Sunday, December 10, 2017

5 The Best Types of Weight loss surgery- Which Type Can Affect You?

surgery

Do you want to do weight loss surgery?
Which is type of weight-loss surgery appropriate for your health?
what is the goal of Your weight loss surgery ??
Try to think more deeply into the question above, before you decide to do weight loss surgery.
I advise you to consult a specialist so you can make the right decision in weight loss surgery.
This weight loss surgery can not be used for common people. Specialist doctors recommend only to persons with special conditions, as follows:



  • person who have a body mass index (BMI) of about 40 or more. Its would be about 100 pounds overweight (for men) and 80 pounds (for women)
  • person who have low body mass index (BMI) are low but still obese and have serious health problems (have serious illnesses such as heart disease, type 2 diabetes, severe sleep apnea, or high cholesterol)
  • person who Have tried unsuccessfully to lose weight by other means.- I suggest to further consult with your doctor.
  • person Fully understand the risks.- I suggest to further consult with your doctor.

This weight loss surgery can save your life in many health conditions, but you must be dedicated to making dramatic and permanent changes to your body how you eat, exercise, and live.

5 Types of Weight Loss Surgery


I will show you some type of weight loss surgery that helps you in making the right decisions for your health. I suggest you to consult again with a doctors specialist about which type of surgery is best for your health so that the results are satisfactory.
Here are 5 methods normally used by surgeons:
  • Gastric bypass (Roux-en-Y Gastric bypass)
  • Laparoscopic adjustable gastric banding
  • Sleeve gastrectomy
  • Duodenal switch with biliopancreatic diversion
  • Electric Implant (Maestro Rechargeable System)
  • Aspireassist

Gastric Bypass (Roux-en-Y Gastric bypass)

Gastric-Bypass

Image from 23
The Gastric Bypass Surgery, also called as Roux-en-Y Gastric bypass (RGBY) by your doctor, is the most common type of weight loss surgery.
Essentially, The surgeon creates a small belly pouch by stapling across or completely transecting your stomach. Then the surgeon attaches the bottom of the small intestine directly to the abdominal pouch.
Therefore, this method can reduce the volume of the stomach from about 1.5 Liters to about 20 ml (As big as the volume of a golf ball). This causes the food to pass through most of the stomach and upper part of the intestine


Laparoscopic Adjustable Gastric Banding (LAGB)


Adjustable-Gastric-Banding

Image from 23
essentially in the process of LAGB surgery : the surgeon makes the gastric into 2 parts (upper pouch size is smaller than the bottom) by using the inflatable band to squeeze it.
Both sections of the pouch are still associated with a small channel.The surgeon can adjust the size of this small channel opening by removing / injecting the solution into the inflatable band through a small port located under your skin. The inflatable band that surrounds your stomach is like a balloon that can deflate or expand to adjust the size of the small channel.
Small channels that slow the emptying of small pouchs. Since these small pouch have a smaller food capacity than your big stomach, so your stomach feels full quicker or sicker (feels full) without losing the nutrients and calories that your body needs.


Gastric Sleeve Surgery (Vertical Sleeve Gastrectomy)

Gastric-Sleeve


Image from 23
essentially in the process of gastric sleeve surgery: the surgeon reduces about 75% of your stomach, leaving only the tube-like parts (like banana shape pouch-see in the picture) attached to the staples.
The remaining stomach that only reaches 25% of the initial condition connect directly to the intestine, so the capacity of your stomach to be reduced. its caused you to feel full faster and reduce the amount of food that can fit in your stomach.
Reducing part of gastric can also affect the intestinal hormone (intestinal bacteria can affect appetite and metabolic disorders). Gastric sleeve surgery can not be returned as normal as the stomach is permanently removed (so think again if you want to do this operation because the effect will be natural until you die).


Duodenal switch with biliopancreatic diversion


Image from 23
from all of the operations I mentioned, duodenal switch operation is the most complex and extreme. The duodenal switch operation consists of 2 separate operations. The first surgery is a surgeon separating your stomach (similar to gastric sleeve surgery).
In the second surgery, the surgeon removes the center of your small intestine, and reattaches to the end of the small intestine (the doctor calls it Duodenum). The truncated part of the intestine is not removed from the body. but it is reconnected to the end of the intestine, so digestive juices of bile and pancreas can flow into the end part of the intestine. it causes the digestive juices to mix with food. So the small intestine does not have time to absorb your food consumed.Duodenal surgery can lose weight faster than in all other types of surgery. However, duodenal surgery can cause problems like lack of vitamins, minerals, and proteins in your body. Therefore, the surgeon can not perform this surgery as often as possible.


