Mini gastric bypass
This type of bariatric surgery was developed in 1996 by Dr. Rutledge, as a modification to the conventional gastric bypass surger y, during which a small pocket of the stomach does not exceed a size of 120 milliliter , and a single connection to the small intestine, where the first third of the intestine is exceeded responsible for the absorption of more than 70% of sugars and fats, called omega loop.
Advantages of the process:
It is the lowest rate of complications among bariatric surgeries The surgery can be reversed.
Allows the patient to eat more food and relatively larger quantities than other operations
Who are the patients who are candidates for the operation?
Type 2 diabetes with a recovery rate of 85% Patients who are sweet eaters.
Gastric reflux diseases and hiatal hernia. Revision of gastric sleeves after weight regain. During and immediately after the operation The duration of the operation in about an hour
The P.C.A. is used for all patients, a pump that pumps certain doses of morphine every hour and continues with the patient for three days after discharge from the
hour hospital stay is 24 hours and the patient can return to work within five-hospital. days of the operation
Nutrition after the operation:
The patient can drink translucent liquids after 6 hours of surgery and soft foods are advanced in the first week such as yogurt, jelly and some fruits and vegetables and soup and then the animal protein, dairy products are included from the second week
The patient needs one type of multivitamin for 3-6 months after the operation and can be modified during follow-up.
Results of the operation:
About 80% of excess weight can be lost in the first year after the operation Gastric reflux treatment.
Improvement and treatment of type 2 diabetes up to 85%
What are the complications of the operation?
Leakage or bleeding of less than 1%
Dumping Syndrome, where the patient feels a slight dizziness in the case of fast
eating or eating large amounts of sweets and can be avoided by dividing meals and eating slowly
Deficiency of some minerals and vitamins if you do not follow the instructions of a dietitian
Sleeve Gastrostomy
This operation is one of the most successful operations in the last 10 years, and is the most performed in the United States and the world, where it was performed as the first stage of surgery for patients with very large weights, until the patient loses part of the weight, and then the work of a diversion, but after a period it was proved that most patients lost more than 70% of the excess weight and did not need other surgeries
The operation is performed by removing a longitudinal part of the stomach that is about 80% of the size of the stomach
Advantages of the operation:
Easy operation where it takes place in less than an hour The patient does not need supplements after the operation The patient does not feel hungry after surgery.
Feel full quickly after eating small amounts of food
Who are the patients who are candidates for the operation?
Patients who depend on large amounts of food BMIIess than 45
Liver patients or those with intestinal adhesions Patients who do not suffer from the evil of sweets Children and patients under 20 years of age During and
immediately after the operation:
The P. C.A. pain control device is used for all patients after surgery where the patient controls the amount of the analgesics for three days after the operation
Laparoscopic surgery is performed in less than an he>ur
The hospital stay is 24 hours and the patient can return to work within 4 days of the operation
Postoperative nutrition:
The patient can drink transparent fluids six hours after surgery and the soft food is gradually added for two days after surgery and then soup, vegetables and soft fruit and animal protein, dairy products are advanced after 10 days of operation
You can eat 80% of your foods within a month of the procedure The patient needs vitamins for only one month after the operation
Results of the operation:
About 70 to 75% of excess weight was lost in the first year after the operation The cure rate of type 2 diabetes is about 80%
Recovery from associated diseases such as high blood pressure and sleep apnea within two months of surgery up to 70%
Complications of the operation: Less than 3% probability of a leak Less than 1% risk of bleeding
likely to have geriatric reflux 3%
Roux En Y Gastric Bypass
Until recently, the traditional gastric bypass was considered the gold standard for bariatric surgery, for its excellent results in weight loss and treatment of type 2 diabetes, and its use as a treatment for morbid obesity in the last 10 years was reduced to a relatively high rate of complications from modern surgeries by 5%, 4.5% leakage or 8% intestinal obstruction, and the comparable results of other surgeries such as Mini gastric bypass in excess weight loss and treatment of obesity complications
The operation remains a good choice in the following cases
Revision of bariatric surgery such as gastric band or gastric sleeve in cases of weight regain.
