Obesity:
- Complications of obesity
- Medical treatment
- Surgery for obesity
- Outcomes of surgery
- Complications of surgery
- NICE guidelines
- Life after surgery
Laparoscopic surgery for obesity:
Mini Gastric Bypass (MGB) - The MGB operation serves to reduce the volume of the body of the stomach and add a malabsorbtive component, but in a way which is less prone to technical complications and is easily refashioned or even reversed if necessary.
This procedure relies on combining a more modest reduction in the stomach capacity with a modest reduction in the available bowel to absorb the ingested meal.
MGB - This type of gastric bypass is based upon the technique used to perform a Bilroth 2 gastrectomy.
It has long been known that patients who have a Bilroth 2 gastrectomy lose weight post-operatively.
The stomach is divided to produce a gastric tube which aids in generating early satiety - both by reducing the volume taken in each meal and by reduction in circulating ghrelin levels. The bypass portion of the procedure is designed to eliminate food from the duodenum and most of the small bowel. This appears to reduce the sensation of hunger by manipulating levels of GLP-1 and PYY in the person.
The theory behind the success of this procedure seems to be the changes in the levels of hormones produced by the elimination of the duodenum from the pathway taken by food, with a reduction in absorption of food.
Diabetes is often eliminated within days of surgery and over 80% of patients with Type 2 diabetes find their disease diasppears within weeks of surgery. Often before significant amounts of weight are lost.
There are less complications from this surgery, which are generally related to the technical points of producing this type of bypass procedure:
Narrowing of the join to the stomach is eliminated, intestinal obstruction due to spaces being formed within the intestinal loops is also eliminated and leakage of the joins formed is reduced by reduction in the joins to one.
I am indebted to Dr Robert Rutledge for his teaching and belief in this form of obesity procedure. The results he has demonstrated with this technique are truly impressive.