There are many gastric bypass surgeries, and most surgeons consider the Roux-en-Y gastric bypass as the gold standard over other surgeries. Gastric bypass is a quick procedure where the reflux is 100% cured, and the diabetes is also cured to some extent. In this procedure, they divide the stomach entirely, make a one-ounce pouch, and leave the rest of the stomach inside. Then, they bring a loop up of the small intestine, divide it, and connect it. This step will leave a bypassed stomach. The results of this operation are that these patients lose about Â¾ of the extra weight.
The surgeon places six ports over the patientâ€™s abdomen.
They begin the procedure by opening the lesser sac enough to visualize the mesocolon window.
After opening the lesser sac, they elevate the mesocolon to create a mesocolonic window.
They open the tiny window enough to bring up the small bowel to create the Roux- Y limb.
Then, they bring up the upper jejunum from this window to create the Roux Y limb.
They score the mesentery of the small intestine with a tri-sector.
Next, they transect the Roux Y limb with an endoscopic tape. Then, they perform reanastomosis in a side-to-side fashion of the small bowel.
After placing the stay sutures, they create two enterotomies and create an anastomosis.
After the creation of anastomosis, they create a triangulation technique to obliterate the common channel.
Finally, they re-enter the lesser sac from the lesser curve to create a staple line and a small narrow gastric pouch.
The more common name for gastric banding is â€œlaparoscopic adjustable gastric band.â€ The idea the band is a minimally invasive procedure that avoids problems, such as stomach stapling problems. The band is a device that they insert on top of the stomach and wrap it. Then, they cinch it down and find the right place for it, depending on the patient through a series of adjustments. Finding the balance between losing weight and throwing up is essential. If it is too loose, patients will not lose the required amount of weight, and if it is too tight, the patients throw up. Surgeons recommend this procedure only for active patients who exercise, are motivated, and are disciplined. Often, their only problem is being hungry all the time, so they lose weight with the help of surgery.
First, the surgeon makes small incisions in the upper part of the patientâ€™s abdomen and chest.
Then, they insert a telescopic camera to see the stomach and guide instruments to it.
They fit the gastric band using instruments that pass through the small openings. Gastric banding restricts the amount of food the stomach can hold.
The reservoir sits under the skin of the abdomen.
After the gastric binding, the patient can eat only small meals, and their hunger is satisfied earlier.
The size of the opening from the pouch determines how quickly food leaves the patientâ€™s stomach.
Inflating the band with fluid makes the stoma narrower and is done a few weeks after the initial operation.
They inject fluid into the reservoir connected to the band by a thin tube. The patient may need to make adjustments 2-3 times in the first few months after the operation.
Finally, they close the incisions in the abdomen with stitches.
In this procedure, surgeons cut the stomach vertically and remove most of it. This step will leave a tube or sleeve of the stomach. These patients have a very extreme weight loss because the sleeve takes control of the patientâ€™s hunger.
First, the surgeons decompress the stomach and remove the excess fat near the stomach.
Then, they locate the pylorus, which is the valve at the end of the stomach. After this, the surgeons begin the process of mobilizing the stomach. This term refers to the process of mobilizing the greater curvature and removing all the blood vessels attached to it.
Next, they use a thick tube called the bougie, which helps prevent the sleeve from being too narrow or wide.
For the removal of the stomach, they use a stapling device, which is a surgical device that cuts and closes both sides of the tissue with tiny titanium staples.
Finally, they remove the specimen through the port.
The significant complications of the surgery include leakage, making the sleeve too narrow, and twisting of the stomach.
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