Revision of mini gastric bypass surgery in cases of bile reflux.
Severe esophageal reflux with pathological changes in the esophagus.
SASI operation
- It is an abbreviation of the name of the operation (Single Anastomosis Sleeve Ileal Bypass).
- It is one of the modern operations that is still under trial and is on the way to obtaining the approval of the American Society for Bariatric Surgery (A.S.M.B.S)
- It consists of two steps, the first of which is a gastric sleeve operation, and the second step is to make one connection to the last part of the intestine about
3 meters from the end of the intestine to the last part
of the stomach (Antrum), so food becomes two ways: the first way, which is the natural path of food, and the second way, which is through the
connection where two thirds are exceeded Small intestine.
- The first results of the operation are the results of other surgeries, such as rerouting, while avoiding to
some extent vitamins and minera-ls,deficie-ncy.
Banded Gastric Sleeve
It is one of the surgeries that have been developed to avoid weight regain with gastric sleeve operations,
without the need for another operation to repair the sleeve, and its steps are the same as the sleeve gastrectomy in addition to placing a minimizer gastric ring that prevents stomach expansion after a period of the operation. In a short time, the patient does not need nutritional supplements after a month of the
operation.
But one of its defects is that it has the same defects as the gastric band being a foreign body, and it can also move from its place in some cases, which
requires surgical intervention later.
Obesity and children:
Treatment of childhood obesity with advanced obesity surgenes:
As a result of the change in lifestyle and the dependence of children on fast -food,. eating arge quantities of sweets, with less movement, the rates of obesity increased among children, with rates
reaching 14 cases per 1000 children.
With the difficulty of applying diets with obesity in children, the laparoscopic sleeve gastrectomy is considered one of the successful solutions to treat childhood obesity for the following reasons:
- The operation does not affect the absorption of minerals and
- Ease of nutritional instructions after
- It does not affect the growth of
- It can be converted to any other surgery in the event that a portion of the weight is returned after the age of twenty.
- Rapid results of the operation at a young age, with success rates of 98°/o.
Obesity and pregnancy:
Treatment of obesity for women with obesity surgeries and its effect on pregnancy. Fertility and reproduction after obesity surgeries.
There is no doubt that bariatric surgery improves fertility rates and pregnancy outcomes for women, but the risks and nutritional instructions–for each surgery must be carefully considered after obesity surgeries for pregnant women, according to the Royal College of Surgeons for Obstetrics and Gynecology
(F.R.C.O.G).
In its study, it also compared obese mothers with mothers who underwent obesity surgeries for them and lost a large percentage of weight before pregnancy, as the results of the study were in favor of women who underwent the operations and the positive effect of the surgeries on the health of newborns.
The negative impact of obesity on the chances of conception and pregnancy and on the health of the mother during pregnancy and the health of the fetus and the possibility of the mother being exposed to high blood pressure and diabetes rel ted to pregnancy is known to have negative effects on metabolic syndrome (high blood lipids – diabetes – high blood pressure).
Morbid obesity has also been associated with negative consequences for fertility and pregnancy, due to the increased resistance of cells to insulin associated with patients with polycystic ovaries, with the difficulty of performing IVF in obesity cases.
Important instructions for those who have undergone surgery and want to become. pregnant:
- It is preferable to wait at least a year and preferably a year and a half after
- In the event of a pregnancy, God willing, a therapeutic nutritionist should be followed up
- Review with your obesity surgeon and communicate with your 08 I GYN specialist for best results
Obesity and diabetes
Treatment of obesity for type 2 diabetes with advanced obesity surgeries Laparoscopic obesity surgery is the latest treatment for type 2 diabetes, according to what has been published by the American Diabetes Association and the American
Society for metabolic and bariatric Surgery . The sleeve gastrectomy and gastric bypass surgeries are the best surgical solutions for diabetics, so the incidence of type 2 diabetes is 8.3°/o.
