Surgical practices
When bariatric surgery is considered, an extensive medical check-up must be conducted to accurately assess the state of health of the patient and decide on the nature of the intervention before submitting an authorisation request to the health insurance doctor.
1) “RESTRICTIVE” INTERVENTIONS
“Restrictive” interventions (which aim at limiting the quantity of food that can be ingested) are highly recommended for people who never feel satiety and who eat too much during any given meal.
INTRAGASTRIC BALLOON
A saline-filled intragastric balloon can help in weight loss among patients whose BMI is above 30. The balloon is inserted under mild sedation and tracheal anaesthesia by endoscopy. This is therefore a non-surgical and reversible intervention, since the balloon is removed after 6 to 9 months by endoscopy.
- Pure endoscopy technique
- Reversible
ADJUSTABLE GASTRIC BAND
The technique consist in placing an adjustable silicone band around the top portion of the stomach. This technique thereby creates a small pouch in the proximal section. Its dilation by small amounts of food is perceived by the brain as a dilation of the entire stomach and generates an early sense of satiety.
- Simple operation
- Adjustable and reversible system
SLEEVE GASTRECTOMY
This technique consists in the definitive removal of a large portion of the stomach, resulting in a tube-like structure to provide an early sense of satiety.
- Rapid weight loss
- Absence of food-related frustrations
2) INTERVENTIONS COMBINING THE RESTRICTIVE ASPECT WITH MALABSORPTION
When the patient displays dietary habits whereby he/she is constantly snacking, or if the patient is diabetic, it is advised to perform an intervention that combines the restrictive aspect and malabsorption.
GASTRIC BYPASS
This technique consists in vertically dividing the stomach to create a small proximal pouch (restriction). This pouch is then directly connected to the jejunum, thereby short-circuiting a large part of the stomach and of the duodenum and proximal jejunum.
- Faster weight loss at the beginning of the treatment
- Absence of food-related frustrations
- Improved control of diabetes
Source: Team Obesity Clinic - Last update: 17/02/2020
