Bariatric Surgery
General information about Bariatric Surgery
The following table describes general information about Bariatric Surgery including Bariatric Surgery cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | $ 2700 – 3700 |
| Anesthesia | General |
| Hospital Stay | 2 to 3 Days |
| Back to Work | 1 to 2 Weeks |
| Duration of Operation | 1-3 Hours |
| Minimum Stay in Iran | 7-10 Days |
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best Bariatric Surgeons in Iran. The price of a Bariatric Surgery in Iran can vary according to each individual’s case and will be determined based on photos and an in-person assessment with the doctor. So if you are looking for the cost of Bariatric Surgery in Iran, you can contact us and get free consultation from Iranian surgery.
What is Bariatric Surgery?
Bariatric surgery is an operation that helps you lose weight by making changes to your digestive system. Some types of bariatric surgeries make your stomach smaller, allowing you to eat and drink less at one time and making you feel full sooner. Other bariatric surgeries also change your small intestine—the part of your body that absorbs calories and nutrients from foods and beverages.
Bariatric surgery may be an option if you have severe obesity and have not been able to lose weight or keep from gaining back any weight you lost using other methods such as lifestyle treatment or medications. Bariatric surgery also may be an option if you have serious health problems, such as type 2 diabetes or sleep apnea, related to obesity. Bariatric surgery can improve many of the medical conditions linked to obesity, especially type 2 diabetes.
Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or by a combination of both gastric restriction and malabsorption. Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques and each surgery has its own advantages and disadvantages.
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Types of bariatric surgery
The most common bariatric surgery procedures are as follows:
. Gastric Bypass
. Sleeve Gastrectomy (Gastric Sleeve)
. Adjustable Gastric Band
. Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
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Gastric Bypass Surgery
What is Gastric Bypass Surgery?
Gastric bypass is a restrictive and malabsorptive weight loss surgery procedure. It restricts the amount of food you can eat and reduces the number of calories (and nutrients) you absorb from food. The Roux-en-Y Gastric Bypass – often called gastric bypass – is considered the ‘gold standard’ of weight loss surgery.
If you have high blood pressure or type 2 diabetes, gastric bypass surgery can make these conditions better, or even make them clear up completely. Up to six in 10 people with diabetes who have a gastric bypass find their sugar levels go back to normal after six years. Weight loss surgery may also make joint problems and breathing disorders, such as sleep apnea, better.
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General information about Gastric Bypass Surgery
The following table describes general information about Gastric Bypass Surgery in Iran including Gastric Bypass Surgery cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | $ 3000-3500 |
| Anesthesia | General |
| Hospital Stay | 2 to 3 Days |
| Back to Work | 1 to 2 Weeks |
| Duration of Operation | 2 to 3 Hours |
| Minimum Stay in Iran | 7-10 Days |
Before Gastric bypass Surgery
Preparing for a gastric bypass operation
Your surgeon will let you know if there’s anything you need to do to prepare for your operation.
If you smoke, you’ll be asked to stop for at least eight weeks before the operation and permanently afterwards. This is because smoking makes you more likely to have complications during and after surgery.
If you can, try to lose some weight before your surgery, as this will make the operation easier and mean you’re less likely to have complications afterwards. Your surgeon may ask you to follow a low-fat, low-carbohydrate diet for one week before your operation. This helps to shrink your liver, so your surgeon is more likely to do your operation using keyhole (laparoscopic) surgery. Having keyhole surgery means you’ll have less pain after the operation and will be likely to recover more quickly.
If you’re taking any medicines (prescribed or bought from a pharmacy), it’s important to tell your surgeon before your operation. This includes non-steroidal anti-inflammatory medicines (eg ibuprofen or naproxen). Your surgeon may suggest you stop taking NSAIDs, or that you take them with medicines called proton pump inhibitors. This is because they can make you more likely to have a stomach ulcer afterwards.
Before you go to the hospital for your operation, you may want to prepare for when you return home. If you live on your own, it may be a good idea to arrange for a relative or friend to help you during the first few days after your surgery.
On the day
You’ll be admitted to hospital either the night before your gastric bypass, or on the same day. You’ll have the surgery under general anaesthesia, which means you’ll be asleep during the operation.
You’ll be asked to follow fasting instructions before your operation. This means you won’t be able to eat, typically for about six hours beforehand. You’ll be able to drink water up to two hours before, but always follow your surgeon’s advice. At the hospital, your nurse will check your heart rate and blood pressure and test your urine.
