This procedure is used to treat patients who are more than 225%
above ideal body weight and is designed to reduce the digestion
and absorption of food. Three-fourths of the stomach is resected,
leaving a 200-ml (6-7 ounce) pouch, which empties into the end
of the small intestine. This procedure prevents ingested food
from mixing with digestive enzymes (chemicals that break down
food) until the food is far down in the small intestine. Therefore,
absorption is greatly reduced.
Most surgical procedures for obesity are performed by gaining
access to the stomach and intestine through a large abdominal
surgical incision. However, some surgeons are now performing some
of the procedures by laparoscopy. The laparoscopic technique requires
a minimal incision, permits a shorter hospital stay, and a speedier
recovery after surgery. However, the laparoscopic procedures are
technically impossible in some patients and should only be performed
in appropriately selected patients by an experienced surgeon.
The indications for the surgical treatment of obesity were established
by a National Institutes of Health Development Conference Panel
in 1991. Patients considered eligible for surgery are those who
are unlikely to lose weight with non-operative therapy, have acceptable
operative risks, and are able to comply with long-term treatment
and follow-up. Moreover, patients should have a body mass index
(BMI) >40 kg/m2 or a BMI between 35 and 40 kg/m2 along with life-threatening lung problems or severe diabetes.
BMI is calculated as body weight (in pounds) multiplied by 704,
divided by height (in inches), divided by height (in inches) again.
Therefore, surgery should only be performed in severely obese
patients whose health is being compromised by their weight problem
