Weight Loss Surgery
Helps you to lose weight by different ways either by restriction or by changing how your stomach and small intestine handle the food you eat. There are different surgical procedures like Sleeve Gastrectomy, Gastric Band, Gastric Mini Bypass and Gastric bypass. Also there are procedures which helps you to loose weight without surgery like Gastric Balloon. Obesity is a chronic, relapsing medical condition for which there is no cure,”only ongoing treatment which will ameliorate the condition. For morbidly obese patients, surgical intervention is an option and is the treatment of choice. Generally, the criteria include both of the following:
1- Have a BMI of over 35 (Asians 32.5 ) with obesity-related medical complications, such as high blood pressure, diabetes, elevated cholesterol, or sleep apnea.
2- Have a BMI of over 40 (Asians 37.5 ) without associated medical complications.
3- Have been unsuccessful after undergoing appropriate medical management like dieting, weight loss medications.
The surgical methods have changed over the years, but can be divided into gastric (stomach) restrictive procedures, wherein the quantity of food is “ restricted ” and combination of restrictive/ malabsorbtive procedures like Gastric bypass procedures, wherein there is a restrictive component but also a component that leads to incomplete absorption of food.
SLEEVE GASTRECTOMY DUBAI ( POPULARLY CALLED LOW MAINTENANCE WEIGHT LOSS PROCEDURE)
SG (sleeve gastrectomy) produces weight loss by two mechanisms
1- Produces early satiety as a purely restrictive procedure
2- Reduces plasma hunger hormone (ghrelin) levels by removing a great part of the Ghrelin production tissue ,Ghrelin is a potent appetite-stimulating hormone.
In SG, resection of the fundus removes the major site of ghrelin release, therefore appetite decreases
COMBINATION RESTRICTIVE/MALABSORPTIVE PROCEDURES ( GOLD STANDARD)
Arguably, the “ gold standard ” in obesity surgery is the Roux-en-Y Gastric Bypass . This procedure involves both a “ restrictive ” procedure by decreasing the size of the stomach by stapling across the top of it and a “ malabsorptinve ” component, achieved by bringing-up and attaching a portion of the small intestine directly to the stomach (thus “ bypassing ” part of the small intestine ).This surgery causes gastrointestinal hormonal changes, which result in decreased hunger and improved satiety or fullness. Individuals undergoing this surgery will lose significant amounts of weight (mainly body fat as opposed to lean body mass or muscle tissue). Weight maintenance is generally excellent with small increases in weight occurring over subsequent years. Like any obesity surgery, the patient will require lifelong vitamin supplements & regular periodic follow-up to preventive any vitamin, iron, calcium deficiencies .
Surgical Results, Complications, and Nutritional Deficiencies (reference: Gastroenterology. 2002 Sep;123(3):882-932):
Mean estimated excess body weight loss as:
1- At 2 years: approximately 60- 80 % of excess body weight lost
Major complications related to this specific surgery ( less than 3-4 %) :
1- Marginal Ulcers at the site of anastomosis (“ attachment ”) of the intestine to the stomach
2- Stomal stenosis (“ narrowing ”) at the stomach outlet, resulting in nausea and vomiting
3- Leakage of intestinal contents
4- Stomach staple line disruption resulting in the ability to consume large volumes of food
5- “Dumping Syndrome ” wherein consumption of food (especially carbohydrates) results in nausea, vomiting, diarrhoea, abdominal pain, flushing, rapid heart beats.
Nutritional Deficiencies from Roux-en-Y Gastric Bypass are specially iron, Vitamin B12, Folate, Vitamin D, Calcium, Thiamine, Protein, therefore needs regular supplementation and follow up with your doctor.
This procedure is now usually laparoscopically, which offers a faster surgical recovery & more safety.
Gastric (stomach) restrictive procedures
Another restrictive gastric approach is laparoscopic gastric banding.
This procedure, which was approved in the U.S. in June 2001, is popular & is done by Laparoscopic technique( through Minimal invasive technique or also called Key hole surgery and therefore recovery time is only a few days. Basically, an adjustable band is placed around the upper portion of the stomach, resulting in (essentially) a much smaller stomach. This restricts the amount of food that can be eaten, similar to the sleeve surgery(see above).
The European literature (where the procedure has been performed for a longer period of time) shows that weight loss is similar to that seen with sleeve surgery. Clinicians in the U.S. report less weight loss than our European colleagues. Complications include band slippage, erosion of the band into the stomach, dilation of the oesophagus, and infections, many of which require removal of the device.
Surgical Results, Complications, and Nutritional Deficiencies:
Mean estimated excess body weight loss and complications from a study published in Obesity Research 2008 are as follows:
1- At 7 years: < 50% of excess body weight lost
2- At 9 years: < 40 % of excess body weight lost
Major late complications related to this specific surgery:
1- Band eroding into the stomach: 3.3%
2- Slippage: 6.5 %
3- Leakage: 9.8%
4- Major reapportion: 24.4%
Nutritional Deficiencies from Gastric Banding:
1- Rarely significant nutritional deficiencies from the surgery itself
2- Thiamine deficiency if persistent vomiting
3- Occasional protein deficiency from “ induced ” dietary changes
Many clinicians recommend this procedure for older individual (60-65 years old) who would otherwise not be a candidate for other kinds of surgical intervention.
MINI GASTRIC BYPASS SURGERY DUBAI
The Mini Gastric Bypass (MGB) is a Short, Simple, Successful gastric bypass weight loss surgery which is gaining popularity in recent years.It is low risk & has excellent long term weight loss & minimal pain.
The mini-gastric bypass procedure is restrictive and malabsorptive. It means that the procedure reduces the size of your stomach, restricting the amount you can eat. The procedure also reduces absorption of food by bypassing up to 6-7 feet of intestines. This has excellent results for individuals who has diabetes with obesity. It reverses diabetes in 60- 80 % of patients.
Benefits Of Mini Gastric Bypass Compared To Gastric Bypass Surgery
1- Shorter operating time.
2- Less re-routing of the intestines.
3- One fewer anastomosis (connection of intestines), which in theory means less chance of a complication.
4- Similar weight loss and recovery.
Simple yet very effective weight loss surgery which is reversible too.
It is simple to perform ,is more effective than band & safer than RNY gastric bypass.
This operation is done to treat morbid obesity type 2 diabetes, hypertension,sleep apnea, and associated co morbidities. Weight loss surgery results in weight loss, typically dramatic & also markedly reduces comorbidities. loke diabetes, high blood pressure, PCOS, back pain , sleep apnoea etc.
The operation usually has hospital stay is usually 2 nights. With excellent long term weight loss, minimal pain and the option for reversal or revision if needed.
If you think you are overweight and want to get rid of your obesity then book an appointment with Dr Girish Juneja who offers the best Mini Gastric bypass surgery in Dubai.