You’ll be asked to wear compression stockings on your legs. This will help prevent blood clots forming in the veins in your legs (deep vein thrombosis). You’ll also need to have an injection of an anti-clotting medicine as well as, or instead of, wearing compression stockings.
Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you feel happy to give your consent for the operation to go ahead. You may be asked to do this by signing a consent form.
Read more about : Bariatric surgery recovery
Is a gastric bypass right for me?
So, who can have a gastric bypass? You may be eligible for gastric bypass surgery if:
. Your BMI (body mass index) score is 40 or more.
.Your BMI is 35 or more and you have other medical conditions such as type 2 diabetes or high blood pressure that may be improved by losing weight.
. You are fit enough to have a general anaesthetic and surgery.
. You are committed to losing weight and maintaining your weight loss through lifestyle and gastric bypass diet changes.
. You have tried to lose weight in other ways such as eating healthily, exercising and taking relevant medicines.
Advantages
. Produces significant long-term weight loss (60 to 80 percent excess weight loss)
. Restricts the amount of food that can be consumed
. May lead to conditions that increase energy expenditure
. Produces favorable changes in gut hormones that reduce appetite and enhance satiety.
. Maintenance of >50% excess weight loss
Disadvantages
. Is technically a more complex operation than the AGB or LSG and potentially could result in greater complication rates.
. Can lead to long-term vitamin/mineral deficiencies particularly deficits in vitamin B12, iron, calcium, and folate.
. Generally has a longer hospital stay than the AGB
. Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance.
Complications of gastric bypass surgery
After any surgery, you may have some complications, including a reaction to the anaesthetic and blood clots in your legs (DVT) or lungs (pulmonary embolism). If you have other conditions linked to your weight, such as high blood pressure or diabetes, these can make you more prone to complications.
After a gastric bypass, you may have some other complications too.
. You may develop an infection in your wound or a chest infection.
. You may get bleeding from a stomach ulcer. Ulcers are more common if you smoke, so you’ll be advised to stop. Your doctor may also suggest taking a type of medicine called a proton pump inhibitor to reduce the amount of acid in your stomach, and advise you to stop drinking alcohol.
. The join between your stomach pouch and small intestine can become narrower, making you feel sick and even be sick.
. You may get a leak where your intestine is re-joined to your stomach. This can be very serious and you’ll usually have an operation to repair it straightaway.
If you lose weight quickly after your surgery, you may develop gallstones. These can be painful and you may need surgery to remove them. Your surgeon may suggest removing your gallbladder during your gastric bypass, or may prescribe medicines after your surgery, to stop this from happening.
If you have tummy pain after your surgery, especially after three months or so, you may have developed an internal hernia. You won’t be able to see the hernia; it won’t be visible as a lump on your skin. It happens when one of the two bowel loops that have been created during surgery twists under the other through a newly created opening. The pain may spread from your tummy to your back. If the twisted bowel gets trapped in this position, it may get blocked or the blood supply to it may be cut off. If you develop an internal hernia, you’ll need more surgery to repair it.
During your operation, your surgeon may find an unexpected problem and may need to switch the keyhole operation to an open procedure. This won’t affect how well the operation works, but it may take you longer to recover afterwards.
Not everyone loses enough weight after gastric bypass surgery. The main reason for this is not following the rules about diet and exercise.
During Gastric Bypass Surgery
The Procedure
There are two components to the procedure. First, a small stomach pouch, approximately one ounce or 30 milliliters in volume, is created by dividing the top of the stomach from the rest of the stomach. Next, the first portion of the small intestine is divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch. The procedure is completed by connecting the top portion of the divided small intestine to the small intestine further down so that the stomach acids and digestive enzymes from the bypassed stomach and first portion of small intestine will eventually mix with the food.
The gastric bypass works by several mechanisms. First, similar to most bariatric procedures, the newly created stomach pouch is considerably smaller and facilitates significantly smaller meals, which translates into less calories consumed. Additionally, because there is less digestion of food by the smaller stomach pouch, and there is a segment of small intestine that would normally absorb calories as well as nutrients that no longer has food going through it, there is probably to some degree less absorption of calories and nutrients.
Most importantly, the rerouting of the food stream produces changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes.
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After Gastric Bypass Surgery
What to expect afterwards
In the hospital
You’ll need to rest until the anaesthetic has worn off. You may also need pain relief.
On the first day, you may have to wear special pads attached to an intermittent compression pump on your lower legs. The pump inflates and deflates the pads and boosts the blood flow in your legs, helping to prevent deep vein thrombosis (DVT). You’ll need to wear compression stockings to help boost your circulation and continue to have injections of anti-clotting medicine.
