Types of Weight Loss Surgery for Women With PCOS

Bariatric surgery can be an effective way of achieving weight loss for women with polycystic ovarian syndrome (PCOS). But trying to figure out which type of weight loss surgery is best for you can be difficult and confusing.

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Bariatric surgery has been around since the 1960s, and now most of the procedures are performed laparoscopically, through a series of small incisions using a camera inside the body.

Choosing the Best Type of Weight Loss Procedure for You

Making the decision to have weight loss surgery is a big one, as is finding your surgeon and ultimately determining what type of surgery to have. Several types of surgery are available, and your surgeon will likely have a preference or recommendation as to which will be most effective for your PCOS.

Your doctor will also be likely to suggest the procedure with which they have the most success—an important reason for seeking a surgeon who has experience working with women with PCOS. As with all surgeries, each procedure has its advantages and disadvantages.

Roux-en-Y

Laparoscopic Roux-en-Y Gastric Bypass is the most widely performed procedure today. It involves the following:

  • rearranging the gastrointestinal (GI) tract so that food bypasses a majority of the stomach and small intestine.
  • creating a small pouch at the top of the stomach.
  • making a second incisionat the lower part of the small intestine, which is then connected to the pouch made at the top of the stomach.

This allows food to bypass most of the GI tract that absorbs nutrition and calories.

Roux-en-Y seems to be very effective at reversing insulin resistance, a significant problem for women with PCOS, even before the patient has lost weight.

On the other hand, this procedure carries a higher risk of malabsorption. This is corrected with supplements that are necessary to prevent severe nutritional deficits. You will also require close monitoring and frequent follow-up appointments to keep an eye on your nutritional status.

Other risks include gallstones, blockage, leakage through sutures or staples, and dumping syndrome (an unpleasant condition where certain foods or drinks cause severe cramping and diarrhea).

Sleeve Gastrectomy

Medically referred to as Laparoscopic Sleeve Gastrectomy (LSG), this procedure involves:

  • removing a major portion of the stomach
  • closing the remaining portion of your stomach using surgical staples, creating a long, vertical "sleeve" or banana-sized stomach.

LSG is relatively new—it's been performed as a standalone surgery for fewer than twenty years—but it has become the most popular bariatric procedure in the United States. Complications such as nutrient deficiencies are less common with this procedure, and it does not include surgical bypass or device implantation.

Although the Roux-en-Y procedure is slightly better over the long term for weight loss, the newest research is showing that other benefits, such as improved insulin sensitivity and other metabolic benefits, are similar between the two procedures.

Lap Band

Lap Band, or Laparoscopic Adjustable Gastric Banding (LAGB), requires a shorter operative time (less than 2 hours) and reduced time in the hospital compared to those of the Roux-en-Y and LSG. This procedure involves:

  • placing an adjustable silicone band containing a circular balloon around the top part of the stomach.
  • adjusting the size of the opening from the pouch to the rest of your stomach by injecting or removing saline solution into the balloon through a small device (port) placed under your skin.

Patients need several follow-up visits to adjust the size of the band opening. If it causes problems or is not helping you lose enough weight, your surgeon may remove it.

Some studies show that this procedure has similar success rates as the Roux-en-Y, however, a greater need for repeat surgery was reported for band slippage or port problems.

Best Options for Women with PCOS

Roux-en-Y leads to a slightly higher loss of excess weight than LSG does, and both lead to greater excess weight loss than LAGB.

It is important to have an open discussion with your physician about your surgical options and determine which procedure they believe would be best for you. Do your own research before your appointment so that you understand your options and goals for surgery—your PCOS symptoms and personal history are unique to you, even if your surgeon has experience treating people with PCOS.

Getting a second opinion is always a good idea, especially if you have any concerns about your planned procedure.

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Article Sources
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