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Bariatric Surgery
Dr Ramen Goel
Laparoscopic Sleeve Gastrectomy
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Laparoscopic Sleeve Gastrectomy
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Sleeve gastrectomy is a procedure that induces weight loss by restricting food intake. The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed. This results in a stomach, which is roughly the size and shape of a banana
or Sleeve. Since this operation does not involve any “rerouting” or reconnecting of the intestines, it is a simpler operation than the
gastric bypass or the duodenal switch.
This procedure is usually performed as single stage surgery for >33BMI patients with co-morbidities or >37 BMI without co-morbidities.
Sleeve gastrectomy is also done on super obese or high-risk patients with the intention of performing another surgery at a later time.
| Surgical time: |
Approx. 1 Hour |
| Hospitalization period: |
3-4 Days |
A Few Advantages of the Sleeve Gastrectomy:
- It does not require disconnecting or reconnecting the intestines
- It is a technically simpler operation than the gastric bypass or the duodenal switch
- It is known to reduce hunger by removal of hunger stimulating hormone producing part of stomach
- Unlike gastric bypass gastric band, patients feels full with liquids as well.
Special Dietary Requirement:
Daily mandatory intake of protein with a multivitamin mineral intake will prevent any possible nutritional deficiency. Iron Calcium supplements are required as well. Special dietary advice is provided to post-operative patients & regular follow up is essential.
Complications:
The reported incidence of complications is at par with other major surgeries performed on obese. These include –
| Operative Mortality | 0.5% | | Intra-operative Complications: | 1.4% including bleeding, injury & stapler malfunctioning etc | | Early Complications: | These includes gall stone
formation, incisional hernia, rarely intractable
vomiting, ulcer, intestinal obstruction, weight regain, metabolic
sequelae including iron deficiency, B12, Folate deficiencies etc | | Late Complications: | This includes wound
infections (1-3%), pulmonary embolism (1%-2%),intestinal leaks (1%-2%),
rarely bleeding, bowel obstructions &
rarely cardio-pulmonary complications etc |
Improvements:
Weight Loss:
| The average excess weight loss is 70% after sleeve gastrectomy surgery.
| | Co-morbidity improvement: | |
| Diabetes: | Resolution/Improvement in >70% | | Hyperlipidemia: | Resolution in >90% | | Hypertension: | Resolution is noticed in >75% patients | | Sleep Apnoea: | Resolved in >85% patients |
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