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Autor: anton • January 12, 2011 • 1,262 Words (6 Pages) • 894 Views
Recent arguments claim plastic surgery to be a life saving alternative while others continue argue the many risks involved. Every year more than 300,000 people die from complications due to morbid obesity. Dying from obesity related illnesses is only second to dying from cigarette smoke. Morbid obesity is a term used to define individuals who are more than 50 percent above their ideal body weight and body mass index that is greater than 40. Ð²Ð‚ÑšAccording to the Centers for Disease Control and Prevention (CDC), approximately 9 million adult Americans are morbidly obese. This is 4.7 percent of the U.S. population, up from 2.9 percent in 1994 (Ð²Ð‚ÑšMorbid Obesity,Ð²Ð‚Ñœ n.d)Ð²Ð‚Ñœ. Because of its seriousness and pervasiveness, morbid obesity has become a very serious health emergency. Obesity is also established as a major risk factor for diabetes, hypertension, cardiovascular disease and some cancers. Other associated conditions include sleep apneas, osteoarthritis, stroke infertility, intracranial hypertension, gastro-esophageal reflux and urinary stress incontinence.
Bariatric surgery has become a progressively more common method of treating individuals diagnosed as being morbidly obese though the different causes of morbid obesity and other obesity problems further complicate the issue of whether obesity surgery is appropriate for the person.
There are three categories of obesity surgery, restrictive surgery, malabsorptive surgery, and combined restrictive and malabsorptive surgery. In restrictive surgery, bands or staples are used to restrict the amount of food that a person can comfortably ingest by making the stomach smaller. In this type of surgery, a stomach pouch is created and the small intestine is made smaller. These changes limit the amount of food that is absorbed which is why the surgery is called malabsorptive. Combined restrictive and malabsorptive surgery involves restrictive surgery, making a stomach pouch, and a bypass, the malabsorptive surgery, in which part of the small intestine is bypassed. The small intestine is bypassed because this is where most of the body's digestion and absorption of food take place.
Two of the most common types of bariatric surgery performed today are gastric banding and sleeve gastrectomy. Gastric banding is a restrictive surgical procedure where two medical devices are implanted in the patient, a silicone band and an injection port. With Gastric banding, a silicone band is placed around the upper part of the stomach which molds the stomach into two connected chambers. The injection port is attached to the abdominal wall, underneath the skin. The port is connected to the band with soft, thin tubing. The band is adjustable. Adjustments are made by your healthcare professional using a needle to inject saline solution into your band through the port. Adding saline increases the amount of restriction provided by the band, helping patients feel fuller sooner and with less food.
Sleeve gastrectomy is also a restrictive bariatric surgery. During this procedure, the surgeon creates a small, sleeve-shaped stomach. It is larger than the stomach pouch created during Roux-en-Y bypass and is about the size of a banana. Sleeve gastrectomy is typically considered as a treatment option for bariatric surgery patients with a BMI of 60 or higher. It is often performed as the first procedure in a two-part treatment. The second part of the treatment can be gastric bypass.
The ideal patient is at least one hundred pounds overweight, has tried and failed at least six diets, is between 15 and 65 years old, understands all the risks of the bypass procedure and is psychologically suited and able to actively take part in the many aspects of the post-operative, follow-up program for life. The most common way physicians screen candidates is by figuring their Body Mass Index, or BMI, a number that shows body weight adjusted for height. Candidates for gastric bypass must have a BMI of 40. Some patients who are suffering related conditions like life-threatening cardiopulmonary ailments or severe diabetes mellitus can have a BMI of 35 or more (Ð²Ð‚ÑšCosmetic SurgeryÐ²Ð‚Ñœ, n.d).
The risks of the various types of morbid obesity surgery are thought to be outweighed by the benefits of achieving significant weight loss when other weight loss efforts have failed. The operation has about a one percent death rate and is higher than those of other primary operations. Immediately following surgery, possible risks include incision infections, the wound bursting open, leaks from staple breakdown, marginal ulcers, various pulmonary problems and deep clotting in veins. Approximately ten percent of patients suffer some post operative complications. Moreover, the way a patient eats will be forever changed. Many patients must eat eight to ten small meals a day to obtain enough nutrients and can drink nothing while eating because the pouch canÐ²Ð‚™t hold both liquid and food. Because the pouch can hold so little food, patients are routinely told to eat protein first because that is the most necessary nutrient. Specifically, there are risks associated with each type of bariatric surgery. The risks associated with gastric banding are migration of implant, tubing-related complications, band leak, esophageal spasm, gastro-esophageal reflux disease, inflammation of the esophagus or stomach, and port-site infection, all of which may result in having another operation to correct the complication.
The benefits of gastric bypass include having a more normal life by losing massive amounts of weight, often over 100 to 200 pounds. Patients look better, fit into more