The term "bariatric surgery" refers to a variety of surgical interventions aimed at assisting those suffering from morbid obesity to lose weight. The surgeon either reduces the stomach in the course of a gastric reduction surgery or creates a "diversion" during such so-called bariatric operations. The doctor not only remodels the stomach, but also the intestinal tract, in this type of obesity surgery. All interventions aim to reduce the stomach's capacity, i.e. its volume, so that the affected person is full sooner.
GASTRIC BYPASS: The Roux-Y gastric bypass is the standard procedure. In the first two years after the gastric bypass, this can reduce obesity by 60 to 70%. On the one hand, this is due to the fact that the body absorbs food more poorly as a result of the stomach's altered approach to the intestines. The fact that the operation lowers ghrelin levels, on the other hand, plays a role. This hormone, among other things, is responsible for the sensation of hunger.
GASTRIC SLEEVE: Gastric sleeve is a relatively new standard method that complements the Roux-Y gastric bypass. The doctor removes three-quarters of the stomach during gastric sleeve surgery. After the procedure, the stomach has the shape of a tube. The reduced stomach volume causes the operated person to feel full even after small amounts of food, and the hunger hormone ghrelin is also reduced. This peptide (= amino acid molecule) stimulates the appetite; its level in the blood rises when you are hungry and falls after you eat.
GASTRIC BALLOON: The gastric balloon is actually not part of bariatric surgery. Rather, it is a non-surgical stomach reduction, because the doctor can insert the gastric balloon by placing it over the mouth using a tube for gastroscopy. In the stomach, it then fills the silicone balloon with air or liquid so that there is less space for food and the person concerned eats less. After six months, the doctor has to remove the gastric balloon again.
GASTRIC INJECTION: The injection in the stomach blocks a key nerve in the stomach. This nerve is in charge of hunger and satiety. When the nerve is treated with gastric injection, the patient's hunger decreases and he or she consumes fewer calories. The injection paralyzes the vagus nerve, which connects the brain to the stomach. As a result, the sensations of hunger and satiety are controlled, which has been lost in many obese patients over the years.
Diabetes Surgery (SADI-S): The SADI-S is a biliopancreatic diversion modification. Laparoscopic surgery is also used for this procedure. The passage of food through the duodenum is completely stopped in this procedure, which is similar to the Roux-Y gastric bypass. It is, however, a single anastomosis bypass. To accomplish this, the duodenum is removed blindly and a 200 cm long loop of small intestine is formed, which is anastomosed directly postpylorically with a gastric sleeve. In the event of insufficient weight loss or resumption of weight gain following gastric sleeve surgery, this procedure is especially well suited as a second step. Following the procedure, regular vitamin checks and vitamin substitution are required.