Procedures / Surgeries performed in dept
Obesity surgery works by helping to reduce the number of calories that are available in your body. There are two ways this can be achieved surgically:
• Restriction – by reducing the size of the stomach, only small meals can be eaten and the appetite is satisfied
• Malabsorption – by bypassing part of the small intestine, less calories from food are absorbed by the body.
1. Sleeve Gastrectomy
In this procedure, the surgeon creates a narrow tube-like stomach and removes the remainder. Hence, the capacity of the new stomach is much smaller than the original. It is usual to offer this operation as a first stage procedure to super obese patients – a second stage procedure is then offered after the patient has lost some of the excess weight to make this type of surgery safer. In a small number of patients, a sleeve gastrectomy may be the only operation that is required. It should be noted, however, that long-term data of weight loss following sleeve gastrectomy is not yet available.
Advantages:
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You can expect to lose roughly 50-60 percent of your excess weight.
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The amount of food that can be consumed at a meal is restricted.
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Food passes through the digestive tract in the usual order, allowing it to be absorbed fully by the body.
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There is no re-routing of small intestines
2. Roux-en-Y Gastric Bypass (LRYGB)
In this procedure, the surgeon creates a small gastric pouch of approximately 30-60ml. The small bowel is then divided and the end brought up and attached to the gastric pouch. In this way, food passes into the pouch and straight down into the lower part of the small bowel. The rest of the stomach and the bypassed part of the small bowel are then re-attached further down. This ensures that the gastric and pancreatic juices enter the small bowel and digest the food. You will need to take tablets daily including a multivitamin and mineral, calcium and vitamin D, Iron, as well as have three monthly vitamin B12 injections.
Advantages:
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Weight loss starts from the time of surgery and can be rapid within the first 6 months.
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You can expect to lose roughly 70 – 80 percent of your excess weight at 2 years.
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In most cases, further surgery is not required.
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Patients report decreased hunger and appetite due to hormonal changes.
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Has the highest and fastest remission rate for diabetes (type 2)
3. Mini-Gastric Bypass
The mini gastric bypass procedure was first developed by Dr. Robert Rutledge from the USA in 1997. A mini gastric bypass creates a long narrow tube of the stomach along its right border (the lesser curvature). A loop of the small gut is brought up and hooked to this tube at about 180 cms from the start of the intestine The MGB has been suggested as the latest alternative to the Roux-en-Y gastric bypass procedure due to the simplicity of its construction, and is becoming more and more popular because of low risk of complications and good sustained weight loss. It has been estimated that 15.4% of weight loss surgery in Asia is now performed via the MGB technique Mini Gastric Bypass (MGB) works by:
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Restrictive – A Small stomach pouch is created restricting the amount of food you can eat.
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Malabsorptive –A portion of the small intestine is bypassed. Since the small intestine is responsible for absorbing the calories from the food you eat, bypassing a portion of the small intestine results in fewer calories being absorbed, thus creating additional weight loss.
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Hormonal – The hormone ghrelin has been nicknamed the “Hunger Hormone” by researchers because of its significant effect on appetite. Gastric Bypass results in a fall in ghrelin levels resulting in a reduced appetite.
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