Bariatric surgery is a surgical intervention for obesity. This type of surgery has been proven to be more effective than lifestyle, dietary and medical interventions in the management of obesity.
Metabolic surgery is a surgical intervention to improve the co-morbidities associated with obesity. These include conditions such as type 2 diabetes mellitus, heart disease, hypertension, obstructive sleep apnoea (OSA) and fatty liver.
Bariatric and metabolic surgery involve making changes to different parts of the gastrointestinal (digestive) tract, such as the stomach and/or intestine, to bring about weight loss.
There are many types of minimally invasive bariatric and metabolic surgery, and these are 4 of the most common types performed in Singapore:
- Laparoscopic sleeve gastrectomy (LSG) is used to permanently reduce the size of the stomach to about 25% its original size, which then becomes like a sleeve or a tube.
- Laparoscopic Roux-en-Y gastric bypass (LRYGB) is another type of bariatric and metabolic surgery. It partitions the stomach into a smaller pouch with a loop of the small intestine attached directly to it. Hence, bypassing the rest of the stomach and the first part of the small intestine. LRYGB works by not just reducing food intake, but also by limiting the body’s absorption of calories and fat, decreasing appetite, and also by resetting the body weight set point. Patients with diabetes may benefit from this type of procedure.
- Intragastric balloon involves placing a saline-filled balloon in the stomach using an endoscope. This balloon induces a sensation of fullness so patients will be inclined to eat less. There are other intra-gastric balloons that can be swallowed and may not require gastroscopy-guided insertion.
- Laparoscopic adjustable gastric banding (LAGB) is used to manage morbid obesity. This surgery involves reducing the size of your stomach by placing a silicone band around the upper end of the stomach. You will then feel full faster, eat less, and thus lose weight. This surgical option is being phased out in favour of the more effective LSG and LRYGB options.