Laparoscopic sleeve gastrectomy

Laparoscopic sleeve gastrectomy is one of the procedures used to lose weight, which has proven effective over the past years and has become the number 1 operation in the world in terms of procedure, in which about 80% of the stomach is removed to become in the form of a banana or a shirt sleeve, hence the name gastric sleeve. Reducing the stomach and thus eating small amounts of food and feeling full quickly.
It is performed through a surgical endoscope through 3-5 small incisions that do not exceed 1 cm. It is allowed to drink fluids on the night of the operation. The hospital is discharged on the next day of the operation. You can return to work 5 days after the operation, after making sure that the internal wounds of the stomach have healed.
And vitamins should be taken regularly during the first year to avoid any deficiency in nutrients, and then vitamins are when needed, and pregnancy should not occur before one year of the operation to avoid any complications for the mother and fetus.
leads to Lose from 50-80% of the excess weight within a year and a half, and the weight loss is more in the months The first and gradually decrease until the final stability after a year and a half. To get better results, you must change the lifestyle from eating healthy meals and increasing the burning rate by exercising regularly.
And due to the ease of the operation compared to gastric bypass operations, this led to the spread of the operation and its being performed by non-specialized centers. Unfortunately, this led to the spread of a rumor that the sleeve gastrectomy fails with time and leads to weight gain again. In fact, 75% of the failure of the sleeve gastrectomy operations is The surgeon failed from the beginning and 25% failed from the person himself.
To obtain optimal and effective results from the sleeve gastrectomy, the entire fundus of the stomach must be removed and the hiatal hernia repaired, which is present with most obese patients. In obese patients, the liver and spleen are enlarged with fat and covering the bottom of the stomach. Hence the problem arises. If the surgeon is not a specialist, he will not be able to completely remove the fundus of the stomach, and this will be the reason for the failure of the sleeve gastrectomy operation due to the surgeon’s lack of experience and not the operation itself, and the other reason for the failure of the sleeve gastrectomy It is the presence of a hiatal hernia, which leads to leaving part of the bottom of the stomach inside the chest, so the hernia and diaphragm must be repaired with sleeve gastrectomy, which requires a surgeon with experience in the field of laparoscopic surgery. And the last reason is the failure of the patient himself to maintain a healthy diet and Binge eating of sugars.
One of the problems associated with esophageal reflux is the occurrence of reflux in the esophagus in 20% of patients, according to the latest research and medical studies. Therefore, the quantification is not suitable for GERD.

Modified quantization

It is adding a ring around the upper part of the sleeve in order to prevent stomach expansion in the future, despite the claim of some centers and surgeons that it is effective in the long term. And a new reuse of the gastric ring, which has been reduced or used for years, due to its failure in the field of obesity surgeries, and which we are raising from patients now, and in our opinion, it is just a commercial goal between the manufacturer and some surgeons, as the price of the ring in Egypt reaches 20 thousand pounds, an increase over the normal cost of gagging.

Sleeve gastrectomy with fundic plication (Nissen operation) for gastroesophageal reflux disease

The Nissen fundal reflux operation is the gold standard for treating GERD. For obese people with GERD, the classic gastric bypass is the gold standard for treating obesity and GERD in one operation.
International studies have now proven that the sleeve gastrectomy leads to reflux in 20% of the people who have the operation, and therefore the sleeve is not suitable in the case of recurrent GERD from the beginning. Its results are still less than the classic gastric bypass operation in the treatment of obesity and GERD.

Laparoscopic Sassi/Bipartite Division

A combination of sleeve gastrectomy and gastric bypass surgery, as after the gastric sleeve procedure, the stomach is connected to the intestine, and therefore there will be two outlets for food from the stomach through the link and through the twelve natural duct, unlike gastric bypass operations, which eliminate the passage of food from the duodenum.
This process is still under experiment, as its long-term results are not yet known, as the combination of the two operations carries some advantages and disadvantages, and research is still ongoing to know the extent of its effectiveness in the long term, and we at the Dr. Ahmed Al-Nabil Center explain this clearly and tell the person who wants It is still being tested.