I read with great interest the case series published this month in Surgery for Obesity and Related Diseases, SOARD, by Yerdel et al. “Sleeve Gastrectomy in patients with previous antireflux surgery. Preliminary results of the “no-touch to posterior wrap” technique. The authors converted 14 Nissen fundoplication patients with morbid obesity to sleeve gastrectomy. Mean follow up time was around 2 years after conversion surgery. Conversion surgery preserved the posterior and right lateral aspect of the wrap. Continue reading “Sleeve Gastrectomy in Patients with Previous Nissen fundoplication”
We have previously discussed the pathophysiology associated with bile reflux from duodenum into gastric sleeve lumen ending into distal esophagus in the setting of hiatal hernia. At Houston Weight loss Surgery Center, we have made the observation of increased incidence of bile gastritis in gastric sleeve patients with hiatal hernia and distal esophagitis. Continue reading “Duodeno-gastric Bile Reflux after Sleeve Gastrectomy”
I read with great interest the article “Gastric Migration Crisis in Obesity Surgery” recently published in Obesity Surgery. The author, Dr. Runkel, is concerned about the increasing numbers of intra-thoracic migration of gastric sleeve leading to GERD and Barrett’s esophagus development. Continue reading “Gastric Sleeve Migration in Weight loss Surgery”
“Without data, you are just another person with an opinion”, concluded R. Cohen MD his attack and critique of the novel weight loss procedure, endoscopic sleeve gastroplasty also known as Endosleeve. Cohen et al conducted a systemic review regarding the efficacy and safety of endoscopic sleeve gastroplasty. The authors found no supporting scientific evidence to recommend the use of endoscopic sleeve gastroplasty for treatment of obesity in clinical practice. Continue reading “Endoscopic Sleeve Gastroplasty Under Fire”
A recent study by Courcoulas et al titled “Patient behavior and Characteristics Related to Weight Regain after Roux-en-Y gastric Bypass” highlights certain behaviors associated with weight regain years after bariatric surgery. Continue reading “Weight Regain after Bariatric Surgery”
Mini-gastric bypass also known as single anastomosis gastric bypass surgery is a non-endorsed weight loss procedure by the American Society of Bariatric and Metabolic Surgery, ASMBS. Bile reflux and the risk of malignancy have been the main concern with mini gastric bypass when compared to the standard Roux-en-Y gastric bypass surgery. Continue reading “Is Mini Gastric Bypass a Safe Option for Weight Loss?”
Gastric sleeve surgery is a restrictive bariatric procedure. Stomach volume is greatly reduced resulting in small meal consumption. Weight loss, however, is not related to stomach volume reduction. Gastric sleeve induced weight loss is a physiologic result of altered gastrointestinal neuro-hormonal signals secondary to increased Continue reading “Is Your Gastric Sleeve Dilated?”
I have recently evaluated a patient for severe heartburn and food regurgitation following gastric sleeve surgery performed in 2013 in Houston. The patient was happy with weight loss results. She had excellent restriction but suffered from severe GERD related symptoms poorly controlled with high dose proton pump inhibitors. Continue reading “Single Incision Gastric Sleeve Surgery”
Bariatric surgery, including gastric sleeve surgery, is the most effective treatment for type 2 diabetes. The combination of post-sleeve gastrectomy weight loss, decreased food intake and neuro-hormonal changes result in durable blood glucose improvement and in many cases Diabetes remission. Few studies, however, have addressed the preventative effect of gastric sleeve and bypass surgery on new onset type two diabetes development. “Preventative effect of bariatric surgery on type 2 diabetes in morbidly obese patients: a national French survey between 2008 and 2016 on 328,509 morbidly obese individuals” is a newly published study in the Surgery for Obesity and Related Diseases journal. This French nationwide retrospective study shows 82% reduction in new onset type 2 diabetes development following bariatric surgery in obese patients. Gastric sleeve surgery and gastric bypass were equally effective in reducing the development of type 2 diabetes.
Obesity is a major risk factor for type 2 diabetes. If you live in Houston and suffer from excess weight or type 2 diabetes, bariatric surgery may be a great solution for you. Don’t wait until you develop advanced type 2 diabetes to consider a safe, effective and minimally invasive procedure like gastric sleeve surgery. Gastric sleeve surgery unlike insulin supplementation reverses the underlying pathophysiology of type 2 diabetes. Gastric sleeve surgery increases gastric emptying. Gastric sleeve surgery promotes the secretion of neuroendocrine signals that favor lower insulin resistance, lower blood glucose levels and weight loss. Take control of your health today and invest in it, for your health is your best wealth. Early intervention in the form of sleeve gastrectomy is associated with a higher success rate of type 2 diabetes remission and lower rate of type 2 diabetes related complications.
I read with interest the new study “Assessment of Sleeve Gastrectomy Surgical Technique: First Look at 30-Day Outcomes Based on the MBSAQIP Database” published by my colleague Dr. Chaar in JACS current issue. The author compares different techniques in staple line reinforcement in sleeve gastrectomy cases collected in the MBSAQIP database. Continue reading “Sleeve Gastrectomy Technique: Does It matter?”