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Bariatric surgery

What is bariatric surgery?
Bariatric surgery is one of the main directions of surgical treatment of pathological obesity (morbid obesity).  It serves to improve the quality of human life and the general state of health.

What type of bariatric surgery is performed?
New Hospitals perform various types of bariatric operations, which result in significant weight loss. However, the method of surgical treatment is selected individually, depending on the patient's condition.

  • Sleeve gastrectomy – laparoscopic vertical resection of the stomach
  • Gastric bypass
  • Mini gastric bypass - a single anastomosis surgery
  • Repeated surgeries (if the patient has previously had any bariatric manipulation/surgery and is still experiencing weight gain).

New Hospitals has a multidisciplinary team involved in bariatric surgery, which includes a bariatric surgeon, endocrinologist, psychologist, gastroenterologist, therapist, cardiologist, gynaecologist, angiologist, anesthesiologist and radiologist. Patients can receive all of these services in one place, both preoperatively and postoperatively, and monitor their health.

Sleeve gastrectomy – laparoscopic vertical resection of the stomach

What is a sleeve gastrectomy?

Sleeve gastrectomy is a gastric operation performed laparoscopically under general anaesthesia and is different from operations performed on gastric cancer and/or peptic ulcer disease.

During sleeve gastrectomy, a large portion of the stomach is surgically removed along the greater curvature, giving the stomach the shape of a tube 1.5 cm in diameter, and the stomach, as a “volumetric bag”, turns into a “tube” where food is quickly evacuated to the duodenum. At this time, the secretory function of the stomach is reduced, and the zone that secretes the hunger hormone ghrelin is removed, which reduces a person’s appetite. As the volume of the stomach decreases, the absorption of food into it decreases. At the same time, important physiological valves (oesophagal valve, same as cardiac sphincter and gastric outlet valve) are maintained.

In what cases is a sleeve gastrectomy is performed?
Sleeve gastrectomy is recommended when the body mass index (BMI) is 40-51. However, there are cases when this surgery is effective in patients with a higher body mass index (BMI). In addition, this surgery is performed in cases where more complex medical interventions are risky due to the associated diseases. If medical evidence is available, surgery can be performed on a patient of any age, both the elderly and the adolescent.
What weight loss can result from sleeve gastrectomy?

After a sleeve gastrectomy, the patient loses approximately 65% of the excess weight. However, this figure may vary. On average, a patient loses more weight during a sleeve gastrectomy than during a gastric banding. According to statistics, 20-25% of patients need to perform the second (intestinal) stage.

What are the advantages of sleeve gastrectomy?

  • Maintaining the physiological passage (flow) of food;
  • Maintaining physiological valves;
  • Fast passage of food (discharge) in the intestines;
  • Does not require replacement therapy;
  • Possibility to perform the surgery laparoscopically;
  • Up to 80% compensation for type II diabetes.

What are the risks associated with sleeve gastrectomy?

  • The tube stricture (i.e. narrowing) formed;
  • Stretching the tube in case of failure to keep diet (an increase of the stomach again);
  • Insufficiency of gastric sutures (in extremely rare cases - 0.05%);
  • Possible short-term development of reflux esophagitis that can be easily treated with medication.
sleeve gastrectomy

Gastric Bypass

Gastric bypass is performed laparoscopically when the body mass index (BMI) is greater than 51 kg/m2 or in the case of the so-called supermorbid weight. A small pouch is formed at the top of the stomach which is then connected directly to the small intestine.

What are the advantages of gastric bypass?

  • Significant and sustainable weight loss;
  • Relative nutritional comfort (fewer dietary restrictions);
  • Almost complete compensation for type II diabetes;
  • Significant reduction in hypercholesterolemia and hyperlipidemia, which, together with the normalization of sugar, prevents cardiovascular disease;
  • In contrast to relatively simple operations, a significant positive effect is evident in the course of diseases caused by obesity (arterial hypertension, respiratory failure, bronchial asthma, reflux esophagitis, musculoskeletal disorders, peripheral vein disease, and ovarian dysfunction).

It should be noted that the patient, after all, bariatric surgeries, should perform 30-40 chewing movements to process food and eat slowly.
What are the risks associated with the gastric bypass?

  • Complex operational intervention;
  • Insufficiency of gastrointestinal sutures;
  • Stricture (narrowing) of the isolated intestine;
  • Stenosis (narrowing) of the gastroenteroanastomosis;
  • Stretching of the small stomach due to poor diet;
  • Formation of gastroenteroanastomosis ulcer up to 3-5%. The figure is rising in smokers; Formation of gastroenteroanastomosis ulcers up to 3-5%. The figure is rising in smokers;
  • The need for replacement therapy;
  • The emergence of hernias after laparotomy.

Insufficient intake of proteins, minerals, and vitamins can lead to general weakness and temporary hair loss. Sometimes it is necessary to re-hospitalize the patient for parenteral (intravenous) feeding.

gastric bypass

Mini Gastric Bypass
Mini gastric bypass is indicated when the body mass index (BMI) is 45 kg/m2. And more.
What are the advantages of mini gastric bypass?

  • Fast passage (discharge) of food in the intestines;
  • Does not require replacement therapy;
  • Possibility to perform the surgery laparoscopically;
  • Up to 90% compensation for type II diabetes;
  • Relative nutritional comfort;
  • Relatively simple surgical technology;
  • Less likely stretching of the formed small gastric tube;
  • Minimal risk of developing dumping syndrome (rapid absorption of carbohydrates).

What are the risks associated with the mini gastric bypass?

  • Complicated surgical intervention compared to sleeve gastrectomy;
  • Abnormal reflux of food in 6-8% of the gastric remnant, which leads to the formation of a vicious circle;
  • Insufficiency of gastric and intestinal sutures (in extremely rare cases - 0.05%);
  • Increased incidence of gastric cancer as a result of bile reflux.

mini gastric bypass