You’ll be encouraged to get out of bed and move around as soon as you can. This helps to prevent both chest infections and blood clots developing in your legs. You may have a nasogastric tube (a tube inserted into your nose that goes down to your stomach) to keep your stomach pouch empty. This is usually taken out the following day.
You’ll have a drip put into a vein in your hand or arm to give you fluids. If you feel well enough, you can start to drink small amounts of water soon after your operation, and the drip will be removed.
Going home
You’ll usually be able to go home one to three days after your operation. You’ll need to arrange for someone to drive you home. Your nurse will tell you how to care for your healing wounds before you go home and give you a date for a follow-up appointment. You may need pain relief for a few days after the operation.
If your surgeon used dissolvable stitches, they’ll be under your skin so you won’t see them. If you have non-dissolvable stitches or clips, you’ll need to have them taken out. This is usually 7–10 days after the operation. Your surgeon will tell you when and where to have them removed.
It will probably take you between four and six weeks to recover fully from a gastric bypass operation. During this time, you’ll notice weight loss and will probably need to carry on eating soft foods. This will vary from person to person, so talk to your surgeon about what’s right for you.
Lifestyle changes after surgery
After gastric bypass surgery, you’ll need to make major changes to your eating habits as your stomach will initially be around the size of an egg. You’ll only be able to eat small amounts at each meal – starting with liquids and purées, before moving on to solid food. Your surgeon or dietitian will give you all the information you need about which foods you can eat and how much.
It’s essential that you make the recommended changes to your diet after surgery. But this may mean you don’t get enough protein or certain vitamins and minerals, which can affect your health. If you don’t get enough iron after gastric bypass surgery, this may cause anaemia. Your surgeon is likely to recommend you take vitamin and mineral supplements, including folic acid and calcium. You may also need to have regular injections of vitamin B12. You’ll need to have regular blood tests to check you’re getting all of the vitamins, minerals and nutrients you need.
You’ll also be asked to make other changes to your lifestyle, such as being more active and keeping the amount of alcohol you drink to a minimum. These changes will help you to get the most from your gastric bypass operation, so you can lose excess weight and keep it off. Being physically active will also help to tone your muscles and improve your posture.
Losing weight after a gastric bypass is usually a positive thing. But some people find it hard to adapt to their lifestyle changes and appearance after the operation. Talk to your GP or surgeon if you’re struggling to cope, or are worried about something, as they’ll be able to suggest ways to help. Your doctor may also suggest a patient support group, where you can get support and advice from other people who have been through the operation too.
Gastric Sleeve Surgery
What is Gastric Sleeve weight loss surgery?
Gastric Sleeve surgery also known as sleeve gastrectomy or vertical sleeve gastrectomy (VSG) is a weight-loss procedure that induces weight loss by restricting food intake. With this procedure, which is usually performed laparoscopically, the surgeon removes approximately 75-80 percent of the stomach. This results in the stomach taking on the shape of a tube or “sleeve” which holds much less food.
The treatment is widely considered around the world for helping people loose that extra fat. Gastric sleeve surgery restricts your food intake, which leads to weight loss. You may lose from 50 to 90 pounds.
It’s done as a laparoscopic surgery, with small incisions in the upper abdomen. Most of the left part of the stomach is removed. The remaining stomach is then a narrow tube called a sleeve. Food empties out of the bottom of the stomach into the small intestine the same way that it did before surgery. The small intestine is not operated on or changed. After the surgery, less food will make you full when eating.
The Gastric Sleeve originated as the restrictive part of the duodenal switch operation. In the last several years, it has also been used as a staging procedure prior to a gastric bypass or duodenal switch in very high risk patients. It has also been used as a primary, stand-alone procedure.
General information about Gastric Sleeve Surgery
The following table describes general information about Gastric Sleeve Surgery in Iran including Gastric Sleeve Surgery cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | $ 2700 – 3300 |
| Anesthesia | General |
| Hospital Stay | 2 to 3 Days |
| Back to Work | 1 to 2 Weeks |
| Duration of Operation | 1 to 2 Hours |
| Minimum Stay in Iran | 7-10 Days |
Before Gastric Sleeve Surgery
How do I get ready for gastric sleeve surgery?
Your healthcare team will need to make sure that gastric sleeve surgery is a good option for you. Weight-loss surgery isn’t advised for people who abuse medicines or alcohol, or who are not able to commit to a lifelong change in diet and exercise habits.
