose weight is constantly increasing.
- More and more institutions are performing the procedure on a large scale.
- The 6-month pre-operative course is too long for some patients.
With more than 500 establishments performing bariatric surgery, it is obvious that regulation of this surgery is necessary. Indeed, patients deserve proper care by a good professional and post-operative follow-up.
The various complications caused by obesity surgery
Complications during or after the operation are not to be neglected. They must be known so that the patient knows what to expect when agreeing to undergo obesity surgery.
Complications during the operation
Overweight can be a source of difficulty during the operation. The patient's morphology may cause discomfort. For example, a bulky organ can obstruct the view of the operating field. The risk of bleeding can sometimes occur, but this is a very rare occurrence. Otherwise, complications may arise from previous operations the patient underwent before the obesity surgery. The surgeon will have to switch to the laparotomy technique to avoid damage.
Post-operative complications
A blood clot may form in the pulmonary artery due to the patient's obesity. The patient's long immobilisation during the operation may also be the cause of this pulmonary embolism. Other concerns may arise after obesity surgery, such as the appearance of haematomas or abscesses or poor healing of stitches.
The importance of follow-up after obesity surgery
Long-term follow-up of the patient is of paramount importance to achieve concrete results. The goal is that he or she should not return to the same weight after using obesity surgery to lose weight. Thus, the follow-up will be based on nutritional and psychological aspects. In all cases, the patient is the actor in the follow-up of the operation. It is up to the patient to maintain a stable weight or to let go at the risk of relapse.
