Bariatrics

Everything you need to know about Bariatric Equipment 

One of the most significant issues that plagues the human population in modern times is obesity. The increase in fast food chains all around the world has become the primary cause of weight gain. As more and more people start consuming processed food, their nutrition is compromised, resulting in extra fat accumulation. Doctors recommend bariatric surgery using bariatric equipment when the increase in weight reaches a point where diet and exercise are not safe or reasonable ways for people to shed the extra pounds. Performing surgeries with the assistance of bariatric equipment helps with weight loss by altering the digestive system through a surgical procedure. Such operations make the stomach smaller, which helps the patient reduce the portions of food and beverage they consume, thus making them feel full faster. This procedure helps patients lose extra weight by reducing the capacity of the stomach. People who have this surgery performed on them lose about 20-30% of their weight, which solely depends on the type of operation they undergo. These procedures require various types of bariatric equipment and there are four types of surgeries including the adjustable gastric band, sleeve gastrectomy, gastric bypass, andbiliopancreatic diversion with duodenal switch(BPD/DS). Weight loss clinics are often the places with the most access to bariatric equipment and understanding of this niche in medicine/health.

History 

In 1954, Dr. A.J. Kremen performed the first gastric bypass surgery, which was a major development in weight loss. In the process, Dr. Kremen and his team connected the patient's upper intestine to the lower intestine to bypass an enormous number of calories that are generally absorbed there. In 1963 Dr. Payne, De Wind, and others altered this procedure by adding a jejuno-colic shunt. Although this technique was an improved version of the original gastric bypass, it caused adverse issues and complications in patients, which led to necessary improvements in the bariatric equipment used and bariatrics in general. In 1967, Dr. Mason developed a new way that would surpass all previous inventions. This procedure involves stapling the stomach and bypassing the small intestine together. This technique showed remarkable results in obese patients but also had very severe side effects that were more hazardous to the human body than the fat itself. In 1996, Dr. Scopinaro and Dr. Giannetta introduced a new procedure, which was yet another improvement from the original procedure. Today we know it as "Roux-en-Y procedure." This process now loops the upper stomach to the small bowel and has fewer complications than the original. 

The inception of weight loss procedures and the public’s interest in leading healthier lives and losing weight helped the development of bariatric equipment grow at an accelerated rate.

Importance and indications of Bariatric surgery 

The use of bariatric equipment in various medical procedures has been a significant breakthrough for all those who have experienced issues related to their weight and cannot find any diet regimen that works for them. Bariatric surgery for obesity must be the last resort the doctor settles for after telling their patients about all noninvasive techniques, including diet, exercise, drugs, and even psychotherapy. Health care professionals should explain that the procedure is not for everyone. There are specific guidelines followed—including some requirements needed by the doctors to know whether the individual gets approved for the operation. The guidelines are as follows:

  • The patient weighs more than 100 pounds or BMI >40 
  • BMI>35 and at least one or more co-morbidity related to obesity, e.g., type I diabetes, hypertension, or sleep apnea, among many others.
  • The inability to achieve a healthy weight loss and maintain it for long periods

Why is bariatric surgery performed?

Healthcare professionals use bariatric equipment to perform various surgeries to help people struggling with their bodies lose excess weight and fight off potentially life-threatening conditions such as:

  • Dangerous fluctuations in blood pressure 
  • Stroke 
  • Sleep apnea 
  • Diabetes
  • Nonalcoholic fatty liver disease.
  • Obesity 
  • Heart disease 

Procedures involved in these surgeries

 There are four different types of procedures professionals usually perform:

  • Gastric bypass
  • Adjustable gastric band 
  • (BPD/DS)
  • Sleeve gastrectomy 

Gastric bypass:

There are two components to this procedure: 

A small portion of the stomach gets formed by separating the top end of the stomach from the abdomen. The first visible part of the intestine is then connected to the small portion of the stomach. This process allows the digestive enzymes to mix with the meal that enters to enable digestion.

Advantages

  • Significant changes in physique and maintenance 
  • Restriction in consumption of food 
  • Increase energy expenditure
  • Favorable changes in the gut hormone

Disadvantages

  • Vitamin/mineral deficiency 
  • The very complicated and risky operation 
  • Long pre-op care 
  • Strict diet adherence 

Sleeve Gastrectomy:

This procedure has many mechanisms upon which healthcare professionals work.

First, the “new” stomach (i.e., a smaller stomach) created holds less food than usual, which means a lower calorie intake. However, the more significant effect is shown in the gut hormones that show the suppression of hunger and blood sugar control.

