WHAT TYPE OF BARIATRIC PROCEDURES EXIST?
How does a gastric band work?
It is a type of bariatric surgery of the restrictive type since it restricts the amount of food eaten. Adjustable gastric band surgery is an inflatable band that is placed on the upper part of the stomach with the aim of creating a gastric pouch or reservoir limiting the amount of food eaten, it is very safe and does not involve stapling or cutting of the stomach.
What is the gastric band made of?
The material that the gastric bands are made of is a special silicone rubber balloon, wrapped around the upper portion of the stomach, connected through a flexible silicone tubing to a subcutaneous access port, that gets injected periodically with saline to expand the balloon to adjust the restriction if needed by the patient. (Kini, Herron, & Yanagisawa, 2007)
What is the follow-up in the hospital after the placement of the gastric band?
The patient stays one night in the hospital to see that all is well, the next day it will have a contrast drink with fluoroscopy (live x-ray) to see that the band is well placed, and start with a liquid diet, later it will be discharged from the hospital.
What are the adjustments of the gastric band?
The adjustable gastric band is regulated through an inflatable camera that connects with a device or adjustment port which goes under the skin.
How often are the adjustments?
The first adjustment is made one month after surgery, and the other adjustments will be made according to the patient’s evolution, weight loss, as well as the feeling of being satiated by the patient, when no longer has full satiety, it’s time for an adjustment.
What is the follow-up of the gastric band?
We have within our multidisciplinary group a bariatric nutritionist who will support you with all the follow-up and your doubts about the meals that you can eat, as well as the portions and all your doubts that come out of your bariatric trip, the adjustments should be with your local doctor or if you want in Tijuana you can also do without problems.
For whom is this surgery indicated?
This surgery is ideal for patients who do not want to have their stomach cut as in the gastric sleeve, nor change the intestinal anatomy as in the gastric bypass. It is also very useful in patients with important scarring diseases, and in extremes of life, where surgery is needed where there are no cuts or stapling.
What is the success rate of the gastric band?
This surgery is the safest but it is the one that has the least success rate, because in the best results a loss of excess weight is reached between 30 to 40% in the long term.
What is the Gastric Sleeve Surgery?
The gastric sleeve surgery is a bariatric procedure of the restrictive type, that limits the stomach´s capacity since 80% of the stomach is cut, allowing the patient to eat only 20%.
This surgery in addition to restricting the amount of food, also works at the hormonal level, since in the part of the stomach that is extracted (gastric fundus) or gastric fundus normally is produced a hormone that is ghrelin. This hormone ghrelin is also called the hunger hormone because in post-operated gastric sleeve patients their levels decrease a lot, allowing that in addition to the patient can eat little, reduce hunger, which is the goal of surgery.
- The process does not require the insertion of prostheses or a gastric band into the body.
- There is no fear of mal-absorption or a nutritional deficiency since the intestines are not by passed or re-reouted.
- It’s a very safe surgery
- This surgery is currently the most-seek in the whole world.
- Weight loss depends on each patient but at least 60-70% of excess weight.
- It has to be taken a daily vitamin for life to promote the absorption of iron that was produced by the part of the stomach removed.
How many days of hospital stay are required in the Gastric Sleeve Surgery?
Patients who are going to have a gastric sleeve, will be 2 nights in the hospital, in which several leak tests are performed in the operating room and the next day in x-rays to rule out complications.
What is the loss of excess weight with the gastric sleeve?
Books and articles mention between 60 to 70% of excess weight loss in a year, although if the patient follows the nutritional indications and exercises can lose more of excess weight, even some reach their ideal weight.
In which patients is this surgery recommended?
This is the most famous surgery and the most performed at the moment worldwide, it has very good results, the risks are low and the weight loss is similar to the patients who are operated by gastric bypass.
This surgery is ideal for patients who eat large portions of food, since by removing 80% of the stomach, the capacity reduces considerably leading to an adequate weight loss.
In whom is this surgery contraindicated?
This surgery is contraindicated in patients suffering from a lot of acid gastric reflux, since in some patients it has been seen that it slightly increases the possibility of developing reflux, and if the patient before the surgery refers to moderate to severe reflux, it is likely that the symptoms become worse.
In patients with obesity and acid gastric reflux, the best surgery is the gastric bypass, since it decreases the weight and improves or eliminates the acid gastric reflux.
The Gastric bypass is a mixed procedure, since it is restrictive because it restricts the capacity of food, the stomach is sectioned making a gastric pouch of approximately 2 to 3 ounces of capacity and this is connected to the small intestine, (bypassing) 2 and a half meters of intestine and making another (anasomosis) to avoid reflux, this means that food will not be absorbed until after that measure since that is where the food will join with the bile and pancreatic juices and initiate digestion, and the acid reflux reduce a lot.
