Weight loss failure after sleeve gastrectomy


Laparoscopic Sleeve Gastrectomy - Obesity Action Coalition

The laparoscopic sleeve gastrectomy (LSG), a relative newcomer to bariatric surgery, is growing in popularity. No intestines are removed or bypassed during the sleeve gastrectomy. How Does the Sleeve Gastrectomy Cause Weight-Loss? Sleeve gastrectomy is a restrictive procedure. Patients who have a very high body mass index (BMI) or severe heart or lung disease may benefit from a shorter, lower risk operation such as the sleeve gastrectomy as a first stage procedure. In patients who undergo LSG as a first stage procedure, the second stage (gastric bypass) is performed 12 to 18 months later after significant weight-loss has occurred, the liver has decreased in size and the risk of anesthesia is much lower. What are the Risks of Sleeve Gastrectomy? This lower risk and shorter operative time is the main reason we use it as a staging procedure for high-risk patients. Major complications requiring re-operation are uncommon after sleeve gastrectomy and occur in less than 5 percent of patients. You should first know the risks and benefits of sleeve gastrectomy, adjustable gastric banding and gastric bypass. Sleeve Gastrectomy May be Performed for the Following Reasons: more...



Vertical Gastrectomy Expected weight loss 70 - 80% of excess

Vertical Sleeve Gastrectomy / Sleeve Gastrectomy. Description of the Vertical Sleeve Gastrectomy. Most common weight loss surgery performed in the U. This is the most modern weight loss procedure that induces weight loss by restricting food intake, invented back in 1999 but modified and refined by Dr. The Vertical Sleeve Gastrectomy is essentially a newer, better version of the vertical banded gastroplasty, a procedure that has been abandoned by virtually all weight loss surgeons, due to high failure rates and complications. Advantages of Vertical Sleeve Gastrectomy Procedure. Allows patients of any weight, including the super super obese and high risk patients, to undergo surgery with small incisions. Disadvantages of Vertical Sleeve Gastrectomy Procedure. Weight loss may be slower than more malabsorption procedure type like the duodenal switch. Risks of Vertical Sleeve Gastrectomy Procedure. more...



Bariatric surgery - Wikipedia, the free encyclopedia

Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestine to a small stomach pouch ( gastric bypass surgery ). The recent guidelines suggest that any patient with a BMI of more than 30 with comorbidities is a candidate for bariatric surgery. Weight loss is predominantly due to the restriction of nutrient intake that is created by the small gastric pouch and the narrow outlet. The procedure is performed laparoscopically and is not reversible. The balloon can be left in the stomach for a maximum of 6 months and results in an average weight loss of 5–9 BMI over half a year. Quoted costs for the intragastric balloon are surgeon-specific and vary by region. A common form of gastric bypass surgery is the Roux-en-Y gastric bypass, where a small stomach pouch is created with a stapler device and connected to the distal small intestine. The gastric bypass had been the most commonly performed operation for weight loss in the United States, and approximately 140,000 gastric bypass procedures were performed in 2005. Its market share has decreased since then and by 2011, the frequency of gastric bypass was thought to be less than 50% of the weight loss surgery market. There are certain patients who cannot tolerate the malabsorption and dumping syndrome associated with gastric bypass. Open weight loss surgery began slowly in the 1950s with the intestinal bypass . Mason and Chikashi Ito at the University of Iowa developed the original gastric bypass for weight reduction which led to fewer complications than the intestinal bypass and for this reason Mason is known as the "father of obesity surgery". more...



