Bariatric surgery: gastric balloon, gastric band and stomach reduction

Obesity has reached epidemic proportions worldwide and it affects both high-income countries and low- and middle-income countries, especially in urban areas. This data leads us to reflect on whether we follow one and the importance of prioritize more natural foods and nutritious and dispense with the processed, high caloric load and little nutritional contribution.

The World Health Organization associates obesity with numerous chronic diseases such as diabetes, cardiovascular disease and cancer. Therefore, at present, there are multiple slimming techniques. All of them seek to provoke a weightloss in the short term through different mechanisms, whether we talk about non-surgical procedures (gastric balloon) or surgical procedures (gastric band or stomach reduction), all of them are looking to cause a short-term weight loss through different mechanisms. Next, we will explain the most used in more detail with its pros and cons.

Gastric balloon

The gastric balloon reduces stomach capacity to store the food we eat, generating a artificial feeling of satiety and preventing consuming the volume of food that we would eat without it. Some studies have shown that the weight loss in people with it is the same as if they had been subjected to a diet plan with the same calorie restrictions.

How does the gastric balloon work?

• First of all, it is a temporary technique since, depending on the type of balloon, it must be removed after 6 to 12 months.
• The volume of the balloon will depend on the body mass index of each patient (BMI). In cases of severe obesity it can reach 700 ml.
• Its implantation is carried out by means of a endoscopy with sedation and once introduced into the stomach swells usually with saline and closes.
• During the first days you can suffer discomfort, nausea and vomiting because the stomach identifies it as a foreign body and tries to expel it until it reaches an adaptation period.
• During the treatment the person will be controlled by a multidisciplinary team that: it will evaluate its evolution, adjust the diet, offer psychological support, define it and carry out controls through analytics to supplement with supplements and vitamin complexes.

Gastric band

Adjustable gastric band is a bariatric surgery procedure used for morbidly obese patients. It involves placing an elastic band or ring that compress the upper part of the stomach (as would a belt) thus reducing its size and creating a sack in which there is very little food. This limits the entry of food into the stomach and slows its passage to the intestine.

How does the gastric band work?

• It is an invasive technique that is performed by laparoscopy under general anesthesia, requires hospitalization.
• The doctor can regulate the degree of compression adding or removing saline solution to the elastic band, enjoying more permanence than the gastric balloon.
• The adaptation is slower and it is advisable to wait at least a week to start an adaptation diet.
• The advantage of the elastic band over other bariatric surgery techniques is that does not modify the anatomy of the stomachTherefore, it is a reversible surgical technique.
• Among its drawbacks is that in some cases can slide the gastric band, causing an enlargement of the stomach volume and in a high number of cases complications such as esophagitis and gastroesophageal reflux appear.
• weight loss is less than in other techniques, so this technique is used less and less.

Other surgical techniques

There are other surgical techniques that consist of shrink stomach by surgery, but irreversibly. These bariatric surgery techniques are considered in cases with morbid obesity, with a BMI equal to or greater than 40, or also in cases with obesity if they suffer a serious pathology, where the risk of continuing with excess weight is greater than their own intervention.

Gastric sleeve or vertical sleeve gastrectomy

It is one of the most practiced and consists of removing most of the stomach leaving a little stomach in the form of a tube or sleeve. With this we get reduce stomach capacity.

Gastric bypass or Roux-en-Y bypass

It is a technique where reduces the size of the stomach so that it is smaller and has very little capacity to store food, about 30 grams. To reduce its size, the stomach is divided into two sections and the upper section, called the stomach pouch, is where the ingested food will arrive. Then a bypass is done where the lower part of the small intestine or jejunum is connected to the stomach pouch, thus managing to derive the food directly to the small intestine without passing through the duodenum and reducing the process of digestion and absorption of nutrients. As a result, the body will absorb fewer nutrients and calories, but it will cause nutritional deficits as it is a malabsorptive procedure.

In conclusion, the different bariatric surgery techniques to treat obesity are not without risks and are considered highly complex. Given their difficulty, they should be carried out by evaluating each case, indicating the best treatment and supervising the evolution of the obese patient. But nevertheless, the success of long-term treatment always it will depend on the person and your willpower to change your lifestyle and eating habits.

Deborah Blasco Nutritional Nurse Specialist