Bariatric Surgery
Minimally Invasive Surgery for Gastric Sleeve Gastric Bypass, Gastric Plication or Banding; Single Operation Conversion Surgery
Sleeve gastrectomy
it is a popular, effective and simple bariatric procedure.
However, heartburn and weight regain are the most common problems.
In my desire for perfection to achieve best results I pursue three main goals in surgery:
1. Dissection of the hiatus and posterior crural proximation to correct heartburn and stomach hernia
2. Uniform and narrow gastrectomy on the entire length of the stomach to avoid long term stomach stretching
3. Accurate re-attachment of the new stomach to its natural attachments to posibly preventing blockages or stomach hernia and acid reflux.
Key points: it is minimally invasive surgery with only four small skin cuts; one night in hospital, most patients drive within 24 hours and return back to light routine within days
Most cost effective procedure for self funded patient.
Ballon Gastric Plication with or without Banding
The gastric plication is a novel technique originally studied and described by Dr Schauer at Cleveland Clinic, Ohio.
My experience with the procedure extends from 2011 in which time I have performed over 1,000 procedures.
The procedure is also suitable for patients who are overweight but not obese and are looking for surgical weight loss solution but do not meet the current medical guidelines for conventional surgery.
The gastric plication can be performed alone or with the gastric band and consist of:
1. gastric plication - the stomach volume is reduced by suturing techniques, without any resection
2. a “gastric balloon” is fashioned from your own stomach that will occupy most of the space while you are overweight and decrease in size by itself as you lose weight - it is permanent, there is no foreign body, does not migrate, there is no need of adjustment, it self adjusts with your weight
3. repair of anti-reflux mechanism by fixation of a hiatus hernia, a condition known to cause acid reflux (heartburn or indigestion)
4. insertion of adjustable gastric band
My impressions and unsolicited feed back
- frequent resolution of pre-existing heartburn
- weight loss of 10-15kg, often seen in most patients within 4-6 weeks after surgery
- early satiety with smaller meals
- long lasting lack of hunger between meals
- ability to eat most food, including meats, chicken, breads, etc - "how do you explain I am losing weight because I can eat anything I want..."
- vomiting is rather uncommon
- there are no pockets created by plication
with the “gastric balloon” you can eat less when overweight and more when you lose weight
- reduction in the rate of gastric band slippage, and erosion.
"Thanks for that, I look forward to hitting the gym once again.
Diet wise I’m pretty much eating proteins every day, steamed vegetables,beans, mushrooms, eggs, cottage cheese, weight watchers type foods, fruits (no sugars) etc.
Apart from the odd piece of toast every few days, I am eating a very very low carb diet, and am avoiding sugar.
Weight wise, prior to surgery, using my scales at home, I was 89.6kgs. Last time I checked, I was down to 79.4kgs.
Very noticeable weight loss, both to my wife and people around me.. Clothes are starting to look big on me.
Having this procedure is by far one of the best decisions I’ve made in my life. “
My recent modification in the technique consists of a fat, omental imbrication which, in theory makes the stomach full when you are overweight and more roomy when you lose weight. It also preserves the gastro-epiploic blood supply reducing the risk of stomach necrosis. Theoretically it gives the stomach the ability to adjust its’ volume depending on your weight, which means you can eat more when you lose weight and less if you gain.