Weight Loss after Sleeve Gastrectomy in

Three years after the initial laparoscopic sleeve gastrectomy, the mean EWL was 51% (range 21 to 82). The laparoscopic sleeve gastrectomy is a safe and efficient operating procedure for treating super superobesity. This is a prospective study that included 30 consecutive super superobese patients and was designed to study the efficacy and safety of the sleeve gastrectomy in this group of these patients. Cautious refeeding was permitted in the absence of fistula, and patients were discharged after removal of the drain. The average preoperative weight was 168 kg (range 140–258 kg). Of the 23 patients that had a followup greater than 18 months, weight loss was satisfactory in 17 patients (77%). Three out of six patients were reoperated with a resleeve gastrectomy, and two with a gastric bypass surgery 18 to 23 months after the initial procedure. Three years after the original sleeve gastrectomy, the average loss of BMI was 20 kg/m² (range 10 to 39 kg/m², Figure 2 ). The average percentage of excess weight loss at 3 years was 51% (range 21–82%, Figure 3 ), while the average weight loss was 56 kg (range 28–144 kg) ( Figure 4 ). Preliminary results showed that the sleeve gastrectomy, after a 24-month period postroperatively was equally effective as gastric bypass in terms of weight loss in the super superobese patients while presenting lower risk for complications (3,6% to 9% resp.). The frequency of complications after gastric bypass in the super superobese can reach up to 23% [ 8 ] and up to 38% for duodenal switch [ 6 ]. In the super superobese patients, the death rate was assessed up to 2.7% after gastric bypass [ 8 ] and 6.25% after duodenal switch [ 6 ]. It is known that the sleeve gastrectomy in the super superobese can be a definitive treatment for an average loss of excess weight by 50% at one year [ 3 , 10 ]. We have shown that the sleeve gastrectomy for the super superobese can allow an average loss of excess weight by 53% at 18 months. If weight loss was insufficient, the sleeve gastrectomy could then be followed by a second operating procedure, like gastric bypass [ 3 ] or biliopancreatic diversion [ 9 ]. more...



Vertical Sleeve Gastrectomy Weight Loss Surgery

Vertical Sleeve Gastrectomy Weight Loss Surgery. The vertical sleeve gastrectomy, or sleeve gastrectomy, is a type of restrictive weight loss surgery . Vertical gastrectomy surgery causes weight loss by restricting the amount of food that is able to be consumed before feeling full. The vertical gastrectomy surgery isolates a small section of the stomach for processing food, limiting the size of meals to approximately one ounce after surgery. The surgery is typically performed on patients who are too heavy to have other types of weight loss surgeries with the expectation that a second surgery will be performed once weight has been lost. The Vertical Sleeve Gastrectomy Procedure. The surgery begins with multiple half-inch long incisions in the area of the stomach. For patients with less weight to lose, this procedure does not produce the same levels of weight loss as other types of surgery. Many patients who intend to have this procedure as their only weight loss procedure have difficulty maintaining the tiny portions required to keep the stomach pouch size small. Total weight loss is less than most types of surgery and the procedure is not reversible because the area of the stomach is removed rather than stapled to prevent food from entering. Many patients will chose another type of surgery, not because of the procedure itself, but because few surgeons perform the surgery and many insurance companies consider it investigative, or experimental. Insurance companies do not pay for surgeries classified as investigational but may pay other types of weight loss surgery . more...



Weight - Loss Surgery May Help Control Type 2 Diabetes in

After 5 years, more patients in surgery group had lower blood sugar than in medication-only group. MONDAY, April 4, 2016 (Health Day News) - New research adds to growing evidence that weight-loss surgery helps patients with type 2 diabetes lower their blood sugar levels for at least five years. But British researchers reported in The Lancet medical journal last September that weight-loss surgery helped type 2 diabetes patients fight their disease. Five years after surgery, half of 38 patients who had surgery saw their diabetes go into remission, compared to none of the 15 patients in the medication-only group. The second group received medications and also had gastric bypass surgery. The final group had medications and had a different weight-loss surgery, called sleeve gastrectomy. After five years, the rates of reaching and maintaining blood sugar levels of 6 percent or less were significantly higher among those who had weight-loss surgery. The findings showed that 29 percent of those who had gastric bypass surgery and 23 percent of those who had a sleeve gastrectomy reached the target level, while only 5 percent of the medication-only group did. The use of heart medications, insulin or other drugs to treat diabetes was also much lower among patients who had either weight-loss surgery, the investigators found. And, more than 88 percent of those who had surgery were able to keep their blood sugar levels in check without insulin, according to the report. However, the researchers noted that weight-loss surgery is associated with some risk for certain complications. The study authors also suggested that gastric bypass may have greater benefits than other forms of weight-loss surgery. The researchers suggested the findings could increase the number of people with poor blood sugar control who could be considered candidates for weight-loss surgery. more...



