Sleeve gastrectomy through 3 ports | Prof. Mahmoud Zakaria Elganzoury| The greatest obesity surgeon in Egypt
Sleeve gastrectomy through 3 ports

Sleeve gastrectomy through 3 ports

Three ports Sleeve Gastrectomy Operation

Laparoscopic sleeve gastrectomy is performed through small openings in the abdomen. It was customary to perform laparoscopic sleeve gastrectomy through 5 holes in the abdominal wall. We perform sleeve gastrectomy through only three openings, and this has a cosmetic effect on the skin as well as reduces pain after the operation. In sleeve gastrectomy, the stomach size is reduced by removing 75% to 85% of stomach volume. The amount of food decreases after the sleeve gastrectomy operation, and the person does not feel hungry due to the decrease in the level of the hunger hormone (ghrelin) after the operation.

We use modern staplers that are used in many bariatric surgery centers in the United States and Europe, as we use the latest high-precision laparoscopy in Egypt.

When is the laparoscopic sleeve gastrectomy performed?

BMI greater than 40 Kg/m2

BMI from 35 to 39.9 Kg/m2 with one of the health problems associated with obesity such as:

  1. High blood pressure
  2. Type 2 diabetes
  3. Sleep Apnea
  4. Fatty liver disease
  5. High blood lipids

For patients with a BMI of 30-34.9 kg / m2, gastric sleeve surgery may be performed if they have been obese for a long time and all other obesity treatments have failed with them, especially those with obesity-related health problems.

How is the laparoscopic sleeve gastrectomy performed?

Removing part of the stomach reduces the level of a hormone called Ghrelin, which is often referred to as the “hunger hormone”. Consequently, many people find that they are less hungry after sleeve gastrectomy. Ghrelin also plays a role in determining blood sugar levels, so people with type 2 diabetes often see a direct decrease in their need for diabetes medication after sleeve gastrectomy. Sleeve gastrectomy leads to the complete cure of type 2 diabetes in more than 60% to 80% of cases.

What are the advantages of sleeve gastrectomy?

The course of food in the digestive system will not change after sleeve gastrectomy, and therefore there is no decrease in food absorption as in the case of gastric bypass surgery, and there is no foreign body implanted around the stomach, as in the case of the adjustable gastric band operation.

Does the patient get better after sleeve gastrectomy as regards obesity-related health problems?

Large clinical trials and studies have proven that sleeve gastrectomy leads to the cure or improvement of many health problems associated with obesity, such as:

  1. 1-Type 2 diabetes: Most studies indicated that 60-80% of patients suffering from type 2 diabetes could achieve a cure or improvement after gastric sleeve.
  2.  High blood pressure.
  3. Fatty liver disease.
  4. Obstructive Sleep Apnea.
  5. Cancer.
  6.  Polycystic ovaries and poor fertility in women.
  7. Depression and psychological problems.
  8.  Sterility.
  9. Low testosterone in men: Sleeve gastrectomy can increase testosterone level.
  10.  Urine Incontinence.

 

What are the benefits of using Laparoscopy in sleeve gastrectomy operation?

1- Pain relief after the operation

2 – Reducing the length of hospital stay
3 – No visible wounds
4 – Faster recovery and return to normal life and work than traditional open surgery

 

We also use the patient-controlled analgesia painkiller (PCA) device, which prevents pain and makes the patient’s recovery faster after the operation. The PCA is a method of pain relief in which the patient controls the amount of pain medicine that is used. When pain relief is needed, the person can receive a preset dose of pain medicine by pressing a button on a computerized pump that is connected to a small tube.

Initially, the laparoscopic sleeve gastrectomy was performed for very high weights (BMI over 60 kg/m2) as a first two-stage operation, and the second stage was the gastric bypass operation, which was performed after the patient reached the appropriate weight. Laparoscopic sleeve gastrectomy had proven to be very successful and many of these patients reached their ideal weight and do not require gastric bypass surgery.

How long does the recovery take after gastric sleeve operation?

  • The operation takes about 60 minutes.
  • The patient is discharged from the hospital 24 hours after the operation.
  • All patients are encouraged to walk as early as 3-4 hours after the operation.

Most patients return to work and/or school one to four weeks after the operation. Fatigue is common in the first two weeks due to reduced calorie intake in the liquid diet phase. However, the majority of patients do not feel hungry during this phase of the diet. The energy level improves rapidly after the introduction of the soft diet, which takes about two weeks after surgery. We sometimes allow patients to work from home 2-3 days a week after surgery.

You can start walking from 30 to 60 minutes a day after pain relief. Patients can start sports after two months of the sleeve gastrectomy operation.

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How is the patient prepared for the operation?

Before surgery, you should provide your doctor with a list of all medications, vitamins, minerals, and herbal or nutritional supplements that you are taking. After surgery, you may have restrictions on eating, drinking, and the medications you can take.

If you take blood thinners such as Aspirin or Marivan, talk to your doctor before surgery. Since these medicines affect clotting and cause bleeding, you may need to change the routine of this medicine before the operation. If you have diabetes, speak with your doctor for specific instructions on taking or adjusting your medication before and after surgery. Smoking of all kinds must be stopped at least two weeks before the operation.

If you have high blood pressure, your blood pressure must be completely controlled before the operation, by regularly taking your medications and measuring blood pressure daily 1 week before the operation.

How much weight will I lose after sleeve gastrectomy?

On average, patients lose about 70 – 80 % of their excess body weight during the first year after the operation.

The first month: patients lose from 10-15 kg.

The first 3 months: 35 to 45% of the excess body weight.

The first 6 months: 50-60% of excess body weight.

First-year: 70 – 80% of excess body weight loss.

Most people reach their lowest weight of 12-24 months after surgery.

تكميم-المعدة-بالثلاث-فتحات

Is there a problem to get pregnant later after gastric sleeve surgery?

We recommend that pregnancy be at least one year after the operation so that the body can adapt to the reduction in the size of the stomach and the amount of food. Vitamins, iron, and calcium must be taken regularly after the gastric sleeve operation for a year, and pregnant women may need additional doses of iron and calcium in consultation with a nutritionist. If Pregnancy occurs under any circumstances during the first year after the operation, the pregnant woman must have a close follow-up with a nutritionist to make sure that she consumes types of foods that are rich and beneficial to the fetus. Any medications or vitamins taken during pregnancy should be under the direct medical supervision of a gynecologist.