Sleeve gastrectomy is also known as sleeve gastrectomy, resection of plums or sleeve gastrectomy. This is a relatively new bariatric surgery that is gaining popularity due to the low rate of complications and good results on the excess weight loss. In the US, 42% of all bariatric surgeries accounted for tubular resection. Originally it was developed as the first step of a more complex and radical procedure known as shunting Biliopancreatic (BPD) with duodenal switch.

Benefits of Sleeve Gastrectomy in Israel

Israeli medical centers offer the highest level of knowledge and skill in performing this operation:

  1. Low complication figures. Special medical equipment for these operations gives an accurate representation of the final amount of the sleeve before it is created. This minimizes the risk that the sleeve is too narrow, which can lead to leakage.
  2. Access to promising new research. Israeli doctors use the latest information to predict who will extract the maximum benefit from this operation. Patients have the opportunity to take part in the testing of new approaches and methods for the treatment of obesity.
  3. Surgeons for the sleeve gastrectomy. Israeli doctors offer a high level of experience and knowledge in this operation. Often turn to them to fix the resection carried out in clinics of the CIS countries.
  4. Hi-tech. Medical centers in the country offering the latest operating technology, including robotic surgical system, fully digital operating.

sleeve gastrectomyEligibility criteria for Sleeve Gastrectomy:

  1. Age 18 - 65 years.
  2. BMI - 40
  3. BMI greater than 35 with the presence of at least one disease associated with obesity - type 2 diabetes, hypertension, sleep apnea, arthritis.
  4. Acceptable operational risk.
  5. Unsuccessful and reasonable attempts to use other methods of treating obesity in the past.
  6. Understanding the risks and liabilities associated with the operation.
  7. Awareness and acceptance of the need for lifestyle changes and follow him.

Laparoscopic Sleeve Gastrectomy

In most cases this operation is performed laparoscopically. Its advantages:

  • Lower levels of pain and analgesics needs.
  • Lower risk of wound infection.
  • Rapid recovery and return to daily activities.
  • Several small incisions (5 mm) instead of a single cavity.
  • Minimum stay in the clinic.

Benefits of Sleeve Gastrectomy

The surgeon removes about 75% of the stomach, leaving a narrow tube or sleeve. Reduced body volume from the size of a soccer ball to banana size. gastric capacity is reduced from about 1.5 liters of feed liquid to 200 ml.

  • It does not operate in respect of the intestine - the removal or bypassing.
  • It does not change the direction of food through the digestive tract - from the mouth, the stomach, and then into the intestine.
  • Preserved function of the stomach - nerves and the outlet valve (pylorus).
  • Not made malabsorption of nutrients.

Despite its small size, the stomach still continues to function normally:

  • Food and nutrients enter the body naturally.
  • Acid continues to be synthesized, promote digestion.
  • Essential vitamins, minerals - B12, calcium, folic acid, iron - normally absorbed.

As a result, significantly reduced body people feel satiety after a small amount of food. they also feel less hungry between meals. After resection tubular patients consume 1/3 to ¼ volume before eaten.

The procedure takes 1 to 2 hours. Compared to gastric bypass, sleeve resection is performed in a shorter time, which can be an advantage for patients with severe diseases of the heart or lungs.

Furthermore, as a result of changes sleeve gastrectomy method of treating oily food in the gastrointestinal tract - Patients often report loss of flavor of foods high in fat and sugar - chocolate, fried foods, soft drinks. Nutritionists point out that this aspect helps patients to adopt healthier eating habits.

What wins sleeve gastrectomy compared with banding ?

  1. Sleeve gastrectomy does not require adjustments every 4-6 weeks after surgery (as long until you reach the perfect degree of limitation - the average is 4-5 adjustments).
  2. Since the implant is not used, there are no long-term risks.
  3. The opportunity for patients to use a variety of foods. Most people can eat all the food consumed prior to the surgery, but in smaller quantities.