Gastric Sleeve Surgery in Louisiana

Gastric Sleeve Surgery (Sleeve Gastrectomy) in Louisiana. The Gastric Sleeve is a restrictive procedure, meaning patients lose weight by limiting the amount of food they take in. Gastric Sleeve Surgery Results. Sleeve gastrectomy patients experienced resolution rates for type 2 diabetes, high blood pressure, high cholesterol, and obstructive sleep apnea that were similar to resolution rates for other restrictive procedures such as adjustable gastric banding.* Potential Gastric Sleeve Patient Concerns. Long term complications that may require reoperation are less frequent than those for RYGB and adjustable gastric band. Because there is no implant, as with the adjustable gastric band, there is no risk of mechanical failure, and the need for frequent follow-up adjustment visits is eliminated. more...



Sleeve Gastrectomy - Institute for Advanced

Sleeve gastrectomy is offered for patients in conjunction with the duodenal switch or used alone as weight loss surgery. The Sleeve Gastrectomy is part of the Biliopancreatic Diversion with Duodenal Switch (BPDDS) weight loss operation. They were happy with the weight loss from the sleeve operation alone. The weight loss is expected to occur over one to one and half years.  Half of the expected weight loss is lost in the first 6 months after surgery. The sleeve gastrectomy surgery is gaining popularity among weight loss surgeries.  The sleeve behaves a lot like the bypass in weight loss, diabetes control, and beneficial side effects. Many of our patients with proper education and good compliance to the rules can achieve even better weight loss.  Please read the Sleeve Gastrectomy Diet Guide to learn more and attend the weight loss surgery seminar for more information about weight loss surgery. With the Sleeve Gastrectomy, patients lose around 70% of their excess weight within one to one and a half years. Although the information presented in our website may be helpful, you will be able to learn substantially more about the benefits and risks of the Sleeve Gastrectomy operation during your visit with the bariatric surgeon or at our free weight loss surgery information seminar . The weight loss surgery education program consists of: The decision to proceed with weight loss surgery in general is a very personal and often difficult one. more...



Gastric Sleeve Works Long Term

Obese patients who have laparoscopic sleeve gastrectomy keep the weight off in the long run, researchers found. In a single-center study, patients who underwent the procedure lost an average 57.4% of excessive body mass index (BMI) over 5 years, Ralph Peterli, MD, of Claraspital in Basel in Switzerland, and colleagues reported online in the journal Surgery for Obesity and Related Diseases. A total of 68 patients had laparoscopic sleeve gastrectomy at their center as either a primary bariatric procedure or as a re-operation after failed laparoscopic gastric banding between August 2004 and December 2007. At the time of sleeve gastrectomy, mean BMI was 43 and 78% of patients were female. Overall, Peterli and colleagues found that the average excessive BMI lost after 1 year was 61.5%, and then 61.1% after 2 years. "The main weight loss occurred in the first postoperative year and appeared in the following years for the most part stable," they wrote. However, 34.3% of patients who had sleeve gastrectomy as their primary procedure and 50% of those who'd had it after a failed gastric banding still had a BMI above 35 kg/m2 after 5 years. "Patients with a prior [gastric banding] show worse results concerning weight loss," they wrote, noting, however, that international consensus considers Roux-en-Y gastric bypass [RYGB] surgery as the best option following failed banding, not sleeve gastrectomy. Among four insulin-dependent patients, only one still needed insulin therapy 5 years after laparoscopic sleeve gastrectomy. They also found that re-operation due to insufficient weight loss was needed in eight patients, or 11.8% of the study population. But they concluded that sleeve gastrectomy is effective nearly 6 years after the initial operation, with nearly 60% of excessive BMI still gone and a "considerable improvement or even remission" of comorbidities. more...



