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Weight loss surgery, which is also known as Bariatric Surgery consists of a variety of medical procedures that assist you in losing weight. When you have serious medical conditions because of your weight or if you can’t lose weight through diet and exercise, weight loss surgery may be an option. The goal of these operations is to modify the stomach and intestines to treat obesity and related diseases. There are many benefits from Bariatric Surgery that will allow patients dealing with obesity to live longer, prevent future health problems, and enjoy a better quality of life. There are also risks, side effects and complications that can occur after a weight loss surgery such as blood clots, excessive bleeding, hernias, and infections. Patients are required to exercise regularly, make healthy changes to their diets, and maintain a permanent healthy lifestyle to ensure the long-term success of their Bariatric Surgery. There are various types of Bariatric or weight loss surgeries available. 

Sleeve Gastrectomy (Gastric Sleeve): This procedure requires a surgeon to remove 75-80% of the stomach. A sleeve Gastrectomy is a simpler, lower-risk weight loss surgery than others that may be too risky for a person who is sick or has medical issues. The outcome of this surgery prevents your stomach from holding as much food and produces less of the appetite-regulating hormone ghrelin, which may lower your craving to eat. Unlike gastric banding, a sleeve gastrectomy is an irreversible procedure. 

Gastric Bypass Surgery/Roux-en-Y: Gastric Bypass is the most common type of Bariatric surgery. During this operation, the surgeon divides the stomach into two parts, a small upper pouch and a lower pouch that is a lot larger. The upper stomach is then connected directly to the lower section of the small intestine. After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine. This decreasing of the stomach creates a shortcut for the food and allows only small portions of food to be consumed which limits the nutrients and calories absorbed. The objective of a Gastric Bypass surgery is to make you feel full quicker, so you don’t overeat. Some advantages of this procedure are, continued weight loss for 18-24 months after surgery, quick and dramatic weight loss, increased mobility, and a better quality of life. Studies have found that most patients have good long-term results keeping most of their weight off for 10 years or longer. This procedure is riskier and more complicated than other Bariatric surgeries. Gastric Bypass is generally irreversible. 

Adjustable Gastric Band (LAP-BAND): This procedure requires a surgeon to wrap an adjustable(inflatable) band around the top portion of your stomach which creates a small pouch above the band on the top of the main stomach, connected to it by a small channel. The band squeezes the stomach into two sections: A small upper pouch and a larger lower section. The smaller upper pouch fills up very quickly from small portions of food which helps you to lose weight quickly. This procedure slows down the passage of food that goes into the main stomach, which in turn reduces the quantity of food intake. After surgery, patients can have the band adjusted at a doctor’s office to tighten or loosen it. The opening to the main stomach can be controlled by inflating or deflating the band with a port implanted under the skin. This surgery is reversible, simpler to do and much safer than Gastric Bypass and other surgeries.

Vagal Blockade (vBloc): This procedure requires a surgeon to implant a pacemaker-like device called a blockade device that sends regular electrical impulses to the vagus nerve, which in turn signals the brain that the stomach is full. This device is placed under the rib cage and is operated by remote control that can be adjusted outside the body. This procedure has a very low rate of complications and is the least invasive of the weight loss surgeries. 

Gastric Balloon/Intragastric Balloon System: This procedure requires a surgeon to place a deflated balloon in the stomach through the mouth. Once the balloon is in place, it is then inflated causing you to have a decreased appetite, and a sense of fullness which will help you to lose weight. 

Aspire Assist: This procedure requires a surgeon to place a tube through a small abdominal incision which is connected to a port that lays on the outside of your stomach area. Shortly after a meal, the patient will attach a tube and pump to the port which will remove a portion of your stomach contents. This process helps patients lose weight because a large portion of a meal will be removed from your stomach before your body has a chance to digest the food and absorb it. The device removes about 30 percent of calories consumed. 

Duodenal Switch: This procedure requires a surgeon to staple about 70% of the stomach off and leave the rest of the stomach connected as it normally does to the first part of the intestine (the Duodenum). This makes the stomach a lot smaller. The intestine is then cut before it reaches the appendix and then re-attached at a lower area of the intestine. This prevents the bile and digestive juices to only begin processing the food when it gets further down the intestine resulting in less caloric absorption.  Duodenal weight loss surgery helps shorten the path food follows through the small intestine. In turn, this reduces the time your body must absorb calories from the food you eat to help you lose weight. This surgery also makes you feel full sooner and causes your smaller stomach to secrete fewer hunger-causing hormones which means you won’t feel as hungry. 

Bariatric surgeons often start out as general surgeons. Obtaining a doctor’s education in Bariatric Surgery requires a four-year undergraduate degree, then four years of medical school, and a five-year residency program. After the residency program is completed, a small group of the best candidates are selected from each medical program to participate in a fellowship training program. Fellowship training is a privilege that only top doctoral candidates are chosen to participate in to become a specialist or experts in their chosen field of medicine or surgery. Fellowship training is part of the process of becoming a specialist physician and requires an additional year or two of education. During fellowship training, a physician goes through rigorous training to become an expert in their subspecialty. The fellowship training program consists of practical experience which includes participation in numerous specialized surgeries which provides significant work experience the physician needs to become a specialist in his/her chosen field to receive their credentials. Physician’s that choose this path are committing to extra education and are devoted to providing the best medical care possible to patients. A Board-certified doctor indicates that a physician has achieved the highest level of accreditation within a given specialty. Board certification is a voluntary, additional step that a physician chooses to prove that they are trained in the latest technology and advancements in their specialty. Physicians are required to successfully pass written and oral board examinations in their specific specialty to verify knowledge, competency, and expertise in their specialty and/or subspecialty of medical practice. Most boards require that physicians recertify throughout their careers to ensure and promote ongoing professional development, practice assessment, and improvement.  Bariatric Surgeons may become board certified through the American Board of Obesity and/or become members of the American Society for Metabolic and Bariatric Surgery. Choosing the right Bariatric Surgeon depends on your needs. Always consider a candidate’s overall qualifications, experience, services offered, and patient satisfaction when choosing a physician.  Always check for all necessary board-certified training and degrees, up to date certifications through an accredited healthcare institution and a valid license to practice through the respective state of Bariatric Surgery or state/international medical board in their country. Look for a physician who has completed an accredited fellowship in a sub-specialty related to your condition or the surgery you have elected. Accreditation information, including fellowships and board certifications can usually be found on a physician’s official online profile. If it’s not, make sure that you request this information. When you, a family member, or friend needs a medical treatment, you want to make sure that you choose a highly qualified doctor who is dedicated to providing outstanding care. 

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