Laparoscopic bariatric surgery is the most common method of bariatric surgery, with over 90% of bariatric procedures being performed laparoscopically today. Laparoscopic surgery is minimally invasive and involves the surgeon making small incisions in the belly and placing a tiny camera, called a laparoscope, inside. Laparoscopic surgery can be performed for all types of bariatric procedures, including roux en y bariatric surgery and duodenal switch bariatric surgery. For individuals who undergo these procedures, maintaining health through bariatric vitamins and supplements such as bariatric protein shakes is often recommended.
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Overview of Laparoscopic Bariatric Surgery
Laparoscopic surgery is a minimally invasive technique that shortens recovery time and reduces pain compared to open surgery. Introduced in 1994, its use rose significantly, from 1.5% to 17.1% between 1998 and 2003, due to its high success rate. After surgery, many patients benefit from specialized supplements, including bariatric multivitamins and bariatric vitamins chewable options, to ensure they maintain essential nutrients.
The primary purpose of laparoscopic bariatric surgery is for weight loss. The surgery alters the stomach to reduce intake and/or reroutes the intestines to impact absorption. It is widely used in gastric bypass, gastric sleeve, and adjustable gastric banding bariatric procedures. Laparoscopic gastric bypass is often referred to as the “gold standard” for bariatric surgery, is considered by many as the best bariatric surgery due to its proven outcomes.
Types of Laparoscopic Bariatric Procedures
Gastric bypass is a restrictive and malabsorptive weight loss procedure. It involves creating a small stomach pouch to restrict intake and rerouting the intestines to decrease food absorption. Individuals who have a successful laparoscopic gastric bypass surgery can expect to lose 60% of excess weight granted they make lifestyle adjustments following the surgery.
A sleeve gastrectomy is a restrictive procedure that works by removing 90% of the stomach, leaving a tube-like structure, limiting food intake. Five or six small incisions are made in the abdomen and a camera is placed inside before the surgeon begins. No alterations are made to the intestines during this procedure.
An adjustable gastric band is a reversible bariatric surgery that involves placing a band around the upper portion of the stomach. This band creates a “new stomach” that is about the size of a walnut and can only hold an ounce of food. The band is inflatable and can be made tighter or looser by injecting a saline solution into the band. The surgeon will make one to five small incisions, and the procedure will only take 30-60 minutes to complete. The average weight loss for this procedure is less than others, with an average of one third of excess weight loss.
The fourth type of laparoscopic bariatric procedure is the Biliopancreatic Diversion with Duodenal Switch (BPD/DS). This is a less common weight loss procedure that is typically reserved for people with a very high body mass index. This is a two-step procedure that involves removing part of the stomach and rerouting a significant portion of the intestines, greatly limiting food absorption.
Advantages of Laparoscopic Techniques
Laparoscopic techniques offer a variety of benefits, including a shorter recovery time and a reduced risk of infection. When surgeries are performed laparoscopically, less trauma is placed on the body when compared to open surgery. Systemic inflammation has shown to be lower following laparoscopic surgery, evidenced by a smaller increase in white blood cell count and C-reactive protein. Smaller incisions also lower the risk of infections and other complications.
The minimally invasive nature of the surgery introduced a lower mortality rate of 0.16%, when compared to an open surgery mortality rate of 0.41%. Laparoscopic surgery makes two-stage procedures possible without the surgeon running into thick scar tissue. For example, a severely obese individual can receive a gastric sleeve procedure to lose initial weight, and then have the second part of a duodenal switch for improved weight loss outcomes. Additionally, laparoscopic bariatric surgery offers a cosmetic benefit – minimal scarring leads to improved aesthetic outcomes.
Disadvantages and Risks
Even though laparoscopic surgery is less invasive and a generally safe procedure, there are still risks such as bleeding from the incision, blood clots, hernias, infection, and abdominal swelling. Specific risks associated with laparoscopic surgery will depend on the type of procedure that is done. Some procedures significantly reduce nutrient absorption, leading to a need for lifelong vitamin and mineral supplementation. Patients may benefit from bariatric calcium chews and bariatric vitamins for hair loss to address post-surgery deficiencies. Long-term follow-up is needed with laparoscopic surgery, just as it is with open surgery. Regular monitoring and lifestyle changes are essential to avoid complications and maintain weight loss.
Success Rates of Laparoscopic Bariatric Surgery
Laparoscopic bariatric surgery weight loss success rates will depend on the type of surgery received and the adherence to lifestyle modifications. In laparoscopic sleeve gastrectomy, research has shown that patients lost 62.3% of excess body weight after five years. In laparoscopic gastric bypass, an average of 61.6% of excess body weight is lost. In laparoscopic adjustable banding, 43.7% of excess body weight was lost after 24 months. In the laparoscopic BPD-DS procedure, a randomized controlled trial reported by Sovic et al. reported a 75% excess weight loss in morbid obese patients. Following surgery, bariatric snacks and bariatric protein bars are useful for patients looking to maintain dietary consistency while managing intake.
Reductions in weight loss are related to significant reductions in obesity-related conditions such as type 2 diabetes, hypertension, and sleep apnea. An improvement in comorbid conditions often leads to a greater quality of life.
Success is dependent on adherence to post-operative guidelines which includes establishing healthy eating habits and engaging in regular physical activity. 150 minutes of moderate exercise is recommended per week and should be started as soon as it is cleared by your doctor following surgery.
Future Trends in Laparoscopic Bariatric Surgery
As technology continues to advance, robotic-assisted surgeries and improved laparoscopic tools are enhancing precision and outcomes. Laparoscopic surgeries remain the most common types of bariatric surgery performed. – although emerging weight loss procedures have been discovered. One advanced form of weight loss procedures is endoscopic bariatric surgery, which makes no incisions and uses an endoscope that is placed down the throat to complete the procedure. Additionally, advances in genetic profiling and precision medicine could lead to tailored bariatric treatments based on individual needs.
Conclusion
Laparoscopic bariatric surgery is a safe and minimally invasive technique that is suitable for morbid obese individuals and individuals who are facing obesity-related health conditions. The surgery has many benefits, including high success rates and minimal scarring. Compared to open bariatric surgery, laparoscopic surgery improves recovery time and decreases the rate of infection. As we look to the future, laparoscopic surgery usage continues to rise with technology advancements and more surgical precision.
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