Gastric Sleeve Surgery - Obesity Weight Loss Surgery

Gastric sleeve surgery, or vertical sleeve gastrectomy, is one of the newer types of bariatric surgery. How Gastric Sleeve Surgery Works. Who Is a Good Candidate for Gastric Sleeve Surgery? What to Do Before Gastric Sleeve Surgery. What to Expect After Gastric Sleeve Surgery. Gastric Sleeve Surgery Risks and Complications. There are several risks and complications of gastric sleeve surgery: (Read more about the risks of gastric sleeve surgery .) Take-Home Points on Gastric Sleeve Surgery. Cost of Gastric Sleeve Surgery. The cost of gastric sleeve surgery can exceed $10,000. (Read more about the cost of gastric sleeve surgery .) more...



MEDLINE Abstract

All patients with weight loss failure after primary LSG underwent radiological evaluation. Thirteen patients (36.1 %) had their original LSG surgery performed at another hospital and were referred to us for weight loss failure. The LSG was realized for patients with morbid obesity with a mean BMI of 47.1 (range 35.4-77.9). The mean interval time from the primary LSG to Re SG was 34.5 months (range 9-67 months). The indication for Re SG was insufficient weight loss for 19 patients (52.8 %), weight regain for 15 patients (41.7 %), and 2 patients underwent Re SG for invalidating gastroesophageal reflux disease. The mean BMI decreased to 29.2 (range 20.24-37.5); the mean percentage of excess weight loss was 58.5 % (Âą25.3) (p < 0.0004) for a mean follow-up of 20 months (range 6-56 months). Further prospective clinical trials are required to compare the outcomes of Re SG with those of Roux en Y Gastric Bypass or DS for weight loss failure after LSG. more...



Gastric Sleeve Surgery Complications, Risks - Weight Loss

Gastric Sleeve Surgery Complications, Risks. Gastric sleeve weight loss surgery is becoming an increasingly popular procedure, and the numbers are accruing. About Gastric Sleeve Surgery Complications. The potential for complications after gastric sleeve surgery can be reduced if you follow the preparation and recovery plans given to you by your surgeon. The risk of postoperative bleeding has been reported to be between 1% and 6% after gastric sleeve ( source ). Gastroesophageal reflux disease (GERD) is common in the bariatric surgery patients, especially gastric sleeve patients. Nutritional deficiencies are common after bariatric surgery, including the gastric sleeve. Nausea is one of the most common side effects of Gastric Sleeve Surgery. Constipation may arise after gastric sleeve because of the dietary changes that comes with gastric sleeve surgery. To minimize your risks of a blood clot or pulmonary embolism after gastric sleeve surgery, we recommend walking every day after the surgery and performing calf muscle exercises. more...



New Guidelines for Weight - Loss Surgery Upgrade Sleeve

Sleeve gastrectomy is an effective form of bariatric surgery and should no longer be considered investigational, according to updated guidelines. In addition, the guidelines suggest that bariatric surgery can be entertained in those with a BMI 30 to 35 if they have type 2 diabetes, which would greatly expand the number of potentially eligible patients. Sleeve gastrectomy is an effective form of bariatric surgery and should no longer be considered investigational, according to updated guidelines cosponsored by the American Association of Clinical Endocrinologists, The Obesity Society, and the American Society for Metabolic & Bariatric Surgery. The recommendations pin the gastric sleeve procedure between banding and bypass in terms of weight loss, Mechanick said. What makes a good candidate for any of the procedures is another area covered in the guidelines, and Youdim said there's more evidence for using bariatric surgery as "metabolic" surgery to treat cardiometabolic complications such as type 2 diabetes, although, she noted, questions remain, particularly about long-term outcomes for safety and diabetes remission rates. The new guidelines suggest that patients with a BMI of 30 to just under 35 who have type 2 diabetes may be offered bariatric surgery, Youdim said, with the caveat that the evidence is limited. The two groups of patients for whom there is the strongest evidence that bariatric surgery is safe and effective are still patients with a BMI of 40 and above, and those with a BMI of 35 and above plus comorbidities. The new guideline also includes updated evidence for counseling women of reproductive age about an increased risk of pregnancy after surgery, and it's recommended that they refrain from trying to get pregnant for one year after surgery, Youdim said. Mechanick added that the guidelines emphasize a team approach to bariatric surgery in order to prevent and treat complications such as metabolic disease that may arise. more...



