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бандажирование желудка с применением системы Bioring

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Bariatric Surgery


Weight loss surgery


The name ‘Bariatric surgery’ is derived from the Greek words baros and iatrike denoting respectively ‘heaviness’ and ‘medicine’, and deals therefore with obesity and problems associated with excessive weight.

Sufferers who have tried unsuccessfully to lose weight through dieting, physical activity, pharmaceutical and dietary supplements and other forms of conservative treatment, and who find their health adversely affected, have still the option of bariatric surgery as the most effective and permanent means of weight loss.

With only 1% of sufferers maintaining their new weight after dietetic and medical treatment (and many of the other 99% returning to their full previous weight or an even greater one), more and more people are opting for surgical treatment to lose weight, improve their health and prolong their lives.

Whether weight loss surgery is suitable for a particular individual depends on his Body Mass Index (BMI). Surgery is recommended if this is 40 or higher, though the necessary BMI level decreases to 35 in the presence of such additional factors as high blood pressure, diabetes, joint problems and varicose veins. (BMI can be measured here.)

For half a century surgeons have been trying to improve the results of obesity treatment, and the basic procedures thus developed are detailed in the article ‘History of bariatric surgery’. The following table presents a classification of bariatric operations according to mechanism.



SIMPLE CLASSIFICATION OF METHODS OF WEIGHTLOSS SURGERY



Mechanism
of action

Operation

Effectiveness

Comments

Decrease of absorbtion of nutrients in the digestive tract (malabsorption)

Jejunoileal bypass

•••••

No longer performed owing to high level of complications.

Biliopancreatic bypass

•••••

Rarely performed owing to relatively high incidence of long-term metabolic consequences.

Narrowing of the lumen of the stomach (restrictive operations)

Sleeve gastrectomy

••••

Relatively new operation of high effectiveness.

Antireflux sleeve gastroplasty

••••

New operation of high effectiveness.

Adjustable gastric banding

•••

World standard.

Vertical gastroplasty

••

Rarely performed; does not give stable weight loss.

Combination of both above-mentioned mechanisms (malabsorption + restriction)

Gastric bypass

•••••

World standard.

Reduction of internal gastric capacity

Intragastric balloon

••

Not strictly surgery, but rather an outpatient endoscopy procedure. Gives a temporary effect.

Decrease of the appetite

Gastric electronic pacemaker

?

Experimental work.



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