Before having surgery, you’ll need to enroll in a bariatric surgery education program. This will help you get ready for surgery, and life after surgery. You’ll have nutritional counseling. And you may have a psychological evaluation. You’ll also need physical exams and tests. You will need blood tests. You may have imaging studies of your stomach, or have an upper endoscopy.
If you smoke, you will need to stop several months before surgery. Your surgeon may ask you to lose some weight before surgery. This will help make your liver smaller, and make surgery safer. You’ll need to stop taking aspirin, ibuprofen, and other blood-thinning medicines in the days before your surgery. You shouldn’t eat or drink anything after midnight before surgery.
Is a gastric sleeve right for me?
So, who is suitable for a gastric sleeve? You may be eligible for gastric sleeve surgery if:
. You have a BMI (body mass index) score is of 40 or more
. You have a BMI o 35 or more and you have other medical conditions such as type 2 diabetes or high blood pressure that may be improved by losing weight.
. You are fit enough to have a general anaesthetic and surgery.
. You are committed to losing weight and maintaining your weight loss through lifestyle and gastric sleeve diet changes.
. You have tried to lose weight by eating healthily, exercising and taking relevant medicines, for at least six months and this hasn’t worked.
Complications and Risks
Long-term complications
There are two types of complications of gastric sleeve surgery: acute and chronic. Acute complications are ones that occur shortly after surgery and chronic issues are ones that arise or persist six months after the date of surgery. Acute complications include bleeding, pain, and blood clots.
Gastric sleeve, overall, is considered safe when compared to other commonly performed surgeries. Deaths from the procedure are rare, and when performed by a competent surgeon, the procedure has minimal complications. That said, complications, when they do happen, can range from minor annoyances to significant and potentially life-altering issues.
Over the past decade, with the improvement of surgical techniques and surgeons’ experience, the gastric sleeve has become an overall safe bariatric surgical procedure. However, complications can still occur during and after surgery.
Below are the main complications and risks of the gastric sleeve surgery:
. Leakage from the staple line – this is a rate but serious complication of the gastric sleeve surgery. The reported leak rate is between 0.7-3 percent. In Iran, we pay paramount attention to our surgical techniques to minimize all the complications.
. Stricture/stenosis – In the past, we had one stricture among our first 20 gastric sleeve procedures. We have not had any strictures within the past 5 years.
. Bleeding
. Blood Clot
. Heart Burn – This is a very controversial topic in bariatric surgery and the data from different centers is inconsistent. In our experience, most patients with heartburn before surgery see improvement of symptoms after surgery due to weight loss. Some patients may develop new heartburn, which is treatable with over-the-counter anti-acid medications, in most cases.
. Nutrient or vitamin deficiency
. Weight Regain – After 1-2 years, slight weight regain is common among all bariatric procedures and about 10-20% of patients can have significant weight regain after gastric sleeve surgery. After 5 years of follow up, many centers collected data to show that the majority of patients can maintain their weight loss after the Gastric Sleeve Surgery.
What are some advantages and disadvantages of the Gastric Sleeve?
Advantages:
. Can lead to significant weight loss (average of 66% of excess body weight)
. Can lead to significant improvement of obesity-related health conditions
. Doesn’t use a foreign object (like the gastric band) and doesn’t reroute the digestive tract (like the gastric bypass)
. Short hospital stays approximately 2 days and recovery time due to minimally invasive procedure
. Limits the amount of food that can be eaten
. Causes significant changes to digestive organs and hormones that result in reduced hunger and increased metabolism.
. Permanent (won’t need more surgeries or readjustments, like the gastric band)
Disadvantages:
. Requires lifelong dedication to specific diet and exercise routines
. Permanent (cannot be reversed)
. Can lead to vitamin deficiencies
During Gastric Sleeve procedure
The Procedure
This procedure works by several mechanisms. First, the new stomach pouch holds a considerably smaller volume than the normal stomach and helps to significantly reduce the amount of food (and thus calories) that can be consumed. The greater impact, however, seems to be the effect the surgery has on gut hormones that impact a number of factors including hunger, satiety, and blood sugar control.
Short term studies show that the sleeve is as effective as the roux-en-Y gastric bypass in terms of weight loss and improvement or remission of diabetes. There is also evidence that suggest the sleeve, similar to the gastric bypass, is effective in improving type 2 diabetes independent of the weight loss. The complication rates of the sleeve fall between those of the adjustable gastric band and the roux-en-y gastric bypass.
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How is Gastric Sleeve Performed?