Advantages:

  • Lessens the amount of meal the stomach can carry 
  • Rapid loss occurs with significant results
  • Requires no foreign objects in operation
  • Short hospital stays required
  • Positive changes in the gut hormone

 Disadvantages:

  • The procedure is not reversible 
  • Long term vitamin deficiencies 
  • A high rate of complications

Adjustable gastric band:

This is an operation in which an external device is implanted and works on making the stomach opening smaller and decreasing the amount of food that can be consumed. The opening gets managed between the opened and closed stomach, which controls the “feeling of fullness.” The opening can be operated manually by bands with sterile saline that can fill the opening. Decreasing the size of the opening is done slowly over time. 

Advantages: 

  • Decreases the capacity of the stomach 
  • Induces weight loss 
  • No cutting of stomach or intestine
  • Only a 24-hour hospital stay is required
  • Reversible and adjustable 
  • The lowest chance of postoperative complications
  • Meager chance of vitamin deficiency.

Disadvantages:

  • The slow speed of losing weight
  • An external device used in body 
  • Band slippage may occur 
  • Mechanical problems related to bands
  • Dilation of the esophagus if overeating occurs 
  • Firm adherence to postoperative care required

Biliopancreatic diversion with the duodenal switch:

There are two steps involved in this procedure. The first step consists of cutting a part of the stomach to remove a relatively large part of the stomach and forming a sleeve with the remaining portion. A valve is left intact, which releases food into the small intestine. During the second step, the surgeon cuts through the small intestine immediately below the duodenum. Then, a second incision is made at the end of the intestine (lower part).

Advantages

  • Greater weight loss 
  • The patient can eventually eat regular meals
  • Reduces the absorption of fat
  • The favorable change in the gut hormone
  • Effective against diabetes

Disadvantages

  • High mortality rate 
  • Longer hospital stays
  • Demand compliance with postoperative care

Bariatric Equipment Options

The following list is composed of various types of bariatric equipment that are usually needed to properly perform procedures and continue with treatment post-operation:

  • Power treatment table
  • Power transport chair
  • Ambulation/mobility aids
  • Bathing equipment (e.g., toilets, drapes, etc.)
  • Beds/mattresses/transportation
  • Ceiling lifts 
  • Commode/shower chairs
  • Stretcher
  • Lateral transfer aids
  • Multi-use/portable lifts
  • Stand assist lifts
  • Transfer/Geri chairs and cushions
  • Wheelchairs
  • Transport devices

Tips for selecting bariatric equipment 

  • Lease or purchase as soon as possible after the patient's admission.
  • Contact local distributors in advance to see what is readily available. Do not wait until you have a patient at the door. 
  • Mark weight limits on existing equipment so that the team can see if other special equipment is needed, which could reduce the likelihood of existing equipment overloading/malfunctioning
  • View the client's body size needs, along with their weight limit.
  • Equipment labeled "CE" stands for extended capacity and sometimes noted on specialized equipment. 
  • Consider the size of the elevator door vs. the equipment to ensure that what health professionals are renting or buying can easily get transported. 
  • When deciding whether to rent or buy, consider the frequency of admission, and costs.

Complications of bariatric surgery

There are many risks and complications in any surgery. Although very useful, the use of bariatric equipment and any associated surgery comes with its share of risks and complications as well. Some are more severe than others and this depends on factors such as the patient's lifestyle and his/her compliance with the postoperative treatment guidelines. The surgeons performing these methods should know about the complications their patients may go through. In case of infection, the doctor must keep in mind that the patient may need to undergo future procedures.

After the procedure, the patient should not eat anything for at least two days so the stomach and intestine can properly heal. Following this, they should follow a strict diet plan for about 3 weeks. Frequent medical checkups to do blood work and various other exams are necessary after most procedures that use bariatric equipment. Also, the client should know that if they experience any detrimental change to their health post-op, they should consult their physician, surgeon, or nearby weight loss clinic immediately.

General information about bariatric surgery

Bariatric surgery costs anywhere between $15,000 to $20,000. These rates depend on the type of operation, the bariatric equipment used, and the complications that the client may face. The cost of the procedure also depends on where the patient is located geographically. It all varies depending on the surgeon, materials, and hospital expenditure. The post-operation costs are very high as well because of all the special care the patient requires. As a side note, nutritionist appointments, which are often necessary for patients and paid directly out of pocket, cost about $50-$100 per visit.

Conclusion

The use of bariatric equipment can be beneficial and help people in many ways, but the associated procedures are often very expensive. All the research done by pioneers in the field discovered a lifesaver for many people. As we all know, being obese is a huge health risk for humans, especially with the obesity rates in America. Obesity is a huge burden for any affected individuals, including the obese themselves and close friends and family. Bariatric operations have proven to be beneficial for almost 75% of patients who undergo related procedures. Due to the multiple advantages that the surgery brings, thousands of people undergo it every year to try and make a difference in their lives.