What is Metabolic Surgery?
Metabolic surgery is a specific type of surgery to treat metabolic disorders such as diabetes and obesity. Metabolism is the chemical process by which your body converts food into energy. This energy can be used immediately or stored for later use in the liver, fat, or muscles. Disruption of the metabolic process can lead to life-threatening conditions if left untreated.
Risk Factors for Metabolic Disorders
Risk factors for metabolic disorders include high blood pressure, high fasting blood sugar levels, high triglycerides, low HDL (good cholesterol), and excess fat accumulation around the waist.
Indications for Metabolic Surgery
Metabolic surgery may be indicated for patients with a body mass index (BMI) of over 27.5 with uncontrolled diabetes, who are not able to manage their condition with diet, medicines and exercises.
Preparation for Metabolic Surgery
- Your doctor will discuss your symptoms and evaluate your condition in detail to decide which type of metabolic surgery is best for you.
- A multidisciplinary team that includes dieticians, psychologists, and medical specialists will ensure that any health problems are well managed.
- Blood tests, an abdominal ultrasound, and a gastroscopy may also be performed to ensure there are no contraindications to the surgery.
Metabolic Surgery Procedure
The surgery is performed under general anaesthesia using minimally invasive laparoscopic techniques. Depending on the condition of the patient, the most suitable technique will be used, which includes the following:
- Gastric bypass: This procedure involves the creation of a small pouch in the upper stomach which is connected directly to the small intestine.
- Sleeve gastrectomy: This procedure converts the shape of the stomach into a narrow sleeve or tube that limits the amount of food that you can consume.
- Biliopancreatic diversion: The procedure involves forming a tubular stomach, which is connected directly to the last part of the intestine.
- Duodenojejunal bypass: The procedure involves connection of the small bowel to the duodenum instead of the stomach.
- Ileal interposition: This procedure involves interposing the last part of the small intestine (ileum) with the middle third of the small intestine (jejunum).
The surgery takes about 2 hours, after which you will be transferred to the recovery room.
Recovery after Metabolic Surgery
Following metabolic surgery, you may have to stay in the hospital for a couple of days to ensure there are no complications. You will be encouraged to start walking as soon as possible; most people can expect to return to routine activities within 2-3 weeks.
Risks of Metabolic Surgery
As with any surgical procedure, there is a minimal risk of complications that include:
- Breathing problems
- Delayed healing or failure to heal
Benefits of Metabolic Surgery
The benefits of metabolic surgery include:
- Better control of blood pressure and blood glucose levels
- Improvement of triglycerides and lipids
- Long-term sustainable weight loss
- Improved efficacy of gastrointestinal hormones
- Reduced risk of diabetic complications such as kidney failure, eye disease, and vascular problems