Most sleeve gastrectomies performed today are performed laparoscopically. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera (laparoscope) and long instruments that are placed through these small incisions.
Sleeve gastrectomy is a restrictive form of operation in which approximately 2/3rd of the left side of the stomach is removed laparoscopically using endoscopic staplers. The stomach thus takes the shape of a hockey stick or sleeve. It can be performed as either first stage of a two-stage procedure for super obese (BMI >60) where it can be followed with malabsorptive surgery or as a single stage procedure by itself.
The capacity of the stomach ranges between 60 – 100 cc. Unlike many other forms of bariatric surgery, the outlet valve and the nerves of the stomach remains intact while only the stomach size is drastically reduced. Though a non-reversible procedure, the part of the stomach that contains Ghrelin, the hormone for hunger is removed; it drastically reduces your appetite and hormones that controls diabetes.
The hour glass configuration only constricts the upper stomach thus acting as a pure restrictive operation. Since the outlet is small, food stays in the pouch longer and one also feels satiated for a longer time.
Scheduled follow-up visits will be at 6 weeks, monthly for the first six months and yearly thereafter or as and when medically required.
After gastric sleeve surgery
What happens after gastric sleeve surgery?
You’ll likely go home the day after surgery. You will be on a liquid diet for the first week or two. Your surgery team will give you a schedule of types of meals over the next weeks. You’ll go from liquids to pureed foods, then soft foods, and then to regular food. Each meal needs to be very small. You should make sure to eat slowly and chew each bite well. Don’t move too quickly to regular food. This can cause pain and vomiting. Work with your healthcare team to figure out what’s best for you to eat. After your stomach heals, you will need to change your eating habits. You’ll need to eat small meals for your small stomach.
People who have weight-loss surgery may have trouble getting enough vitamins and minerals. This is because they take in less food, and may absorb fewer nutrients. You may need to take a daily multivitamin, plus a calcium-vitamin D supplement. You may need additional nutrients, such as vitamin B-12 or iron. Your medical team will give you instructions.
You’ll need to have regular blood tests every few months in the year after surgery. This is to make sure you don’t have low blood iron (anemia), high blood glucose, or low calcium or vitamin D levels. If you have heartburn, you may need to medicine to reduce stomach acid.
After losing weight, it’s possible to regain some of the weight that you lose. To avoid this, make sure to follow a healthy diet and get regular exercise. The sleeve may widen (dilate) over time. This will let you eat more. But keep in mind that if you eat all you can, you can regain weight. You may want to join a weight-loss surgery support group to help you stick with your new eating habits.
New eating habits
The first day after surgery, you’ll drink clear liquids. By the time you leave the hospital, you can eat pureed foods and protein shakes and will continue to do so for about 4 weeks.
Keep in mind that you have to change the way you eat forever. After that first month, you’ll switch to eating soft solid foods very slowly. Other pointers to keep in mind:
. Everything must be chewed thoroughly before being swallowed.
. Don’t drink while you eat, as this might cause your new stomach to overfill.
. Drink liquids a half-hour after finishing a meal.
. Avoid high-calorie sodas and snacking.
. Take vitamin and mineral supplements every day.
After 2 or 3 months, you can move on to regular meals. But remember, you will not be able to eat as much as you used to.
Laparoscopic adjustable gastric banding (LAGB) Surgery
What is Laparoscopic adjustable gastric banding (LAGB)?
The Adjustable Gastric Band – often called the band – involves an inflatable band that is placed around the upper portion of the stomach, creating a small stomach pouch above the band, and the rest of the stomach below the band.
General information about Laparoscopic adjustable gastric banding Surgery
The following table describes general information about Laparoscopic adjustable gastric banding Surgery in Iran including Laparoscopic adjustable gastric banding Surgery cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | $ 2700 – 2900 |
| Anesthesia | General |
| Hospital Stay | 1 to 2 Days |
| Back to Work | 1 Week |
| Duration of Operation | 1 Hour |
| Minimum Stay in Iran | 7 Days |
Before Laparoscopic adjustable gastric banding (LAGB) Surgery
Why might I need LAGB?
LAGB is used to treat severe obesity. It’s advised for people who have tried other weight loss methods without long-term success. Your doctor may advise LAGB if you are severely obese with a body mass index (BMI) over 40. Your doctor may also advise it if you have a BMI between 35 and 40 and a health condition such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.