There is a close relationship between obesity and diabetes, as Dr. Ahmed Bahaa El-Din, member of the American Society for metabolic and bariatric surgery and fellow Surgeon, at Saint Jean’s Hospital in Belgium, explains that the American Diabetes
Association has recognized that endoscopic obesity surgery is one of the effective treatments for diabetes based on the recommendations of the American Society for Metabolic and bariatric Surgery in 2011 if the patient’s body mass index (BMI) is 30. After many operations such as laparoscopic gastric bypass, and longitudinal stapling of the stomach (sleeve gastrectomy), the cure of type 2 diabetes was
78 to 86°/o, and with research, it was discovered that
the hunger hormone called ghrelin is the main cause of diabetes, the quantities of this hormone is doubled in obese patients and type 2 diabetes, and after obesity
surgeries the secretion of this hormone decreases below normal levels and hormones increase Satiety in a very large amount, which creates the hormonal balance within the digestive system.
This led to the conclusion that the increase in the hunger hormone and the lack of the satiety hormone is one of the most important causes of diabetes.
Hormonal imbalance results in a S,i_gni.f_icant qecrease
in the sensitivity of insulin receptors inside the body, after surgery, the sensitivity of insulin receptors increases, and the level of blood sugar returns to its normal level within 3 to 15 days of the operation, and the success rate is 87°/o complete cure.
There are a number of laparoscopic obesity surgeries that treat diabetics, including: 1- stomach longitudinal stapling – sleeve gastrectomy
2- Gastric bypass surgery.
There are several results of obesity surgeries for diabetics, including: 1- Improvement in treating diabetes 86°/o
2- A permanent loss of 80°/o of excess weight after a year and a half of the proced.ure. 3- A cure for obesity-related diseases, such as high blood pressure
4- 100°/o complete recovery from high blood lipids
- Diabetes type II: in which the recovery rates after surgery reach 78°/o, and the rate of improvement in treatment reaches 86°/o.
- Type 1 diabetes: improving treatment and reducing the amount of insulin to less than half, with complete cure of diseases associated with diabetics, such as heart disease, high blood pressure, high blood lipids, and – fewer direct complications from
Source:
American Society for Metabolic and Bariatric Surgery.
Bariatric Surgery Guidelines and Recommendations:
Society of American Gastrointestinal and Endoscopic Surgeons
American Society of Gastrointestinal and Endoscopic Surgeons
Society of American Gastrointestinal and Endoscopic Surgeons
http://www.sages.org/pubIications/guideIines/ guide lines-for-clinical-application-of- laparoscopic• bariatric-surgery/
Other laparoscopic surgeries
Therapeutic endoscopes provide multiple solutions for many common diseases in our Arab and Egyptian societies.
1. Laparoscopic surgery to remove the gallbladder:
Gallbladder is a small organ the size of a pear located at the bottom of the liver is the upper right side of the abdomen its main function is the storage of gallbladder juice that is made in the liver and from there it travels throug channels until it reaches the gallbladder when the food is eaten and the percentage of fat is many, the gallbladder and after about
30 minutes begin to constrict and thus allow the passage of
the gallbladder juice through the its duct to reach the small bowel.
Ga llbladder diseases are common and affect women mostly and to a lesser extent men and one of the most common diseases is gallstones, which are formed by the saturation of gallbladder juice with cholesterol, which forms the nucleus
of the formation of stones and there are many theories that explain the causes of the gallstones.
Symptoms of gallstones are often evident, namely the occurrence of abdominal pain in the upper right side after 30 to 45 minutes after eating fat pain ranges in severity from mild to severe and tends to the right shoulder and back and reduces episodes of pain by moving a way from fat eating.
Abdominal ultrasound is very important to confirm the diagnosis .
The only solution is to perform gallbladder surgery through laparoscopic surgery with small openings of no more than four and only a day in the hospital.
2- Laparoscopic surgery for appendectomy
3 – Laparoscopic surgery for gastric acid reflux
4 – Laparoscopic surgery for abdomina l wall hernia operations