Laparoscopic Gastric Bypass (2)

 

 

 

Benefits of Gastric Bypass

• Effective diabetic treatment: gastrectomy affects hormone secretion in the body. Therefore, around 80% of patients have their diabetes cured after the surgery. It is also effective in managing hypertension, hyperlipidemia and sleep apnea.
• Effective weight loss: this surgery is by far the best laparoscopic weight loss surgery.
• Quick recovery: laparoscopic surgery is relatively less traumatic and allows quicker recovery.

Risks of Gastric Bypass

• Lack of vitamins: gastric bypass affects absorption in the small intestines. As chronic vitamin deficiency may lead to anemia, patients are required to take vitamin supplements and undergo regular checkups to screen for anemia and malnutrition.
• Complications: this is a relatively complicated surgery. The risk of complications is about 1%. Therefore, it is highly advisable to have the surgery performed by experienced surgeons.
• Not suitable for upper endoscopy: since the majority of the stomach and duodenum are bypassed, endoscopy cannot be used for examination.

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Gastric Bypass (1)

 Gastric bypass is by far the most effective weight loss surgery for obese as well as diabetic patients with a success rate of over 80%. Gastric bypass is a combination of restrictive and malabsorptive weight loss surgeries. It reduces stomach volume and appetite while bypassing the duodenum to reduce calorie absorption in order to achieve significant weight loss. However, patients are required to take vitamins regularly and undergo regular checkups to prevent the risk of anemia.  

 

Procedure of Laparoscopic Gastric Bypass

Laparoscopic gastric bypass is suitable for patients with a BMI over 40. A liquid diet is suggested two weeks before the surgery. No food is allowed on the day before the surgery. Performed under general anesthesia, 4 to 5 small incisions will be made on the abdomen, each being 1-2 cm in diameter, so that laparoscopic instruments could be inserted. Gastrectomy will then be performed to reduce stomach volume by 20-30ml.

The ileum will then be connected to the stomach, bypassing the duodenum. The remaining part of the stomach will remain in the body for secreting gastric juices for iron and calcium absorption. The surgery takes around 2-3 hours. Patients have to be hospitalized for 4-5 days but may move around after surgery. Patients are advised to maintain a liquid diet for the first two weeks after surgery, and then progress to a puree diet. One month later, normal diet can be resumed. However, patients need to follow dietitians’ advice and exercise regularly, as well as undergo regular follow ups for effective weight loss.

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Adjustable Gastric Band Plication (LAGBP) (2)

Benefits of LAGBP

• Reversible: Unlike sleeve gastrectomy, gastric plication only folds in the greater curvature of the stomach and securing with sutures to achieve the “banana-shape”. Sutures can be removed if necessary and the stomach will resume its original shape. 
• Low risk: This surgery is low risk and patients are expected to make quick recovery via this minimally invasive approach. Since it does not require stapling (as in sleeve gastrectomy), therefore risk of perforation or bleeding is relatively lower.
• Effective appetite reduction: When compared with gastric banding, gastric band plication has more prominent results on weight reduction, achieving results similar to laparoscopic sleeve gastrectomy but without resecting the stomach.

 

 Risks of LAGBP

• Some patients may experience nausea and vomiting after the surgery. This can be improved by changing eating habit.
• Weight regain is much reduced when plication is combined with gastric banding.

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Adjustable Gastric Band Plication (LAGBP) (1)

This is a restrictive laparoscopic procedure that combines the benefits of both gastric banding and gastric plication. It is suitable for patients who wish to restrict their stomach size without removing part of their stomach (ie. it is completely reversible).

By folding in the greater curvature of the stomach, stomach size will be reduced (forming a “banana shape” stomach), and thereby effectively limiting the amount of food that could be taken.

This surgery also reaps better results than using a gastric band alone. However, as the top part of the stomach responsible for hormone secretion is not removed; appetite is less reduced. Studies have shown that weight regain is significant following plication ONLY, therefore for better long lasting weight loss, a gastric band is also placed for later adjustment if needed.

 

Procedure of LAGBP

This surgery is suitable for patients with a BMI of more than 30. A liquid diet is suggested two weeks before the surgery. No food is allowed on the day before the surgery. Performed under general anesthesia, 4 to 5 small incisions will be made on the abdomen, each being 1-2 cm in diameter, so that laparoscopic instruments could be inserted. The greater curvature of the stomach will be folded and secured with sutures, then followed by placement of an adjustable gastric band at the top of stomach.

The surgery takes approximately one and half to two hours. Patients may move around after the surgery and will be hospitalized for 3 to 4 days. For the first two weeks after the surgery, only liquids may be taken. Normal diet may be resumed after one month. Patients are strongly advised to have strict diet control and maintain a healthy lifestyle to prevent weight regain. Patients will be followed up regularly to monitor weight loss and nutritional status.