Is gastric bypass safe?
The procedures performed by Stop Obesity are safe, they are performed by bariatric surgeons and their multidisciplinary group that are experts on their field.
Who is suitable for a gastric sleeve and who is for gastric bypass?
The gastric sleeve is recommended in patients that eat large quantities of food, this will help them feel decreasing the amount of food ingested by restricting the size of the stomach by 80% and hormonally reducing hunger with decrease production of ghrelin hormone.
The gastric bypass has excellent results in weight loss, but the benefit is greater on patients with diabetic or reflux history. Studies show that stimulates that when food reaches the duodenum, it realizes a substance called incretin, that helps maximize the effect of insulin and improving glycemia, by presenting food earlier to the ileum and duodenum. During the process of selecting the operation, those patients with diabetes should consider gastric bypass (Kini et al., 2007).
The gastric bypass is also recommended in patients who ingest sweets constantly, the procedure causes a rapid passage of sugars to the pouch causing a dumping syndrome, sometimes referred to as the “post-operative police office”, the patient may experience tachycardia, nausea, and may perceived by the patient as unpleasant and results in the avoidance of sweets (Kini et al., 2007).
What is the loss of weight with the Gastric Bypass Surgery?
The weight loss is similar to that of the gastric sleeve, approximately 60 to 70% of the excess weight in a year.
For whom is the Gastric Bypass Surgery more recommended than the Gastric Sleeve Surgery?
The gastric bypass is recommended more in patients with morbid obesity who have a lot of acid reflux, which is avoided due to the anatomy proper to the surgery since almost 90% of the stomach is sectioned and anastomosed (or connected) to the intestine causing reflux of acid into the esophagus. It is also excellent in patients with metabolic syndrome that includes difficult-to-control diabetes, hypertension, and elevated triglycerides.
The Gastric Mini-bypass or bypass of ONE anastomosis is a mixed procedure, since it is restrictive because it restricts the capacity of food, since the stomach is sectioned making a gastric pouch (gastric pouch) of approximately 2 to 3 ounces of capacity and this is connected to the small intestine, (bypassing) 2 and a half meters of intestine, this means that food will not be absorbed until after that measure since that is where the food will join with the bile and pancreatic juices and initiate digestion.
What is the loss of weight with the Gastric Mini-Bypass Surgery?
The weight loss is similar to that achieved after a gastric bypass, around 60 to 70% of excess weight
What is the difference between a Gastric Bypass and a Gastric Mini- Bypass?
In a gastric bypass there are 2 anastomoses and in the minibypass it is only 1, this makes the mini- bypass slightly safer than the regular gastric bypass since the risks of complication decrease even more.
Actually if the patient does not have problems of reflux any of the 2 options would be good, however if the patient has acid gastric reflux, the possibility of it increases exists, so in those cases, it is widely recommended the gastric bypass that in all cases of acid gastric reflux improves them and in many it eliminates it completely.
What material are the staples with which the Gastric Sleeve or the Gastric Bypass are made of?
–The staples are Titanium to staple, seal and cut the stomach, the staples we use in stop obesity are the same as those used in any quality hospital in the USA. (They are permanent, inert, without any reaction) and can be done after any study as a tomography or resonances without problems, since it is not metal.
Is pregnancy possible after having surgery for bariatric surgery?
In fact, all patients with obesity have problems getting pregnant since they have a higher incidence of PCOS ( polycystic ovarian syndrome) or polycystic syndrome because the adipocytes or obesity cells compete with the hormones that release the ovules, this means that many patients do not ovulate properly and cannot get pregnant, then after the bariatric surgery and if they do not take care of themselves, sometimes after the postoperative months they get pregnant without even wanting it since they begin to ovulate normally when losing weight, so we recommend that if the patient is in a reproductive age with some method at least the first year after surgery since losing weight in the first months after surgery and becoming pregnant will not have the expected result and ideally it will be a year after surgery to try to get pregnant since It takes a year to complete all the weight loss that the patient in question will have.
How long after a Bariatric Procedure, could I go the Gym?
It is recommended that you spend at least 6 to 8 weeks to be able to go to the gym and lift weight, since it is the time required for the complete healing of the tissue and to avoid hernias.
How long after the bariatric procedure, could I swim?
After 4 to 6 weeks it is safe to swim.
What is the follow-up after a Bariatric Procedure?
We have a bariatric nutritionist who is in constant communication with patients and supports them with all their questions and comments via email, messages and Messenger
What is material that the staples used during the sleeve gastrectomy are made of?