Expected Monthly Weight Loss With the Gastric Sleeve

Expected Monthly Weight Loss With the Gastric Sleeve. And, while your doctor can estimate the amount of weight you are likely to lose altogether, you can expect to lose more weight during the first few months and less as you get closer to your target weight. Your excess body weight is the difference between your ideal weight and your current weight. So, if you weigh 100 lbs more than your ideal weight, your excess weight is 100 lbs. In this example, if you lost 50 percent of your excess weight - or 50 lbs - over the 12 to 18 months after the surgery, that would be a reasonable result. Since weight loss is reported as a percentage, the number of pounds you shed per month depends on where you started. Findings in the October-December 2013 issue of the "Journal of the Society of Laparoendoscopic Surgeons" suggested that people having sleeve gastrectomy lost more of their excess weight in the first few months after surgery. In this study of 100 patients, on average, subjects lost about 18 percent of their excess weight in the first month. Average weight loss by the end of 6 months was 50 percent of the excess body weight, and by the end of the first year, they had lost about 63 percent of their excess weight. The amount of weight lost after gastric sleeve depends on several factors. more...



Sleeve Gastrectomy Failure : Just When We Thought We Had

Sleeve Gastrectomy Failure: Just When We Thought We Had the Perfect Operation. Sleeve gastrectomy is gaining popularity among the bariatric surgery community. Whereas short-term studies have demonstrated the safety and efficacy of sleeve gastrectomy, its long-term outcomes and durability are unknown. Our goal is to provide an updated summary of the current bariatric literature in regard to sleeve gastrectomy failure. The exact failure rate of sleeve gastrectomy is unknown.    Updated position statement on sleeve gastrectomy as a bariatric procedure. Systematic review of sleeve gastrectomy as a staging and primary bariatric procedure. The Second International Consensus Summit for Sleeve Gastrectomy, March 19–21, 2009. Short and midterm outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. The First International Consensus Summit for Sleeve Gastrectomy, New York City, October 25–27, 2007. Laparoscopic sleeve gastrectomy: influence of sleeve size and resected gastric volume. Does gastric dilation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Laparoscopic Sleeve Gastrectomy. Sleeve gastrectomy as sole and definitive bariatric procedure: 5 year results for weight loss and ghrelin. more...



Gastric Sleeve Surgery Risks - Obesity Weight Loss Surgery

Gastric sleeve surgery has its share of potential risks and complications. These risks must be weighed against the potential benefits of gastric sleeve surgery in minimizing the health risks associated with obesity, including diabetes, cardiovascular disease, arthritis and certain types of cancer. Still, a decision to undergo gastric sleeve surgery should be made after serious consideration of the risks it poses as well as consideration of how the surgery will affect your life and lifestyle. Your bariatric surgeon should discuss gastric sleeve as well as other procedure choices, along with the risks and benefits of each, during your consultation. Some gastric sleeve surgery risks include: Gastric sleeve as a standalone procedure is a relatively new weight loss surgery. Understanding Gastric Sleeve Surgery. The sleeve as a standalone procedure is most effective in patients who are similar in body weight to those who are considering an adjustable gastric band surgery with the Lap Band or Realize Band. Gastric sleeve surgery is now increasingly offered as a standalone, primary weight loss procedure. Additional Gastric Sleeve Risks and Benefits. All surgeries have some risk, including gastric sleeve surgery. Other gastric sleeve risks that can occur well after your surgery include weight regain, heartburn and vitamin deficiencies. In addition to these risks, advocates of the sleeve surgery say it also has some distinct benefits. Specifically, gastric sleeve may reduce levels of ghrelin, the "go" hormone that tells your body it's hungry, thus reducing your appetite and aiding weight loss. more...



