Bariatric and Metabolic Surgery
Metabolic – Bariatric Surgery
If you look at the number of severely overweight people, Germany is way ahead compared to its neighboring countries, but there are far more bariatric interventions in the neighboring countries than in Germany. Nevertheless, bariatric metabolic surgery has also made a name for itself in Germany in recent years and has developed into a renowned specialty of visceral surgery.
Individual decision – the choice of the surgical method
Despite the numerous interventions in recent years, no uniform standard method has developed in bariatric metabolic surgery. Every decision on the operation and the method used is an individual decision. The most common restrictive procedures include the gastric sleeve (sleeve gastrectomy) and the gastric band (gastric banding). The gastric band ties off the upper part of the stomach from the rest of the stomach, leaving the patient with only their forestomach to eat. With a gastric sleeve, the surgeon removes most of the stomach. Both methods ensure a reduction in the size of the stomach, which results in a massive reduction in weight. In addition to the two variants, there are also different types of gastric bypass.
The gastric bypass and the omega loop
Gastric bypass is also called Roux-Y gastric bypass and refers to the complete severing of the stomach in the upper segment. The surgeon creates a small stomach pouch, which he then connects to the small intestine. The remaining part of the stomach as well as parts of the upper small intestine and the duodenum are completely excluded from digestion after the operation. Due to the delayed mixing of digestive juices and food, a large part of all calories supplied is not utilized and is excreted again through the stool without being utilized. The omega loop is a smaller version of the gastric bypass. With this method, no surgical influence is taken on the digestive tract.
The Metabolic Surgery
When talking about bariatric surgery, one rarely hears about metabolic surgery, although this is also part of bariatric surgery. Metabolism comes from the Greek and means metabolic processes or metabolism. Metabolic surgery is very old, without being widely used by name, because according to the definition, metabolic surgery refers to operations on a functionally and anatomically correct organ system or individual organ. The aim is to have a positive effect on health by having biological effects on metabolic processes. A good example of metabolic surgery is surgery for an ulcer disease, i.e. an ulcer on the duodenum. For this purpose, surgeons have been operating on completely intact stomachs for more than 100 years, such as partial removal, interventions on the pylorus and nerve transections in order to be able to heal the said ailment.
Metabolic surgery in bariatric surgery
Bariatric surgery also involves an intervention on an organ that is usually completely intact, namely the stomach. The consequences of this should not only be a reduction in weight, but also a significant improvement in the entire health area, e.g. B. the lipid metabolism, blood pressure and diabetes. For this reason, it can be said that metabolic surgery is not only related to bariatric surgery, but also to diabetes surgery.