What to Expect
Prior to Procedure
Each bariatric surgery program has specific requirements. You may have the following done:
. Thorough physical exam and review of your medical history
. Mental health evaluation and counseling
. Ongoing consultations with a registered dietitian
. Program to help you lose weight through diet and exercise
Leading up to your procedure:
. Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
. Do not start any new medications, herbs, or supplements without talking to your doctor.
. Arrange for a ride to and from the hospital. Also, arrange for help at home.
. If advised by your doctor, take antibiotics.
. The night before, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor. You may be given laxatives and/or an enema to clear your intestines.
. Shower or bathe the morning of your surgery.
. General anesthesia will be used. You will be asleep for the surgery.
Advantages
. Reduces the amount of food the stomach can hold
. Induces excess weight loss of approximately 40 – 50 percent
. Involves no cutting of the stomach or rerouting of the intestines
. Requires a shorter hospital stay, usually less than 24 hours, with some centers discharging the patient the same day as surgery.
. Is reversible and adjustable
. Has the lowest rate of early postoperative complications and mortality among the approved bariatric procedures.
. Has the lowest risk for vitamin/mineral deficiencies
Disadvantages
. Slower and less early weight loss than other surgical procedures
. Greater percentage of patients failing to lose at least 50 percent of excess body weight compared to the other surgeries commonly performed.
. Requires a foreign device to remain in the body
. Can result in possible band slippage or band erosion into the stomach in a small percentage of patients.
. Can have mechanical problems with the band, tube or port in a small percentage of patients.
. Can result in dilation of the esophagus if the patient overeats
. Requires strict adherence to the postoperative diet and to postoperative follow-up visits.
. Highest rate of re-operation
. Return to top
Risks and Complications
There are some risks associated with having a gastric band.
These include the following:
Some people have an adverse reaction to anesthesia, including allergic reactions, breathing problems, blood clots in the legs that may travel to the lungs (pulmonary embolism), blood loss, infection, and heart attack or stroke during or after surgery.
Weight loss may be slower compared with other types of surgery
The band can slip or have mechanical problems, or it may erode into the stomach, requiring removal.
The port can shift, making additional surgery necessary. Between 15 and 60 percent of people are reported to need follow-up surgery.
The individual needs to follow dietary recommendations with care, as overeating can lead to vomiting or dilation of the esophagus.
As with other types of weight loss surgery, gastric banding also carries these risks:
. Injury during surgery to the stomach, intestines or other abdominal organs
. Hernia
. Inflammation of the stomach lining (gastritis), heartburn, and stomach ulcers
. Wound infection
. Gastrointestinal scarring that can lead to bowel blockage
. Poorer nutrition as a result of the restricted food intake
Weight loss can give some people a boost in confidence, and this can be another benefit.
However, if a person undergoes the procedure in the hope of sudden weight loss, or if weight loss is their main reason for choosing surgery, they may be disappointed.
During Laparoscopic adjustable gastric banding (LAGB) Surgery
The Procedure
Description of the Procedure
To prepare you for surgery, an IV will be placed. You may receive fluids and medications through the IV during the procedure. A breathing tube will be placed through your mouth and into your windpipe. This will help you breathe during surgery. You will also have a catheter placed in your bladder to drain urine.
Several small incisions will be made in the abdomen. Gas will be pumped in to inflate the abdomen. This will make it easier for the doctor to see. A laparoscope and surgical tools will be inserted through the incisions. A laparoscope is a thin, lighted tool with a tiny camera. It sends images of the abdominal cavity to a monitor in the operating room. Your doctor will operate while viewing the area on this monitor.
An adjustable round band is placed around the top of the stomach and fastened into place. This creates a smaller stomach area for food. Tubing is placed from the band to an access port in the abdominal wall. The band can later be adjusted with a special saline solution and needle syringe. The incisions will be closed with staples or stitches.
The common explanation of how this device works is that with the smaller stomach pouch, eating just a small amount of food will satisfy hunger and promote the feeling of fullness. The feeling of fullness depends upon the size of the opening between the pouch and the remainder of the stomach created by the gastric band. The size of the stomach opening can be adjusted by filling the band with sterile saline, which is injected through a port placed under the skin.
Reducing the size of the opening is done gradually over time with repeated adjustments or “fills.” The notion that the band is a restrictive procedure (works by restricting how much food can be consumed per meal and by restricting the emptying of the food through the band) has been challenged by studies that show the food passes rather quickly through the band, and that absence of hunger or feeling of being satisfied was not related to food remaining in the pouch above the band. What is known is that there is no malabsorption; the food is digested and absorbed as it would be normally.
The clinical impact of the band seems to be that it reduces hunger, which helps the patients to decrease the amount of calories that are consumed.