Revised sleeve gastrectomy : another option for weight loss

, Anne-Sophie Schneck Affiliated with Hôpital Archet, Université de Nice. , Jean Gugenheim Affiliated with Hôpital Archet, Université de Nice. , Antonio Iannelli Affiliated with Hôpital Archet, Université de Nice. All patients with weight loss failure after primary LSG underwent radiological evaluation. Twenty-four patients (66.6 %) out of 36 had a history of gastric banding with weight loss failure. The LSG was realized for patients with morbid obesity with a mean BMI of 47.1 (range 35.4–77.9). The mean interval time from the primary LSG to Re SG was 34.5 months (range 9–67 months). The indication for Re SG was insufficient weight loss for 19 patients (52.8 %), weight regain for 15 patients (41.7 %), and 2 patients underwent Re SG for invalidating gastroesophageal reflux disease. The mean BMI decreased to 29.2 (range 20.24–37.5); the mean percentage of excess weight loss was 58.5 % (±25.3) (p  more...



Los Angeles Laparoscopic Bariatric Surgery, Gastric Bypass

Bariatric surgery is the clinical term for several different procedures. The procedures use one or both of two approaches to help patients lose weight and improve or resolve co-morbid conditions. During these procedures, the surgeon creates a small stomach pouch, that limits the amount of food patients can eat. For example, Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption. Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption. Resolved type 2 diabetes in 83.8% of patients and often resolved the disease within days of surgery. For more information about the effect of gastric bypass on weight-related co-morbid conditions, visit Health Benefits . Visit Health Benefits and Risks of Surgery for full descriptions of the benefits and risks of gastric bypass. Resolved type 2 diabetes in 47.8 percent of patients and often resolved the disease within days of surgery. Visit Health Benefits and Risks of Surgery for full descriptions of the benefits and risks of gastric banding. To learn more about sleeve gastrectomy, visit the website of the American Society for Metabolic and Bariatric Surgery (ASMBS) and review the ASMBS Position Statement on Sleeve Gastrectomy As a Bariatric Procedure . Visit Health Benefits and Risks of Surgery for full descriptions of the benefits and risks of sleeve gastrectomy. The American Society for Metabolic and Bariatric Surgery recommends that laparoscopic bariatric surgery should be performed only by surgeons who are experienced in both laparoscopic and open bariatric procedures. more...



Endoscopic Surgery for Bariatric Revision After Weight

Endoscopic Surgery for Bariatric Revision After Weight Loss Failure. Currently, the best treatment for obesity is bariatric surgery where both roux-en-Y gastric bypass and sleeve gastrectomy offer substantial weight loss. Unfortunately, 20% of patients who undergo bariatric surgery fail to lose enough weight defined as less than 50% of excess body weight loss or regain of weight. For those patients who fail to lose weight after bariatric surgery and have failed maximal medical therapy and diet supervision, the treatment is re-operation and revision. The investigators propose to use the Apollo Over Stitch endoscopic suturing device that has already been approved by the FDA as an option for bariatric surgery revision without having to re-operate on the patient. The investigators believe that the endoscopic technique may be able to provide weight loss without having to re-operate on the patient. The most effective weight loss procedures in the United States are both roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)where the majority are performed laparoscopically. Estimated excess body weight loss (EBWL) is > 50% at the end of one year. Surgery would be for those who still fail to lose weight despite the aforementioned efforts. It is hypothesized that failure of weight loss for RYGB is gastrojejunostomy (GJ) dilation defined as > 2 cm. The investigators propose to use the endoscopic suturing device designed by Apollo Endo Surgery to decrease the GJ dilation to 5-6 mm thus causing restriction, delayed food transit time, and promote early satiety. Endoscopic procedures are same day procedures with little morbidity and mortality when compared to laparoscopic or open bariatric surgery revision. Failure of weight loss despite maximal medical therapy and medically-supervised diets. more...



