Dr Mauricio Valencia

What is a gastric sleeve surgery?

Manga gastrica en MedellinIt is a surgery which a resection of the stomach is made to the larger portion (fundus and body) thats responsible for storing food and leaving the part responsible for the crushing of them (antrum).

Normal capacity of the stomach are approximately 1500cc, after this procedurea gastric capacity of 150 cc is left, it means that you lose the ability to store food, thats the reason for called these procedure “restrictive”. What happens with a gastric capacity of 10% less of the initial value?

You must change your eating habits:

  1. Change the use of sugar and fats with sweeteners and food without fats. You should not eat sweets or fats since these can produce a gastric emptying faster than normal and produce symptoms of hormonal discharge by exposing the small intestine (duodenum) more quickly to these concentrations of carbohydrates, these symptoms are sweating, dizziness, tachycardia, diarrhea, or abdominal pain (dumping syndrome)
  2.  You must eat quality food. Portions rich in proteins, vegetables, and fruits. Leaving flour and cereals to last. Initially, the diet for the first 5 days is liquid followed by 15 days of compote type diet, 20 days after surgery in company with a nutritionist the process of food restructuring food technique.
  3.  Is it final? The gastric sleeve is a resection surgery. The stomach that is dried is extracted from the body so you can not have the same gastric capacity that you had.
  4.  Are vitamins required with this surgery? No process of malabsorption of nutrients are carried out and it continues to have hydrochloric acid (gastric acids) that are necessary for our body to absorb vitamins, therefore, this surgery does not require any substitution of vitamins.
  5. Who are candidates for this surgery? Patients with morbid obesity who have failed medical management and have an impact on their health or quality of life due to obesity, as long as they do not have gastroesophageal reflux disease with esophagitis grade 3-4 , Barrett's esophagus, peptic stricture or giant hiatal hernia.
  6.  What are the risks of the surgery? It is a major gastrointestinal surgery and like all gastrointestinal surgeries, there are risks of infection, bleeding, leaking of the resected organ, venous thrombosis, and thrombosis of the portal vein.
  7.  How are these risks avoided? Risks are inherent in the surgical procedure, but performing it in centers equipped with all the quality supplies and in the hands of certified surgeons and with extensive experience in bariatric surgery make the risks minimal, in the literature the risk of leakage is less than 1. %, infection less than 4% and bleeding 5%.
  8.  How much weight will I lose? With gastric sleeve surgery, you lose   60 to 80% of excess weight. An example if a patient weighs 100 kg and his ideal weight is 60 kg, he has 40 kilos of excess weight, of these he loses from 24 to 32 kg with this type of surgery. Weight loss depends on the monitoring and adherence to the recommendations given by the bariatric team.
  9.  Are there contraindications to be a candidate for this surgery? If clinical signs or symptoms of eating disorder are present in the clinical interview, it is not advisable to perform this surgery until this disorder is compensated. 

What is an intragastric balloon?

Balon gastrico en Medellin

If you're not sure whether to go with surgery procedure an intragastric balloon procedure is the best alternative for you. Medical evidence has shown that it is a good option to achieve a significant weight reduction. Is a newer kind of weight-loss procedure. A saline-filled silicone balloon is placed in your stomach, which helps you lose weight by limiting how much you can eat. It also makes you feel fuller faster.

The treatment is carried out during a period of 6 months where a weight loss of between 8 and 30 kg is achieved, the result depends on the adherence of the patient to the measures of diet and physical activity.

The location of the balloon is performed through endoscopy, a minimally invasive procedure performed through the mouth, without incisions with deep sedation, without hospitalization needed.

The balloon is taken to the stomach and then filled with fluid, achieving a volume of between 500 and 700cc, depending on the weight and other characteristics of the patient.

The main objective pursued with a gastric balloon is to facilitate changes in lifestyle, recovering habits of eating and physical activity that allow to the patient lose excess weight and maintain it in the future through of healthy habits.

Although this procedure is effective and minimally invasive, it could presents discomfort in the first day like sensation of gastric repletion (fullness) and sometimes vomiting, accompanied by abdominal pain. These discomforts are mostly controlled with ingested medications, however after the first week the improvement is usually complete and finally a easy fullness after the ingestion of food will stay which is ultimately part of the goal of treatment.

The balloon is removed 6 months after its placement, by means of endoscopy without surgery, and depending on the amount of weight loss and the characteristics of the person, if a complete loss of excess weight has not been achieved, you can try the replacement of the ball and its maintenance for a longer period of time or its definitive withdrawal.

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