Electric Implant (Maestro Rechargeable System)

Electric Implant also called as Maestro Rechargeable System (MRS) by your doctor, acts like a pacemaker to transmit electrical signals to the nerves between the stomach and the brain, is called the vagus nerve.
This nerve provides a signal to the brain when the stomach is full. This tool is installed inside your stomach and has a remote control that can be programmed from outside the body.
The tool system is set and programmed to give a pulse of about 5 minutes and 5 minutes to the vagus nerve during your move and awaken. When you sleep, this tool should be turned off so as not to disrupt the body's metabolism.


Aspireassist

Aspireassist

Image from 23
Aspireassist is an operation without changing the anatomy of your internal organs. This operation is very different from existing surgeries such as Gastric bypass, Gastric appeal, Sleeve gastrectomy, and Duodenal switch. The point of this surgery is that the surgeon will place a device (in the form of a channel) in your stomach. This tool is used as a channel to pump food and drinks you have been eating for 30 minutes. To see how aspireassist works can be seen in the video below.


Many advantages are obtained by using aspireassist procedure. In Operation aspireassist, the device can be removed at any time without any anatomic changes from your stomach (so it is very safe for health). With this operation also, no extreme changes in food and diet after the operation is done. already many patients who have tried this surgery and managed to lose weight. But the most important is to maintain a healthy lifestyle pattern by following a counseling program in stages and sustainable.

ASPIREASSIST

ADJUSTABLE GASTRIC BANDING

GASTRIC BYPASS

SLEEVE GASTRECTOMY



Excess Weight losss
________________
(per protocol**, first year)14






Excess Weight losss
________________
(per protocol**, first year)14





Excess Weight losss
________________
(per protocol**, first year)14





Excess Weight losss
________________
(per protocol**, first year)14



Serious Complications
________________
(post-procedure pain, infection)14






Serious Complications
________________
(Includes slippage / dilation,  erosion, obstruction, death)17** (post-procedure pain, infection)14




Serious Complications
________________
(Includes staple line failure, leaking, bleeding, obstruction, marginal ulcer, death)17**




Serious Complications
________________
(Includes staple line failure, bleeding, postoperative strictures, death)17**


Average Procedure Time18




Average Procedure Time18


Average Procedure Time18



Average Procedure Time18


Anatomical Changes




Anatomical Changes




Anatomical Changes




Anatomical Changes



Endoscopic Procedure
_______________ (Non-Surgical)




Laparoscopic
_______________
Surgery



Laparoscopic
_______________
Surgery



Laparoscopic
_______________
Surgery


Reversible




Reversible




Not Reversible



Not Reversible












Length of Time
______________ in
Hospital or Clinic

(on average)



Length of Time
______________in
Hospital or Clinic

(on average)18





Length of Time
______________in
Hospital or Clinic

(on average)18



Length of Time
______________in
Hospital or Clinic

(on average)18


No Vomiting or 
___________________Dumping
Syndrome
__________________Related
 to the Therapy



Regurgitation / vomiting is
common initially21



Sugary Foods can
 cause dumping



No Vomiting 
or________________
Dumping Syndrome


Gradually learn
healthy behaviors




Very small meals,
No drinking with meals

(~200ml or <1 cup)19




Very small meals

(~200ml or <1 cup)20



Very small meals

(~200ml or <1 cup)20
Pros :
      Can be reversed.
      Short hospital stay(only 15 min procedure) and low risk of surgery-related problems.
      No vomitting and dumping.

Pros

·       Can be adjusted and reversed.
·       Short hospital stay and low risk of surgery-related problems.
·       No changes to intestines. Lowest chance of vitamin shortage.

Pros

·         Greater weight loss than gastric band.
·         No objects placed in body.


Pros

·         Greater weight loss than gastric band.
·         No changes to intestines.
·         No objects placed in body.
·         Short hospital stay.

Cons
   Possible future surgery to remove or replace a part or all of the asipireassist system.

Cons

·       Less weight loss than other types of bariatric surgery.
·       Frequent follow-up visits to adjust band; some people may not adapt to band.
·       Possible future surgery to remove or replace a part or all of the band system.

 


Cons

·         Difficult to reverse.
·         Higher chance of vitamin shortage than gastric band or gastric sleeve.
·         Higher chance of surgery-related problems than gastric band.
·         May increase risk of alcohol use disorder.