Benefits sleeve resection before shunting

According to the research, plums Gastrectomy as much effective as bypass surgery (Roux-en-Y gastric bypass) and has its own advantages:

  1. Loss of overweight similar bypass surgery.
  2. Such elimination of problems associated with obesity - diabetes, hypertension, fatty liver disease, sleep apnea, as well as with the Roux-en-Y gastric bypass.
  3. Lower rates of complications.
  4. The relatively short hospitalization, approximately 1-2 days.
  5. Low probability of a nutritional deficiency.

Weight loss

On average, people lose up to 70% of excess body weight. This mainly occurs in the first 9-12 months after surgery. Patients get rid of more kilograms if also develop a healthy eating plan and regular physical activity. Such people lose weight to a greater extent than those who are more inert, continues to follow unhealthy eating behavior.

For example, if the patient's height 163 cm, weight - 133 kg BMI - 50.1, excess weight is 67 kg. For this case, after the sleeve resection on average he will lose 47 kg, some patients lose weight more, and a few - lose less than that amount.

Hormonal (metabolic) changes

In addition the reduction of the stomach size, this procedure reduces the amount of ghrelin hormone by 50-65%. Since the remote part of the body is rich in cells that produce it. Patients report less feeling of hunger between meals. The duration of this effect is not yet clear, but the majority of patients significantly decreased hunger after surgery.

  • Reducing ghrelin = reduction of hunger.
  • Increased PYY = Increased satiety.
  • Increase GLP-1 = An increase satiety.

Possible complications after sleeve resection

This operation has been used successfully for the treatment of severe obesity. Because this is a relatively new procedure, no data on weight loss or recovery for three years. The risk of death after gastric resection drain is 0.2% within 30 days after surgery.

The probability of serious postoperative complications is five - ten percent, lower rates as compared to the bypass. This is due to the fact that the small intestines do not share and do not reconnect. The low probability of side effects and short-time operation is the reason for using a tubular gastrectomy procedure as intermediate for patients with high risk.

Possible complications:

  • It leaks out of the sleeve, which can lead to infection or abscess. This usually occurs in the first few days after surgery, but sometimes occurs within 2 weeks after surgery. This complication requires urgent surgery to remove the infection and leakage control. After this recovery may take several weeks. Leakage probability is 1%. The following symptoms may indicate it - fever or abdominal pain in the early postoperative period. Early treatment - the key to successful management of the problem. Therefore, the patient is in Israel for at least 2 weeks after resection of the stomach sink.
  • the formation of blood clots in the legs and lungs.
  • Bleeding.
  • Allergic reactions to the anesthesia or medication.
  • Narrowing the sleeve for the removal of which required endoscopic dilatation.

Adverse events requiring reoperation, not typical tubular gastrectomy and occur in less than 5% of cases.

One of the unusual problems that may arise later, is that after surgery the stomach can stretch that lead to weight gain later. This can happen if a person tries to regularly eat more than the body can accommodate in a comfortable condition. It is important that patients appreciate the new volume of the stomach and avoid overeating. As with all weight-loss operations, there is a need to supplement surgery changes in eating behavior and lifestyle.

It is important to understand that the sleeve resection - an irreversible procedure. Some patients after surgery required treatment of heartburn.

aftercare

After the banding operation plums gastrectomy does not require any adjustments. After discharge need to be met with a doctor, after 3 weeks, then every 3 months during the first year after the operation, then - 1 times per year. Once in 6-12 months the patient delivers a blood test to monitor the lack of vitamins and minerals. After sleeve gastrectomy is recommended taking a multivitamin every day to reduce the risk of deficiency.

Thus, the sleeve gastrectomy - a bariatric operation, providing significant weight loss. The best results are achieved when surgery is combined multidisciplinary program aimed at changing lifestyles and human behavioral skills.

cost of operation

Sleeve gastrectomy is worth 29600 dollars. This amount is already included payment of all specialists, hospitalization in the recovery room and hospital operating rental and logistics services.

Additional costs may include:

  • Blood - 80 dollars.
  • Histology - 680 dollars.

The final amount: 30360 USD.

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