Revised sleeve gastrectomy : Another option for weight loss

All patients with weight loss failure after primary LSG underwent radiological evaluation. Thirteen patients (36.1 %) had their original LSG surgery performed at another hospital and were referred to us for weight loss failure. The LSG was realized for patients with morbid obesity with a mean BMI of 47.1 (range 35.4-77.9). The mean interval time from the primary LSG to Re SG was 34.5 months (range 9-67 months). The indication for Re SG was insufficient weight loss for 19 patients (52.8 %), weight regain for 15 patients (41.7 %), and 2 patients underwent Re SG for invalidating gastroesophageal reflux disease. The mean BMI decreased to 29.2 (range 20.24-37.5); the mean percentage of excess weight loss was 58.5 % (Âą25.3) (p < 0.0004) for a mean follow-up of 20 months (range 6-56 months). Further prospective clinical trials are required to compare the outcomes of Re SG with those of Roux en Y Gastric Bypass or DS for weight loss failure after LSG. more...



Sleeve Gastrectomy surgery risks and complications

Problems with the outlet of the stomach (narrowing or stretching) Be sure to discuss the procedure with your doctor. Bariatric and metabolic surgery is not cosmetic surgery. A decision to elect surgical treatment requires an assessment of the benefits and risks to the patient and the meticulous performance of the appropriate surgical procedure. The success of bariatric and metabolic surgery is dependent on long-term lifestyle changes in diet and exercise. Metabolic and bariatric and metabolic surgery is as safe or safer than other commonly performed procedures, including gall bladder surgery. 20,27 When performed at a Bariatric and Metabolic Surgery Center of Excellence, metabolic and bariatric and metabolic surgery has a mortality rate of 0.13 percent. These risks vary depending on weight, age, and medical history, and patients should discuss these with their doctor and bariatric and metabolic surgeon. more...



Complications associated with laparoscopic sleeve

Owing to an increase in the number of bariatric surgical procedures, general surgeons should have an understanding of the complications associated with LSG and an approach for dealing with them. Laparoscopic sleeve gastrectomy (LSG), also known as longitudinal or vertical gastrectomy, is a relatively new and effective surgical option for the management of morbid obesity ( Fig. It was initially introduced in 1990 as an alternative to distal gastrectomy with the duodenal switch procedure to reduce the rate of complications. The incidence of obesity in Canada is on the rise, and more patients are undergoing bariatric surgical procedures. We present our operative approach to LSG and review the major acute (within 2 wk of surgery) and late complications that can arise in patients following LSG ( Table 1 ). Two 10 mm ports are placed in the supraumbilical and left midabdominal areas. Finally, 2 additional 5 mm ports are placed in the left and right upper quadrants of the abdomen. This releases attachments to the greater curvature of the stomach and gastric fundus. The risk of postoperative bleeding has been reported to be between 1% and 6% after LSG. Intraluminal bleeding from the staple line usually presents with an upper gastrointestinal bleed. Diagnosis and management of intraluminal bleeding follows the common algorithm taken for an upper gastrointestinal bleed. In a recent prospective randomized trial, Dapri and colleagues 13 compared the rate of staple line bleeding after LSG using 3 different techniques: stapling the stomach with no reinforcement, or reinforcement with either suturing or buttressing with Gore Seamguard. These investigators observed a significantly lower rate of bleeding with the use of buttressing material. Gastric leak is one of the most serious and dreaded complications of LSG ( Fig. more...



