Bariatric Surgery

This is a permanent restrictive technique which limits the volume of food consumption. As a result of this, weight-loss is accomplished. The band is placed round the stomach, externally and creates a type of hourglass that its upper part contains much less food than the whole stomach.

Laparoscopic band placement procedure lasts less than 1 hour. Its advantage is mainly that the width of the band can be adjusted through a valve which is placed under the skin. This way, it can clench to reduce the food quantity going through the intestine or unclench so that the food quantity increases. After laparoscopic band placement, hospital stay is 1 day or maybe less. Excess weight-loss is approximately 55%.

Following gastric banding, special attention to food consumption guidelines has to given in order to achieve maximum weight-loss results. And this is because, liquid or soft fatty food (like ice-cream, alcohol, milkshakes, sweets e.t.c) which can easily access the ‘hourglass’ should not be consumed. All other food types can be consumed on daily basis without the need of supplements or vitamins. Postoperatively, it is also necessary to ensure physical activity so as to accelerate your metabolism and consequently the excess weight-loss.

This is a new surgical weight-loss technique which looks like sleeve gastrectomy. The difference is that the part of the stomach is not excised, but it is inverted towards the interior, so as to make sure that its volume and capacity is being limited.

The advantage of this surgical method is that since there is no incision in the stomach, the possibility of complications such as leak of gastric contains is eliminated.

The weight-loss is satisfactory and reaches approximately the 50% of the excess weight, but it is less than the weight-loss achieved after sleeve gastrectomy.

Gastric plication is performed laparoscopically and the procedure lasts approximately 90 minutes. Postoperatively, the mean hospital stay is 1-2 days. This novel technique is used for the treatment of morbid obesity the last 5 years. For this reason we are only aware of its short-term results. There is no experience and knowledge of its results after a longer period of time. (e.g. for 10-15 years postoperatively)

This surgical technique limits the volume of food that can be consumed and at the same time reduces the appetite and bulimia. This is achieved, because after sleeve gastrectomy the stomach stops producing ghrelin, a hormone causing increase of appetite.

Stomach content is restricted with suturing so as to take in 100-150 ml of food, while pylorous remains to control the natural outlay of food to the duodenum and the small intestine. Gastric emptying, which now looks like “sleeve”, accelerates resulting into the production of hormones that reduce food appetite. Through these mechanisms, this surgical approach assures very satisfying weight-loss results.

In other words, after SG excess weight is lost because we satiate easier and the food quantity able to fit in our stomach is much less than before. This procedure is performed laparoscopically and its duration is ± 90 minutes. Postoperative hospital stay is approximately 2 days. Excess weight-loss reaches 65-70% after sleeve gastrectomy.

This procedure is known as gastric bypass. It is a more complex operation, which combines the reduction of food intake with the change of hormone production in the alimentary canal and the appetite decrease.

It is performed laparoscopically and it takes approximately 2-2,5 hours. A small gastric poutch is formed (small part of the stomach) just after the esophagus which fills easily with small quantity of food. This sac is connected directly with the small intestine and this way, food doesn’t go through the rest of the stomach, neither the duodenum. That is why this procedure was named gastric bypass. Since the pyloric valve is excluded, after the consumption of sugar-containing food, the patient tends to vomit, feels seasick, sweats and generally avoids the consumption of food rich in carbohydrates.

After gastric bypass, sweet intake in being limited and weight-loss is greater. Yet, this technique has more complications than the previous ones. Moreover, consumption of vitamins, calcium, iron and folic acid is considered necessary on daily basis for life. Mean hospital stay is 3-5 days postoperatively and excess weight-loss can reach 70%.

It is a simpler technique than the original gastric bypass. A single anastomosis between the small intestine and the gastric poutch along the lower curvature of the stomach is created. This procedure is performed laparoscopically and lasts approximately 1,5 hours. The gastric poutch is connected with the small intestine 2 metres from the beginning of the small intestine (Treitz connection). This way, food after consumption goes faster to the distal small bowel and causes secretion of entero peptides resulting into quick satiety and restoration of the weight loss.

This procedure offers the same results with the gastric bypass in terms of weight loss, but also for the treatment of obesity co-morbidities, such as type 2 diabetes.

After mini gastric bypass, patients should receive food supplements, such as: calcium, vitamin B12, folic acid and iron.