Surgery

Contraindications for Bariatric Surgery



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Bariatric surgery is a procedure which is becoming rapidly popular especially among those suffering from morbid obesity as in the case of BMI more than 40. It is a surgery which requires extensive post operative care and behavioral modifications. Unless these requirements are met, the outcome of this major undertaking would not be evident and the risk involved in performing the surgery would not be worthwhile.

What is bariatric surgery?

The procedure can be performed by several different methods and in each of these methods the principle idea will be to reduce the capacity of the stomach and therefore make the patent feel full after a relatively small meal. The ultimate effect would be a lower caloric intake, less absorption and therefore a reduction in the extreme obesity that the person is suffering or else prevent further weight gain.

How is it performed?

As mentioned earlier, among the different methods made use for this procedure, connecting the small intestine directly to a very small gastric pouch will be the most serious surgery which also seems to have the better results. At the same time, placing a device to prevent the stomach from accommodating too much foods as well as reducing the size of the stomach by removing part of it are other methods which has been used extensively.

What are the contraindications for performing Bariatric surgery?

Bariatric surgery is a major undertaking and would itself have many side effects or complications in among 20% of people undergoing this procedure. Therefore, the decision to perform the surgery should be a well calculated decision and it should focus on the patients ability to tolerate the surgery, the benefits gained by the patient following surgery as well as the compliance of the patient for follow-up care.

First of all, Bariatric surgery will not be the first option when treating obesity as there are many other options such as dietary management, exercises as well as medications. If these fails and if the person falls above the usually considered BMI of 35, further evaluation for Bariatric surgery can be undertaken.

If the evaluation reveals any existing medical problems which will shorten the life even following performing the Bariatric surgery, these individuals may not gain much from the surgery itself and therefore excluded from being considered. Among the conditions which fall in to this category, end stage renal failure, liver failure, severe pulmonary disorders and life threatening disseminated cancers…etc can be highlighted.

Furthermore, if the evaluations reveal that the person has a history of being non-compliant in early instances of treatment, they should be assessed closely for being able to follow instructions after the surgery and in most instances such non-compliance is a contraindication to perform this surgery. This category of patients may also include people with schizophrenia and active substance abuse as they may not understand the nature of the operation and the necessary follow-up care which is considered essential.

 

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