After Laparoscopic adjustable gastric banding (LAGB) Surgery
Post-procedure Care
At the Hospital
While you are recovering at the hospital:
. Pain medication will be given as needed.
. On the day after the surgery, x-rays will be taken to make sure the band is in place. If everything looks fine, you will be given fluids, then progress to pureed food.
You may be asked to do the following:
. Use an incentive spirometer to take deep breaths every hour. This is to prevent breathing problems.
. Wear elastic surgical stockings or boots. This is to promote blood flow in your legs.
. Get up and walk to circulate blood and promote healing.
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
. Washing their hands
. Wearing gloves or masks
. Keeping your incisions covered
There are also steps you can take to reduce your chance of infection such as:
. Washing your hands often and reminding visitors and healthcare providers to do the same
. Reminding your healthcare providers to wear gloves or masks
. Not allowing others to touch your incision
At Home
Be sure to follow your doctor’s instructions. You will need to practice lifelong healthy eating and exercising habits. Keep in mind after your surgery:
. It will take 2-4 weeks to fully recover. You may be out of work for several days after surgery.
. Meet regularly with your healthcare team for monitoring and support.
. Your doctor may recommend that you meet with a therapist to discuss emotional changes after surgery.
Your new stomach pouch will be the size of a small egg. It will be slow to empty. This will make you feel full quickly. Nutritional guidelines include:
. Eat very small amounts and eat very slowly. You will begin with 4-6 small meals per day. A meal is 2 ounces of food.
. For the first 4-6 weeks, all food must be pureed. After you move to solid foods, food must be well-chewed. When making food choices, ensure that you are getting enough protein.
. Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
. This procedure does not cause nausea and diarrhea if sweet or fatty foods are eaten. In fact, some people gain back weight because they continue to eat high-calorie foods. To promote ongoing weight loss, you will need to eat healthy foods.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
What is Biliopancreatic Diversion with Duodenal Switch (BPD/DS)?
The Biliopancreatic Diversion with Duodenal Switch – abbreviated as BPD/DS – is a procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy. Next, a large portion of the small intestine is bypassed.
BPD/DS is generally performed as a single procedure however, in select circumstances, the procedure may be performed as two separate operations — sleeve gastrectomy followed by intestinal bypass once weight loss has begun.
Why it’s done
Healthcare providers may recommend the BPD/DS to people who are severely obese. These people usually have a body mass index (BMI) of 50 or greater or a BMI of 40 or greater with serious type 2 diabetes and other serious health problems. These health problems include:
. Type 2 diabetes
. Sleep apnea
. Heart disease
. Lung disease
. High blood pressure
. High cholesterol
. Nonalcoholic fatty liver disease
A BPD/DS is typically done only after you’ve tried to lose weight by improving your diet and exercise habits.
General information about Biliopancreatic Diversion with Duodenal Switch
The following table describes general information about Biliopancreatic Diversion with Duodenal Switch Surgery in Iran including Biliopancreatic Diversion with Duodenal Switch Surgery cost in Iran, recovery time, and to name but a few.
| General Information | |
| Cost | $ 3200 – 3700 |
| Anesthesia | General |
| Hospital Stay | 2 Days |
| Back to Work | 1 to 2 Weeks |
| Duration of Operation | 3 Hours |
| Minimum Stay in Iran | 7-10 Days |
Before Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Surgery
How you prepare
If you qualify for a BPD/DS, your health care team gives you instructions on how to prepare for surgery. You may need to have various lab tests and exams before surgery.
Food and medications
Before your surgery, give your surgeon and any other health care providers a list of all medicines, vitamins, minerals, and herbal or dietary supplements you take. You may have restrictions on eating and drinking and which medications you can take.
If you take blood-thinning medications, talk with your doctor before your surgery. Because these medications affect clotting and bleeding, your blood-thinning medication routine may need to be changed.
If you have diabetes, talk with the doctor who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them after surgery.
Other precautions
You may be required to start a physical activity program and to stop any tobacco use.
You may also need to prepare by planning ahead for your recovery after surgery. For instance, arrange for help at home if you think you’ll need it.
What you can expect
BPD/DS is done in the hospital. The length of your hospital stay will depend on your recovery and which procedure you’re having done. When performed laparoscopically, your hospital stay may last around two days.
Before the procedure
Before you go to the operating room, you will change into a gown and will be asked several questions by both doctors and nurses. In the operating room, you are given general anesthesia before your surgery begins. Anesthesia is medicine that keeps you asleep and comfortable during surgery.
