Bariatric surgery methods come to the fore when it is not possible to solve the person’s weight loss problem on their own, by improving their nutrition and physical activity, or by getting the help of a dietitian. At the beginning and most commonly used of these methods are gastric sleeve or gastric sleeve operations, gastric bypass and gastric balloon applications. Apart from these, although different invasive methods such as stomach botox have been developed, the three methods listed above are the most widely used and generally accepted bariatric surgery methods today.
In fact, theoretically, in all three methods, or more generally in all bariatric surgery methods, the main purpose is to shrink the stomach or to provide the least energy intake by bypassing the foods entering the stomach. The differences differ according to the patient’s condition, the knowledge and experience of the physician who controls the weight, and the purpose of losing weight.
Generally, bariatric surgery methods are seen among the least preferred weight loss methods when there is no serious comorbidity or a significant decrease in quality of life. As a result, regardless of the reason, bariatric surgery is a surgical method, even if it is performed only for aesthetic concerns, and it has negative effects on body integrity. At this point, the physician and the patient come together to evaluate the possible profits and losses of the operation and the risk, and accordingly choose the most ideal weight loss method or bariatric surgery method. Here, in the evaluations of weight loss and selection criteria, the comfort and quality of life of the patient should be evaluated and addressed at the highest level. Because, in addition to medical reasons and additional diseases, one of the most important reasons for resorting to weight loss methods and surgical interventions is the increase in the quality of life of individuals. Therefore, the bariatric method to be used should provide this quality of life increase.
Cost and benefit analysis comes first among the criteria that come to the fore when choosing the bariatric surgery method. Today, although the reason for health is in the first place, economic cost is also an important issue in choosing the most ideal bariatric surgery method. First, the negative effects and positive effects of the applied method on the patient are evaluated together, and the bariatric surgical method options that are reduced from here are then evaluated according to secondary criteria. In fact, the differences between bariatric surgery methods used today are quite low and hundreds of studies have been conducted and published on three of the most widely used bariatric surgical methods, gastric bypass, gastric sleeve and sleeve gastrectomy. All these studies are handled in a pragmatic manner, and by revealing the negative aspects of the bariatric surgery method, it offers a solution in terms of eliminating these negativities. As a result of this, bariatric surgery methods are much more advanced today compared to the past and the differences between them are gradually closing.
Since bariatric surgery methods are becoming more widespread and the differences between them are less than in the past, it is not possible for the patient to choose or decide alone in the selection of the most ideal and appropriate bariatric surgery method. At this point, the patient and the physician should act together and enter the decision-making process regarding the most ideal weight loss method. In this process, the rationale of the weight loss method and time are very important.
Although the gastric balloon method seems to involve less invasive procedures than the gastric sleeve method or gastric bypass method, serious errors and complications may occur in the processes of placing the balloon into the stomach and removing it from the stomach. Again, issues such as whether the balloon is filled or not, material science and its content are the subjects where the gastric balloon method deviates from the ideal weight loss method. In addition, the tendency to regain weight after the removal of the balloon from the stomach is higher than other methods, which is one of the main obstacles to this method being ideal. There is also a significant decrease in the comfort of life after the gastric balloon.
In the gastric bypass method, on the other hand, the method deviates from being ideal because the undigested foods that pass into the intestine without passing through the stomach are not subject to sufficient research yet, it is a surgical operation and it contains many variables, especially the anesthesia or operation compliance level. Surgical complications that may occur after or during the operation also prevent this method from being the most ideal and harmless method compared to other methods.
Gastric sleeve method or sleeve gastrectomy is one of the most popular bariatric surgery methods from past to present. Although this method seems to be the most ideal and sustainable solution in terms of directly reducing the volume of the stomach, leaks that may occur especially in the sutures at the cut site can cause serious complications that will cost the patient’s life. For this reason, the gastric sleeve method, which is performed by people who are not experts and lacking in knowledge, can turn from being the most ideal bariatric surgery method to the most dangerous bariatric surgery method.
In fact, all of the bariatric surgery methods are pre-planned surgical methods that are seriously thought through, designed, deficiencies and dangers considered. However, the common point of all these methods is that they are limited to the unique unknowns of the human body. Not every body reacts the same to every surgical method or every anesthetic agent. Similarly, different results can be obtained in an operation or surgical intervention environment where all conditions are the same. For this reason, it is imperative that the patient and the physician perform a serious evaluation and process analysis in the selection and application of the ideal bariatric surgical method.
Another important criterion in bariatric surgery methods, which comes to the fore in the selection of the ideal method, is the quality of life after the operation and the sustainability of weight loss. When examined at this point, gastric sleeve or gastric sleeve is the method that reduces the quality of life the most in the short term after the operation, followed by the gastric balloon. The method that affects the quality of life least negatively is the gastric bypass method. However, when evaluating on the basis of risk, the most ideal method is gastric balloon, followed by gastric bypass and gastric sleeve methods. In fact, when the most ideal bariatric surgery method is viewed from a positive point of view, the ranking obtained from a negative point of view is the opposite of each other. Therefore, it can be stated that a definitive and absolute evaluation of the most ideal bariatric surgical method is not possible.
In short, the most ideal bariatric surgery method comes to the fore as the bariatric surgery method that the patient and the doctor will come together and evaluate the risks, gains and losses together. The most important evidence for this argument is that there is no significant difference between the frequency of use of these three most widely used bariatric surgical methods in the field of surgery, where research is constantly being conducted in a progressive and pragmatic way. In other words, if there was a bariatric surgery method that was far better than other bariatric surgery methods, other bariatric surgical methods would probably be a thing of the past and only that most ideal bariatric surgery method would be discussed.