Bariatric Surgery – Laparoscopic surgery
- Sleeve gastrectomy: In this procedure around 70% of the stomach is removed turning its size from a rugby ball to a banana and thereby reducing the amount that you can eat as well as decreasing your feeling of hunger. It is a less ideal procedure if you have complaints of gastric reflux, diabetes or if you are addicted to sweets. In these cases, you can better choose to have a gastric bypass. With the sleeve gastrectomy procedure, you will long-term lose about 50% of your overweight. This procedure can also be done by a scar-less single port approach in our hospital, which will give you better cosmetic results as well as less pain
- Mini gastric Bypass: In mini gastric bypass
surgery, the stomach is divided into upper and lower pouches and the small intestine is rerouted. This allows for both restrictive and malabsorption weight loss procedure.
- Roux- en-y Bypass surgery: In this procedure a small stomach pouch (size of an egg) is created and connected with the small bowel in order to bypass a part of the remaining stomach. It is having over several decades proven to be a great procedure to lose weight (average long-term excess weight loss around 70%), to cure diabetes and to resolve complaints of (gastroesophageal) reflux. The gastric bypass is, therefore, by many considered as the golden standard weight loss surgery.
- SADI-S Surgery: In this procedure a long narrow stomach sleeve is created and connected with a long small bowel loop in order to bypass a part of the remaining stomach (mini-bypass/ Omega loop) or to the duodenum (SADI-S). Both are good procedures to lose a significant weight and to cure diabetes (long term average weight loss 75%), however, the chance on malnutrition and vitamin deficiency is much higher compared to the prior mentioned procedures. Therefore, we like to reserve this technique for revision procedures after failed other bariatric procedures.
- Laparoscopic gastric band: In this procedure a silicone band is placed around the stomach to create a small stomach pouch.
However, the Lap Band has lost it popularity and has become obsolete as the weight loss is not great (average long-term excess weight loss around 40%) and the band may leads to many long-term band related complications.
- Laparoscopic biliopancreatic diversion duodenal switch: In these procedures a big stomach pouch or sleeve is created and connected with the small bowel in order to bypass the remaining part of the stomach using two intestinal reconnections.
These are very effective procedures in terms of weight loss (average long-term excess weight loss around 85%), however, as these are very malabsorptive procedures the chance on malnutrition and vitamin deficiency is high compared to other bariatric procedures. Therefore, we like to reserve these techniques for super-super obese patients and revision bariatric surgical procedures.
- SASI Surgery: Sasi is a procedure which combines the advantages of sleeve and mini-bypass surgeries.
Gastric sleeve is made and the path is diverted by attaching the stomach outlet to the intestine after excluding part of it. this is done with the stomach outlet not separated and thus there are two ways of eating:
* 30% of food is on the normal pathway, and thus vitamins and minerals are absorbed.
* 70% of food goes down the path of diversion, and therefore prevents the absorption of many nutrients, thus losing weight and treating diabetes.