Advantages
. Results in greater weight loss than RYGB, LSG, or AGB, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up.
. Allows patients to eventually eat near “normal” meals
. Reduces the absorption of fat by 70 percent or more
. Causes favorable changes in gut hormones to reduce appetite and improve satiety.
. Is the most effective against diabetes compared to RYGB, LSG, and AGB
Disadvantages
. Requires a longer hospital stay than the AGB or LSG
. Has a greater potential to cause protein deficiencies and long-term deficiencies in a number of vitamin and minerals, i.e. iron, calcium, zinc, fat-soluble vitamins such as vitamin D.
. Compliance with follow-up visits and care and strict adherence to dietary and vitamin supplementation guidelines are critical to avoid serious complications from protein and certain vitamin deficiencies.
Risks and Complications
As with any major surgery, a BPD/DS poses potential health risks, both in the short term and long term.
Risks associated with BPD/DS are similar to any abdominal surgery and can include:
. Excessive bleeding
. Infection
. Adverse reactions to anesthesia
. Blood clots
. Lung or breathing problems
. Leaks in your gastrointestinal system
Longer term risks and complications of a BPD/DS may include:
. Bowel obstruction
. Dumping syndrome, causing diarrhea, nausea or vomiting
. Gallstones
. Hernias
. Low blood sugar (hypoglycemia)
. Malnutrition
. Stomach perforation
. Ulcers
. Vomiting
During Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Surgery
The Procedure
The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach, so that when the patient eats, the food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream.
The bypassed small intestine, which carries the bile and pancreatic enzymes that are necessary for the breakdown and absorption of protein and fat, is reconnected to the last portion of the small intestine so that they can eventually mix with the food stream. Similar to the other surgeries described above, the BPD/DS initially helps to reduce the amount of food that is consumed; however, over time this effect lessens and patients are able to eventually consume near “normal” amounts of food. Unlike the other procedures, there is a significant amount of small bowel that is bypassed by the food stream.
Additionally, the food does not mix with the bile and pancreatic enzymes until very far down the small intestine. This results in a significant decrease in the absorption of calories and nutrients (particularly protein and fat) as well as nutrients and vitamins dependent on fat for absorption (fat soluble vitamins and nutrients). Lastly, the BPD/DS, similar to the gastric bypass and sleeve gastrectomy, affects guts hormones in a manner that impacts hunger and satiety as well as blood sugar control. The BPD/DS is considered to be the most effective surgery for the treatment of diabetes among those that are described here.
After Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Surgery
What happens after BPD/DS weight-loss surgery?
You will wake up in a recovery room. You will be given medicine to control pain. You will be moved to a hospital room. You will be asked to get out of bed to move around within the next day. This helps prevent blood clots in your legs. You will have liquid nutrition. Your team will tell you when you’re ready to go home.
At first, you may have stomach or bowel cramping, or nausea. Tell your healthcare provider if pain or nausea is severe or doesn’t improve with time. Take pain medicines as prescribed. Your healthcare team will tell you when it’s OK to shower, drive, return to work, exercise, and lift objects.
Call your healthcare provider if you have any of the following:
. A fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
. A red, bleeding, or draining incision
. Frequent or persistent nausea or vomiting
. Increased pain at an incision
. Pain or swelling in your legs
. Trouble breathing or chest pain
You will get instructions about how to adapt to your new diet after your surgery. You will likely be on liquid nutrition for a few weeks after surgery. Over time, you’ll start to eat soft foods and then solid foods. If you eat too much or too fast, you will likely have stomach pain or vomiting. You’ll learn how to know when your new stomach is full.
Your healthcare provider or nutritionist will give you more instructions about your diet. You’ll need to learn good habits like choosing healthy foods and not skipping meals. Your healthcare provider or nutritionist will also need to screen you for low levels of nutrients.
You will need to take daily supplements after BPD/DS surgery. These include:
. Vitamins A, D, and K
. Multivitamin
. Iron supplements
. Calcium supplements
. Vitamin B-12 supplements or injections
Work with your healthcare team after surgery to stay healthy. Make sure to:
. Follow the nutrition plan set up by your dietitian
. Get regular physical activity. Start slowly and build up to more activity.
. Talk with a counselor or weight-loss surgery support group to help you adjust.
Bariatric surgery cost
How much does bariatric surgery cost?
On average, bariatric surgery costs between $2700 and 37000 depending on what type of surgery you have and whether you have surgery-related problems. Costs may be higher or lower based on where you do your procedure.