Obesity & Diabetes Care
Obesity is the chellenge of century
Obesity(Bariatric) surgery is a great revolution for the treatment of obesity
Indications for obesity surgery
A surgical approach will only be considered if all conditions are met.
- A Body Mass Index ( BMI ) over 40kg/m2
- A Body Mass over 35kg/m2 in association with documented concomitant disease that could benefit from weight loss:Diabetes type 2, arterial hypertension, radiologically proven degenerative arthritis, sleep apnea,quality of life.
- A patient age between 18 and 65 years
- Obesity which has been stable for over five years
- Unsuccessful dietary or drug measures for over a year
- Absence of endocrine disease
- Sufficient comprehension and compliance from the patient
- No history of excessive alcohol intake; no history of drug abuse
- Acceptable operative risk
Calculate your BMI
Body mass index (BMI) is measure of body fat based on height and weight that applies to both adult men and women.
Normal weight = 18.5 - 24.9
Overweight = 25 - 29.9
Obesity = BMI of 30 or greater
Types Of Bariatric Surgery
- Gastric Banding
- Vertical Banded Gastroplasty
- Sleeve Gastrectomy
- Gastric Plication
- Roux-en-Y Gastric bypass(more restrictive)
- Minigastric bypass(more malabsorptive)
- Billio pancreatic diversion (BPD)
- Deudenal switch
- Sleeve Gastrectomy + Deudenojejunostomy
- Ileal Interposition
Adjustable Gastric Banding
The Swedish adjustable gastric band (SAGB) consists of a silicone inflatable band and an attached access port. The band is placed around the top part of the stomach (like a belt) to form a narrow constriction. This functionally divides the stomach into a small (15cc) proximal gastric pouch and the large remainder of the stomach. Eating small amounts fills the pouch and causes a feeling of fullness.
The access port is implanted under the skin of the abdomen and connected to the band via a small tube. After surgery the tightness of the band can be adjusted for optimal weight loss by injecting or removing saline from the access port.
The operation is performed laparoscopically using small incisions. The operation takes about an hour and patients can usually go home the day of surgery or the morning after.
In this procedure about 80% part of stomach has been resected and due to resection of stomach main part a hormone gherlin that is responsible for hunger has been decreased.patient feel satiety and can not eat much.
This is the restrive type of procedure. In this procedure there is no resection of stomach no small intestine bypass. The main part of stomach has been plicate and the intra gastric volume has been decreased . Patient can not eat much.
Roux-en-Y gastric bypass
In this procedure stomach pouch is only 30cc.small intestine has been bypassed.patient can not eat much and due to bypass of small intestine absorption of neutrients is also little.
Mini gastric bypass
In this procedure stomach pouch is about 50cc.Small intestine has been bypassed .There is only one anastomosis.At any stage of life this procedure is reversible.
Surgical Treatment Of Diabetes
Metabolic Surgery(Surgical Treatment Of Diabetes)
This is a nobal procedure for the treatment of diabetes.In this procedure the distal part of small intestine has been replaced by proximal part of small intestine(jejunum).
Sleeve Gastrectomy with deudenojejunostomy
This is also type of metabolic surgery.In this procedure main part of stomach has been removed and small intestine has been bypassed.