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Laparoscopic Sleeve Gastrectomy
Also known as the Greater Curve Gastrectomy, Vertical Gastrectomy, or, simply, the “Sleeve“). The procedure involves a longitudinal resection of the stomach starting from the antrum at the point 5–6 cm from the pylorus and finishing at the fundus close to the cardia. The remaining gastric sleeve is calibrated with a bougie and the ideal approximate remaining size of the stomach after the procedure is about 150 mL. The result is that, with a minimum amount of food, you, the patient, will feel full very quickly and subsequently reduce your food intake. More importantly, the portion of the stomach that is removed secretes ghrelin and other “hunger hormones” responsible for appetite; by removing this part, one’s appetite is reduced, further significantly contributing to weight loss. Dr. Katakwar has significant experience with laparoscopic sleeve gastrectomies.
Lap. Roux en Y gastric bypass
Laparoscopic gastric bypass surgery achieves weight loss by combining a reduction in stomach size with a reduction in the length of the small intestine used for absorption of food and calories. The combination of eating less food and lower absorption of calories leads to weight loss. In this complex operation, a small pouch is made from the top section of the stomach and is connected to a loop of the jejunum (bypassing the duodenum and the first part of the jejunum). Smaller portions of food are consumed, and as a large section of the small intestine is skipped, the energy absorbed from the food is consequentially less.
Laparoscopic mini gastric bypass
Your stomach be divided into two pouches, an upper pouch and lower pouch. The lower portion of your small intestine is fused to the smaller upper pouch. The creation of a smaller stomach pouch, which holds less than a cup of food, will help you get fuller quicker and feel fuller longer, and you will ultimately lose weight faster. By surgically resecting the small, upper pouch to the lower portion of your bowels, food will not be completely broken down, absorbed, or processed within your system prior to exiting your body
Metabolic surgery
“Metabolic surgery” is the term used to describe surgical procedures to treat metabolic diseases, especially, type 2 diabetes, dyslipidemia and Insulin resistance.
A. Sleeve gastrectomy with loop duodenojejunal bypass (LDJB-SG) is a relatively new procedure. The pyloric preserving mechanism could decrease the incidence of dumping syndrome. Also, the mixture of alkaline bile and pancreatic enzyme with gastric acid around anastomosis also decrease the incidence of marginal ulcer. The acid and intrinsic factor secretion would be maintained. Thus, iron, vitamin and protein deficiency should be less because some part of antrum is preserved
B. Sleeve Gastrectomy With Ileal Transposition (SGIT):
SGIT proved to be as effective as RYGB on obese diabetic rats as a weight loss procedure. Also, glucose homeostasis improved in SGIT, similar to RYGB, in spite of the absence of duodenal-jejunal exclusion.