 

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Sleeve Gastrectomy (2)

 

 

Benefits of laparoscopic sleeve gastrectomy

• Obvious weight loss: ~70-80% of the stomach will be removed thus significantly reduce stomach volume and induce a much earlier sense of satiety.
• Effective diabetic control: with the reduced stomach volume and changes in hormones, such as increasing glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) for diabetes treatment that is stimulated by faster stomach emptying.
• Reduced appetite: There is an immediate reduction in levels of the appetite stimulating hormone – Ghrelin, thus significantly reduce patient’s hunger sensation and appetite.

Risks of laparoscopic sleeve gastrectomy

• Low risk: overall mortality risk is <1%.
• Irreversibility: once the greater curve of the stomach is removed, normal stomach anatomy cannot be reinstated.
• Heartburn: patients may experience a higher incidence of reflux / heartburn following surgery. 

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Sleeve Gastrectomy (1)

 Want to have a better control of eating volume without the need to avoid various foods? Laparoscopic sleeve gastrectomy, a restrictive minimally invasive laparoscopic surgery, is the most widely performed weight loss surgery in Asia. By reducing the stomach size, patients will feel a sense of fullness much earlier, and thereby substantially reducing the volume intake.

Besides more effective weight loss, this surgery is effective in diabetic treatment with a remission rate of almost 70%. This surgery can significantly suppress the secretion of Ghrelin – a powerful appetite stimulating hormone. Patients recover quickly from surgery and are able to return to their daily activities in a short period of time. In order to achieve your target body weight, patients will have regular follow up with Dr. Wong and his team of allied health specialist (including dietitian and physiotherapist).

Procedure of laparoscopic sleeve gastrectomy

This surgery is indicated for patients with BMI over 30. Two weeks prior to surgery you are instructed to have only fluid diet and milk supplements. The surgery is performed under general anesthesia. Dr. Wong will make 4-5 small (1-1.5cm) incisions and remove 70-80% of the stomach in order to create a ‘banana’ shaped stomach. The entire procedure last for about one and half hours and patients will be discharged from hospital 3-4 days after surgery.

After your surgery, fluid and congee diet must be maintained within the first month in order to allow for good wound healing. After then, a “new” normal diet can be resumed. All patients must follow dietitians’ advise to ensure effective weight loss.


       

 

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Adjustable Gastric Band (LAGB) (2)

Benefits of LAGB:

• Improved eating habit: many overweight patients fail to feel sense of fullness due to eating too quickly. After surgery, eating too quickly will induce an early sense of satiety and may occasionally vomit, therefore, patients are taught to adjust their eating habits. 
• Low risk of surgery: overall mortality rate is approximately 0.05%
• Durability: all gastric bands are designed to last lifelong.
• eversibility: since the surgery does not involve removing or cutting any part of the stomach, the band can be easily removed by minimally invasive approach at any time.
• Adjustable: doctors can control the volume of saline to control the band tightness according to patient’s weight loss progress.
• Quick recovery: with the benefits of minimally invasive technique, patients recover quickly from surgery and can return to their normal daily activities soon after surgery.

Risk of LAGB:

• Risk of adjustment (access) port damage (up to 3%), slippage (3-8%) and erosion (up to 2%).
• Involves implantation of a “foreign body”.
• Relatively less weight loss compared with other bariatric surgeries.

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

Laparoscopic Adjustable Gastric Band (LAGB) (1)

Asian diet consists mainly of volume instead of fast foods and sweets in the West. The influence of the “Western” portion sizes is causing more and more obese populations worldwide.

For BMI over 30, with an over-eating habit, LAGB may be a possible solution for weight loss by reducing the portion size ingested and improving daily eating habits.

This is one of the most widely adopted weight loss surgery as it is minimally invasive. Doctors can adjust the band according to the condition of the patient.

 

Procedure of LAGB:

Under normal conditions, once food is ingested, it will passes through the stomach and be broken down and absorbed in the small bowel. During the minimally invasive LAGB surgery, only four small incisions will be made. A silastic gastric band will be placed at the upper portion of the stomach to create a 15-20 ml “gastric pouch”. The adjustment port will be placed under the skin so it is completely invisible.


According to patient’s weight loss progress, doctors will adjust the band tightness by injecting saline solution via the adjustment port to the band. Patient will usually notice slight hold up sensation following adjustment but there should be NO pain.


The surgery is performed under general anesthesia, which takes about 1-1.5 hour. Shortly after surgery (on the same day) patient can start mobilizing and the length of stay is usually 1-2 days after surgery. No long-term medication is required. However, patients should change / restrict their diets, according to instructions given by Dr. Wong and your dietitian. Patients who had received LAGB will have to come back for follow up on a more regularly basis (every 1-2 months) during the first 2 years – as this is the “golden period” for weight loss. Long-term follow up is also needed.

Reference information: http://www.obesitysurgery.com.hk/english.html

The information aims to provide educational purpose only.  Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.