Stomach Surgeries

Laparoscopic Partial Gastrectomy

• Usually performed for benign or low grade tumours such as gastrointestinal stromal tumour (GIST)

Laparoscopic sleeve gastrectomy

• In this procedure approximately 80% of the stomach is removed leaving a banana shaped stomach.
• The surgery is done laparoscopically and results in a 2-3 day hospital stay.
• Patients return to work in two weeks.
• Weight loss is rapid and complete in about 12 months.
• The average weight loss is 75% of excess weight.
• The surgery works by restriction (smaller stomach) and gastro-intestinal hormonal changes.
• There is a dampening (reduction) in the hunger hormone Grehlin and an increase in satiety hormones such as GLP-1 and PYY.
• The end results in less hunger and earlier satiety with a meal.

Advantages

1. Rapid and significant weight loss in 12 months
2. No foreign body
3. No intestinal surgery
4. Both a restrictive and hormonal procedure
5. Good quality of eating.

Disadvantages

1. Non-reversible
2. Potential micronutrient deficiency
3. Gastro-oesophageal reflux in 15% of patients

Laparoscopic gastric bypass (RYGB)

• The surgery like the sleeve works with a restrictive component and a gut-hormone component.
• Again, hunger hormones are dampened and satiety hormones enhanced.
• Patients are less hungry and sated with small amounts of food.
• Weight loss is significant and rapid occurring over 12 months.
• The average weight loss is 75% of excess weight.

Advantages

1. Long-track record
2. Reversible
3. Good weight loss
4. Good quality of eating

Disadvantages

1. Risk of small bowel obstruction
2. Risk of stomal ulcer
3. Dumping syndrome
4. Risk of micronutrient deficiencies

Laparoscopic adjustable gastric band removal

• Usually indicated for poor weight loss or complications such as dysphagia (difficulty swallowing), food intolerance, heartburn and regurgitation. Infectious problems such as port site infection, band erosions, band slippage and other hardware problems.