Treatment
- MBS is recommended for individuals with BMI 35 kg/m2, regardless of presence, absence, or severity of comorbidities.
- MBS is recommended in patients with T2D and BMI 30 kg/m2.
- MBS should be considered in individuals with BMI of 30–34.9 kg/m2 who do not achieve substantial or durable weight loss or co-morbidity improvement using nonsurgical methods.
- There is no upper patient-age limit to MBS. Older individuals who could benefit from MBS should be considered for surgery after careful assessment of co-morbidities and frailty.
- Children and adolescents with BMI 120% of the 95th percentile and a major co-morbidity, or a BMI 140% of the 95th percentile, should be considered for MBS after evaluation by a multidisciplinary team in a specialty center.
Metabolic and Bariatric Surgery (MBS) Procedures
Bariatric surgeon determines which kind of operation is recommended depending on the patient’s case and condition, however the final decision is made by the patients after options have been given.
The most common Bariatric Surgeries are:
- Laparoscopic sleeve gastrectomy (LSG): In this procedure, A large part of the stomach is removed, creating a smaller reservoir for food, and the part of the stomach responsible for secreting ghrelin (the hormone that regulates appetite) is removed.
- Laparoscopic RNY Gastric bypass surgery (LRNYGB): by making a small pouch of the stomach and then making two anastomoses, the first between the stomach pouch and the jejunum, and the second is a jejuno-jejunostomy.
- Laparoscopic Single Anastomosis Gastric bypass (LSAGBP): by making a long pouch of the stomach and then performing an anastomosis between the gastric pouch and the jejunum.
Laparoscopic Revision or Conversion Bariatric Surgeries:
- Laparoscopy re-sleeve or converting it to other operations.
- Removal of Gastric Banding and conversion it to other operations.
- Conversion of Vertical Banded Gastroplasty (VBG) to other operations.
- Revision of gastric bypass.
- And other internationally approved operations.
Other Surgeries are performed for selected patients:
- Single Incision Laparoscopic Sleeve Gastrectomy (SILS)
- Laparoscopic Sleeve Gastrectomy with band (Banded-Sleeve)
- Laparoscopic Nissen fundoplication with sleeve gastrectomy (N-Sleeve)
- Laparoscopic Banded Bypass
- Laparoscopic Single Anastomosis Duodenal Ileal Bypass with sleeve gastrectomy (SADI-S)
- Laparoscopic Biliopancreatic diversion with duodenal switch off (BPD-DS )
- Laparoscopic Esophageal reflux surgeries and hiatal hernia repair after bariatric surgeries
- Laparoscopic reversal of Bypass (UNDO)
When you should see a doctor?
If a person is overweight or obese, it is recommended that they visit a specialist doctor specialized in weight loss. The doctor will take a detailed history, perform a thorough physical examination including body measurements, and BMI calculation as well as checking for other health problems. They also might order some blood tests.
Through this, the doctor will evaluate the cause of the obesity, and make sure there are no medical illnesses, like hypothyroidism, that are contributing to the weight gain. They will identify complications or illnesses related to obesity that need to be treated. They will also decide on the treatment plan, and whether medications or surgery is most appropriate option depending on the case.