 


Cons

·         Cannot be reversed.
·         Chance of vitamin shortage.
·         Higher chance of surgery-related problems than gastric band.
·         Chance of acid reflux.

 



Image from 23

FOOTNOTES

*Sleeve Gastrectomy follow-up ranged from 3 to 60 months. **Serious complication rates may be lower in Centers of Excellence. LAP-BAND® is a registered trademark owned by Apollo Endosurgery, Inc. Realize® is a registered trademark of Ethicon Endo-Surgery.
**Per protocol weight loss numbers include all treated subjects who completed the scheduled followup visits up to and including 52 weeks.
1. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord 1992;16:379-415.
2. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343-1350.
3. Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group.Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403.
4. Wadden TA, Foster GD, Letizia KA. One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol 1994;62:165-171.
5. Sugerman HJ, Sugerman EL, Wolfe L, Kellum JM, Schweitzer MA, DeMaria EJ. Risks and benefits of gastric bypass in morbidly obese subjects with severe venous stasis disease. Ann Surg 234:41-46, 2001.
6. Sjostrom CD, Peltonen M, Wedel H, Sjostrom L. Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension 36:20-25, 2000.
7. Foley EF, Benotti PN, Borlase BC, Hollingshead J, Blackburn GL. Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 163:294-297, 1992
8. Carson JL, Ruddy ME, Duff AE, Holmes NJ, Cody RP, Brolin RE. The effect of gastric bypass surgery on hypertension in morbidly obese subjects. Arch Intern Med 154:193-200, 1994.
9. Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM. Long-term effects of gastric surgery for treating respiratory insufficiency of obesity. Am J Clin Nutr 55:597S-601S, 1992.
10. Barvaux VA, Aubert G, Rodenstein DO. Weight loss as a treatment for obstructive sleep apnea. Sleep Med Rev 4:435-452, 2000.
11. Charuzi I, Ovnat A, Peiser J, Saltz H, Weitzman S, Lavie P. The effect of surgical weight reduction on sleep quality in obesity-related sleep apnea syndrome. Surgery97:535-538, 1985.
12. McGoey BV, Deitel M, Saplys RJ, Kliman ME. Effect of weight loss on musculoskeletal pain in the morbidly obese. J Bone Joint Surg 72:322-323, 1990.
13. Karlsson J, Sjostrom L, Sullivan M. Swedish obese subjects (SOS)–an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 22:113-126, 1998.
14. Thompson C., Abu Dayyeh B., Kushner R., Sullivan S., Schorr A, Amaro A, Apovian C, Fullum T, Zarrinpar A, Jensen M, Stein A, Edmundowicz S, Kahaleh M, Ryou M, Bohning J.M., Ginsberg G., Huang C, Tran D., Martin J., Jaffe D., Farraye F., Ho S., Kumar N., Harakal D., Young M., Thomas C., Shukla A., Ryan M., Haas M., Goldsmith H., McCrea J., Aronne L. The AspireAssist Is an Effective Tool in the Treatment of Class II and Class III Obesity: Results of a One-Year Clinical Trial. Gastroenterology. April 2016 Volume 150, Issue 4, Supplement 1, Page S86. Includes all treated subjects who completed the scheduled followup visits up to and including 52 weeks.
15. Nguyen NT, Slone JA, Nguyen XM, Hatmen JS, Hoyt DB. A prospective randomised trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: outcomes, quality of life and costs. Annals of Surgery 2009 Oct;250(4):631e41.
16. Brethauer S, Hammel J, Schauer P. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Related Dis 2009;5:469-475. 
17. Tice J et al. Gastric Banding or Bypass? A Systematic Review Comparing the Two Most Popular Bariatric Procedures. The American Journal of Medicine (2008) 121, 885-893.
18. Shi et al. A Review of Laparoscopic Sleeve Gastrectomy for Morbid Obesity. Obes Surg 2010.
20. Mayo Clinic Website: http://www.mayoclinic.com/health/gastric-bypass-diet/my00827 accessed January 6, 2012.
21. Realize Band Website: http://www.realize.com/bariatric-surgery-risks-complications.htm, accessed January 6, 2012.
22. Data on file at Aspire Bariatrics.
LAP-BAND® is a registered trademark owned by Allergan, Inc. Realize® is a registered trademark of Ethicon Endo-Surgery.
23. Aspireassist website :https://www.aspirebariatrics.com/weight-loss-options/

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