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Stomach Surgery

If your weight is very high and dangerous to your health, doctors may recommend you have stomach surgery.

The intention of the surgery is to make your stomach smaller. It can help you eat less and lose weight. You however need to stick to a special diet after the operation.

If you have this kind of surgery, you can expect to lose between 25 to 44 kilograms (55 - 97 pounds) within a year of the operation. The surgery should also help you maintain low weight.

To have the surgery, you will normally have tried other ways of losing weight without success.

In addition, you may need to lose some weight before the operation in order to reduce the risk of complications after the surgery.

You will also be required to stop smoking at least six to eight weeks before the surgery.

How it Works

Stomach surgery enables you to feel full after eating less. The surgery makes your stomach smaller. It therefore holds less food and sends a signal to your brain to tell it you are full sooner than usual. You therefore stop eating.

However, to lose weight, you need to stop eating when you feel full otherwise you will feel ill, and put on weight.

You need to follow a strict diet after the operation. The surgery is a way of helping you stick to a diet and exercise programme and is not a cure.

Some kinds of stomach surgery work by changing the way your body absorbs food. Your body absorbs fewer calories and fat from your food.

Types of Operations

  • Open surgery: This operation is done through one large cut in your abdomen.

  • Laparoscopic surgery/ Keyhole surgery: This operation is done through several smaller cuts. The surgeon uses a special camera to see inside you during the operation.

    Both keyhole and open surgery work well. However, with keyhole surgery, you are likely to spend less time in hospital and get fewer problems with your wound.

    The Operation

    Stomach surgery operations are done under general anaesthetic (you are asleep during surgery) and normally last an hour. Some may take several hours.

    The operations last longer if you have a lot of fat on your abdomen. This is because it takes more time to cut through the fat and close it up afterwards.

    Your gallbladder may be taken out during the operation unless it is healthy.

    The gallbladder stores a fluid called bile. The bile helps your body break down food. If you lose weight quickly, you may get gallstones.

    Gallstones are hard lumps that grow in your gallbladder and can be very painful.

    Benefits of Stomach Surgery

    If you have a health condition that was aggravated by the obesity, losing weight should help with your condition.

  • Immediate weight loss following the surgery. Patients lose weight rapidly and continue to do so until about 24 months after the surgery.
  • Patients with diabetes can have lower blood sugar levels within days of having surgery. More than 75% people with diabetes completely recovered from diabetes after having stomach surgery.
  • About 75% of patients with high cholesterol or high blood pressure get lower levels after the operation.
  • People with sleep apnoea sleep better or are cured after surgery.
  • You feel less anxious and depressed after your operation.
  • You find it easier to move and do things such as housework and shopping.
  • You find sports, social activities and sex more enjoyable.
  • You feel happier and more confident
  • It easier to get into relationships
  • It is easier to get and stay in a job.

    Who Can Qualify for Stomach Surgery

    You can qualify for stomach surgery if you are obese and your weight is dangerous to your health. Other factors to consider:

  • You are very obese (BMI of 40 or more)
  • Your weight is causing you harm (BMI of 35 to 40) and you have health concerns e.g. diabetes, high blood pressure, severe sleep apnoea, obesity-related heart disease.
  • You have not succeeded in losing weight in other ways such as dieting, exercising and taking medications.
  • You are fit enough to have an operation under a general anaesthetic.
  • Your risk of death from not having the surgery is greater than the risk of possible complications from undergoing the surgery.

    Dangers of Stomach Surgery

    Serious problems after stomach surgery affect 1 in 5 people. There is a minute chance that you will die during the surgery or soon afterwards.

    The risk of dying is the same irrespective of the type of stomach surgery you have.

    If you have other health problems, your chance of dying is slightly higher than someone who does not have any other health issues.

    To reduce the risk of infections and death, it is better to choose a hospital where surgeons perform many stomach surgery operations. An operation done by an experienced surgeon also reduces the risk.

    A second operation because of problems after the first operation is likely in 1 out of every 50 patients. Some types of stomach surgery present a higher risk.

    Other Risks and Side Effects of Stomach Surgery

  • Lifestyle changes: Life-long use of special foods and medications may be necessary.

  • Complications: Some patients require follow-up surgery to correct complications.

  • Vomiting: This happens when the small stomach is overly stretched by food particles that have not been chewed up well.

  • Gallstones: About 30% of patients who have gastric surgery develop gallstones. A person's risk of developing gallstones increases due to substantial weight loss. Gallstones are prevented with supplemental bile salts. These are taken for the first 6 months after surgery.

  • Subphrenic abscess: Some patients get a pool of thick yellowish/greenish liquid in the abdomen around the stomach called subphrenic abscess. Subphrenic abscess is a sign that there is an infection.

    It normally happens a few weeks after surgery and causes some pain in the abdomen. A fever and a cough may accompany it. It needs to be drained and treated with antibiotics. Surgery may also be needed.

  • Nutritional deficiencies: Some patients who have weight-loss surgery develop diseases related to nutritional deficiencies. These include anaemia, osteoporosis, and metabolic bone disease. To avoid these diseases vitamin and mineral supplements need to be taken.

  • Lungs: A small number of people get an infection in the lungs or pneumonia. It is also possible to get collapsed lung tissue. These problems need hospital treatment. It is possible to get other kinds of lung and breathing problems.

  • Wound infections: These happen around the area where the operation is done. Wound infections are treated with antibiotics.

  • Avoid pregnancy: It is necessary for women to avoid pregnancy until their weight becomes stable. Rapid weight loss and nutritional deficiencies can harm a developing foetus.

  • Other side effects including nausea, bloating, diarrhoea, excessive sweating, increased gas and dizziness may occur.

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