What is obesity? ?
Obesity is a condition in which the body has an abnormally large amount of fat accumulated. This will cause various problems such as diabetes, high blood pressure. Fatty liver disease Sleep apnea Coronary artery disease or cerebrovascular disease GERD osteoarthritis of the spine or knees, etc. It also increases the risk of breast cancer. Colon cancer as well
drug treatment Exercise or eating a low-calorie diet Can lose weight But it is not possible to maintain or maintain weight for the patient all the time. Patients often gain weight back. Therefore, surgical treatment was performed. This can reduce more weight and can maintain weight for a longer period of 7-10 years or more. In patients with a low body mass index, weight loss can be considered by controlling diet and exercising. However, if the patient has a very high body mass index, there are often limitations in exercising due to obesity-related congenital disease. Moreover, exercise and diet alone often cannot reduce weight enough to cure obesity-related medical conditions such as diabetes and high blood pressure. Sleep apnea osteoarthritis Hypercholesterolemia Fatty liver disease, etc.
What is bariatric surgery? ?
Gastric surgery to reduce the size of the stomach together with reducing absorption in the stomach or small intestine In addition, hunger hormones produced in the stomach will decrease after surgery, causing appetite to decrease after surgery as well. The purpose of surgery is to treat obesity and treat co-morbidities that come with obesity, such as diabetes and high blood pressure. Fatty liver disease Sleep apnea disease, etc., makes the patient healthy after surgery. Be strong and live a normal life
Who is bariatric surgery suitable for??
Gastric bypass surgery for weight loss is not suitable for all overweight people. Before surgery, the doctor will give the patient detailed information. Physically check for readiness and screen appropriate patients. which has the following indications
Those who have lost weight through other methods but have not been successful
1. Body mass index (BMI) > 27.5 kg/m2 along with uncontrolled obesity-related illnesses.
2. Body mass index (BMI) > 32.5 kg/m2 along with obesity-related diseases such as diabetes, high blood pressure, high blood fat, sleep apnea, fatty liver, etc.
3.Body mass index (BMI) > 37.5 kg/m2
What are the advantages and disadvantages of traditional, popular surgery for treating obesity? ?
Sleeve surgery (Sleeve Gastrectomy)
Bypass surgery (Roux-en-Y Gastric Bypass)
-Reduce excess weight by 60%-70% in 1 year.
-The stomach size decreases while the sphincter and digestive tract remain the same.
Reduce the chance of Dumpling Syndrome
-Not suitable for patients with severe acid reflux. This is because after surgery the reduced size of the stomach will cause gastric pressure to increase.
Makes there a 15% chance of having acid reflux.
-Controlling weight and treating diabetes is less difficult than bypass surgery, especially in people who have had diabetes for more than 5 years.
-Able to use a gastrointestinal endoscopy to check or examine the stomach.
-Reduce excess weight by 70%-80% in 1 year.
-The stomach decreases along with changes in the digestive tract, with a connection between the stomach and the middle small intestine. Causes Dumpling syndrome in 15-30% and has a 15% chance of developing ulcers at the junction between the stomach and small intestine.
– Suitable for patients with acid reflux. This is because after surgery the pressure in the stomach decreases, causing acid reflux symptoms to improve or disappear after surgery.
– Suitable for people with severe diabetes. Can’t control diabetes
-Unable to have a gastrointestinal endoscopy or stomach examination. This is because a new path was made to connect the stomach to the small intestine.
-There is a risk of having a hernia in the future and there is a point where the intestines are cut.
and more stomach than other types of surgery
A new surgical treatment for obesity, Sleeve Plus (Sleeve Gastrectomy Plus Proximal Jejunal Bypass) Traditional surgery still has some areas that need to be developed. Therefore, a new surgical method was developed to achieve better results. Gastric bypass surgery
Sleeve Plus (Laparoscopic Sleeve Gastrectomy with Proximal Jejunostomy Bypass) is a new surgical technique. It has been made since 2010 and has become more and more popular due to its good weight loss results. It treats diabetes well and the risk of surgery is low. It is a laparoscopic surgery that combines a sleeve gastrectomy with a passage from the duodenum to the middle intestine to reduce absorption and stimulate satiety hormones (GLP-1, PYY) faster. Makes the patient feel full faster. Together with a smaller stomach size, the level of the hunger hormone (Ghrelin) will also decrease. In addition, the food connection between the duodenum and middle intestine is made. It is also easier to do and there is no risk of wounds at the junction, which is different from bypass surgery where there are wounds at the junction of the stomach and small intestine.
As for the results in weight loss and diabetes treatment, it was found that It’s no different from bypass surgery, with less risk of complications and a better risk of vitamin and nutrient deficiency than bypass surgery. Good weight loss with less excess weight. 70-80%
It can also be considered for patients who have had previous sleeve surgery. But there may still be unsatisfactory results, such as less than 50% of excess weight lost or in cases where weight regain is found after sleeve surgery. Or in cases where diabetes has not yet disappeared, additional Sleeve Plus surgery can be considered.
Advantages of Sleeve Plus Surgery
Disadvantages of Sleeve Plus Surgery
-Reduce excess weight by 70-80% in 1 year.
-The stomach size decreases while the sphincter and digestive tract remain the same.
Reduce the chance of Dumpling Syndrome
-Reduced risk of vitamin B12 deficiency compared to bypass surgery. Because the digestive tract is still similar to the original.
-There is a single seam between the duodenum and the middle part.
(Single Anastomosis)
-Control weight and treat diabetes well.
-Able to use a gastrointestinal endoscopy to check or examine the stomach.
-There is no risk of wound formation around the intestinal surgery area.
-Not suitable for patients with severe acid reflux. This is because after surgery the reduced size of the stomach will cause gastric pressure to increase.
Makes there a 15% chance of having acid reflux.
From the current information of Dr..Satianphong Chantawiboon, a surgeon who performs advanced laparoscopic surgery and bariatric surgery, found that In more than 50 cases of patients who have undergone surgery, they have been able to lose weight very well and treat their diabetes well without any post-surgery complications being found. When compared with foreign medical reports since 2010, results were found. The treatment was equally satisfactory and no serious complications were found. In summary, obesity treatment with Sleeve Gastrectomy Plus Proximal Jejunal Bypass is a new option for obesity treatment. Suitable for patients who are overweight and have diabetes. It is recommended to consult a specialized surgeon. This is because it is still a new technique that requires surgical expertise and selection of treatment methods to suit each patient. If interested, follow more information on the Facebook page. Obesity can be operated on. By Doctor Fong
2023-10-12 13:45:43
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