Gastric Band Failure, Gastric Sleeve Success - Weight Loss

Sleeve gastrectomy is a safe and effective revisional procedure for failed or complicated gastric banding with good surgical outcomes and 2 year weight loss, according to results of a study published online November 13, 2013 in Surgery for Obesity and Related Diseases. This study shows that successful results are possible with revisional sleeve gastrectomy after band removal. The study was conducted in order to compare outcomes of patients who underwent the operation as a revisional procedure (revisional group) with patients who had the gastric sleeve as a primary procedure (control group). It involved 76 revisional sleeve gastrectomy patients and 279 primary sleeve gastrectomy patients. Of the 76 revisional procedures, the reasons for gastric band removal were inadequate weight loss (47), band slippage (10), band erosion (7), and pouch dilatation (12). Weight loss results for up to 24 months were available for 56 patients in the revision group and 184 patients in the control group. The % Excess Weight Loss (EWL) at 6, 12, and 24 months for the revision group vs the control group, respectively: The authors said that the results confirmed that laparoscopic sleeve gastrectomy, performed in two steps, is a safe and effective revision procedure for failed or complicated gastric banding with good surgical outcomes and 2 year weight loss. The four primary bariatric procedures are gastric bypass, gastric band, gastric sleeve (sleeve gastrectomy), and duodenal switch. If you had your gastric band removed for insufficient weight loss or complications, then you may want to discuss the option of revisional sleeve gastrectomy with your surgeon to see if this step is right for you. Study: “Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a “two-step approach”: A multicenter study,” Surgery for Obesity and Related Diseases, published online 13 November 2013. more...



Laparoscopic Sleeve Gastrectomy

Alternative procedures to the sleeve gastrectomy include the laparoscopic adjustable band and the laparoscopic gastric bypass. The laparoscopic gastric band is the simplest and safest weight loss procedure currently performed. Weight loss with this procedure is in the region of approximately 65%. There is no "dumping" with the sleeve gastrectomy as seen with the gastric bypass, and significant dietary change is not required as compared to the gastric band. Weight loss with the laparoscopic sleeve gastrectomy can be very rapid. The more weight you have to start with, the more weight you will probably lose with surgery and our recommended dietary and exercise regime. If your liver is excessively large at the time of surgery, your procedure may be aborted and rescheduled for a later date. It increases your risk of pulmonary complication and blood clots regardless of the procedure you have performed. If this is the case your surgery will have to be postponed until these tests have been completed and evaluated by your anaesthetist. These can occur after any type of surgery, and the risk persists after surgery for up to three weeks. If this was to happen you may require conversion to an open procedure and removal of the spleen. Although the procedure is carried out with keyhole surgery it is still major surgery and you and your family should realise that any complications of this procedure could result in death. The risk of a leak is less than 5% but should it occur, it will require further surgery and the placement of drains. As has been discussed previously, as this is a restrictive procedure it is possible to cheat the operation and not lose weight. more...



How Does a Gastric Sleeve Affect Dieting

However, and this is the second key point, while a gastric sleeve procedure is a great help in a weight loss program, it’s still up to the individual to work at the weight loss. It’s tempting to think of the gastric sleeve surgery as ‘the solution’ but in a sense, it’s just a tool, something to help you with a lifelong diet and lifestyle change. This is an important part of preparing the food for digestion and when you have a stomach altered by a gastric sleeve operation; it becomes even more important. That means, for example, if you don’t chew enough and large chunks of food pass down the esophagus to the stomach, those chunks could cause problems in the radically smaller stomach of a gastric sleeve. For one thing, the stomach obviously holds less food and liquid. The downsized stomach is one reason that a gastric sleeve is effective in helping weight loss. Managing your digestion to make the most of a gastric sleeve. The management of liquid and food becomes a relatively significant issue for people with a gastric sleeve. Too much liquid, especially with food, fills the stomach sleeve too quickly and reduces the time the food has in the stomach to mix with stomach acids, which are very important in the digestive process. While a gastric sleeve requires less adjustment to the type of foods you eat than other forms of bariatric surgery, there are still some useful guidelines. The idea is not to send big, hard chunks of food into the narrow and limited space of a gastric sleeve. Some experimentation is a good idea, for as usual, experience is among the best teachers of what you can and can’t eat to keep the gastric sleeve comfortable. They believe there are several contributing factors including a pattern of eating too much of the wrong foods that force the gastric sleeve to stretch and accommodate ever more food, changes in the digestive processes of the intestines, and a psychological desire to eat more. more...




Copyright © kirakosjatekok.info 2017 | Sitemap