- All the operations at Stop Obesity used during the staple, seal and cut of the stomach are Titanium staples and are the same quality as the ones used in the hospitals in the USA. They are permanent, inert, generate no reaction and are safe to be patient after on any procedure such as tomography or MRI, as it is a special metal.
Will I be able to get pregnant after having surgery for bariatric surgery?
All patients with obesity have problems when trying to get pregnant, since the adipose tissue competes with the hormones and complicates the ovulation process, this means that the patients do not ovulate properly and have difficulty getting pregnant, after the bariatric surgery, patients that are not using a contraceptive method, have more chances of getting pregnant as they start to ovulate normally after losing weight, we recommend to use at least one contraceptive method at least the first year after surgery, since losing weight in the first months and getting pregnant after, will not show the expected results. Ideally, we recommend to wait a year after finishing the weight loss of the operation.
Is Tijuana / Mexico a safe place to go?
Yes, it is very safe, as in any big city, there is some areas that are insecure, but the Medical and commercial areas of Tijuana are extremely safe and near to the border, away from conflictive zones.
I want to get surgery at stop obesity, what should I do?
Contact our coordinator Yoli Varga, she will try to answer all your doubts and schedule your surgery as soon as possible, there is a 300 USD deposit to save a surgery spot, the spots in the hospital are limited and free spots don’t last long.
What is next after I did the deposit and schedule a day on for my surgery?
After this, you will have to purchase a flight ticket to arrive at least one day before the date of you scheduled surgery and notify our coordinator, she will be in charge to make the arrangements for you to be greeted by fully identified Stop Obesity personnel at your arrival to the San Diego International Airport, they will bring you through the border to your hotel in Tijuana or directly to the hospital to perform all the preoperative preparation, depending on the time of your arrival to San Diego. All preoperative preparation can be done next day at the hospital without a problem.
What do I need to do after my arrival to the hotel in Tijuana?
Our exclusive and fully identified Stop Obesity chauffeur who will speak 100% English will pick you up the day of your surgery at your hotel, bring you to the hospital, where the coordinator will greet you and guide you step by step to settle you in the hospital and your comfortable room, once in your room you will be evaluated our certified medical internist/intensivist, after the assessment of your evaluation is made the operation and to ensure the postoperative management to be the safest.
After the internist evaluation, at what time will my surgery be performed?
At Stop Obesity, we perform 3 surgeries per day bay surgeon, and they are schedule according to the patient and surgeon needs, if the patient is in a delicate condition or advanced age, they receive priority since it is all based on the safety of the patients and the comfort of the bariatric surgeon.
How long does the surgery last and what happens after?
The time that the surgery takes, varies from one procedure to another, the approximate times are:
- Sleeve Gastrectomy: 2 hours approximately, which consist of 20 to 30 minutes before the surgery are needed to perform the anesthetic procedure to de patient, all preoperative protocol, after this the surgery begins and takes approximately 1 hour, after this, 20 to 30 minutes to close and clean all the area and wake up the patient from the anesthetics.
- Gastric Bypass: 2 hours.
- Gastric minibypass: 1:30 to 2 hours.
- Single Incision Laparoscopic Surgery (SILS): 1:30 hours.
- Review surgery: 2 to 3 hours.
To begin we must know that all the bariatric patients, have multiple illnesses associated to the obesity, such as
- Arterial Hypertension
- Metabolic syndrome.
- Hepatic steatosis that can progress to cirrhosis.
- Venous diseases (venous insufficiency, pressure ulcers, etc.)
- Cardiac infarction, atherosclerosis and Kidney failure.
- In women infertility, polycystic ovary syndrome.
- There are types of cancer associated with obesity such as (Breast, pancreas, liver, endometrial, colorectal, and renal cancer)
Fortunately, bariatric surgery has shown benefits in all these aspects, varying in the percentage of improvement according to books or articles read, but all agree that all the aforementioned diseases improve or are controlled in all cases, achieving a substantial improvement in quality and life expectancy of patients.
A large review of 621 studies involving 135247 patients found that bariatric surgeri causes improvement of diabetes in more tan 85% of the diabetic pupulation and remission of the disease in 78% (ASMBS 2019).
95% of the patients who had surgery reported markedly improved of quality of life. Obese people who had bariatric surgery not only live longer, but also live much bettter (UCLA Health).
90% of patients that had bariatric surgerie experience improvement in related medical conditions, including, Asthma, high nlood pressure, Gastroesophageal reflux disease (GERD), Sleep apnea (University of Michigan Health System).
A study in England have shown that patients who underwent a bariatric procedurehad a 77% decreased risk of developing hormone -related cancer (breast, endometrial, prostate) when compare with patients who did not have surgery (weight los surgery may affect the risk of cancer) ScienceDaily Jul , 2018.
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