Different types of weight loss surgery in Mexico:
Gastric Sleeve is one of the most popular weight-loss surgeries and is often referred to as the vertical sleeve gastrectomy (VSG) or sleeve gastrectomy. In this procedure, a large portion of the stomach, normally between 80-85%, is removed and the remaining stomach (which is in the shape of a banana) is stapled.
This type of weight loss surgery is an effective solution for people who wish to overcome obesity and related health issues. It works by reducing hunger and only requires a small amount of food before they feel satisfied. Studies have reported that the percentage of excess weight loss a patient can expect in the first year after surgery is at 82%.
Benefits of gastric sleeve surgery:
- Short recovery time – return to work within 1-2 weeks or less
- Decreases hormones that trigger hunger
- Stomach capacity reduced permanently
- Induces long-term excess weight loss
- No foreign object is placed in the body
Disadvantages of gastric sleeve:
- A non-reversible operation
- Potential for long-term vitamin deficiencies
- A higher early complication rate than the gastric banding
Roux-en-Y (RNY), commonly known as gastric bypass surgery, works by reducing the stomach size into a small pouch (typically about the size of an egg). This is followed by bypassing a major part of the stomach and intestine to connect the new stomach pouch directly to a section of the small intestines. It reduces calorie absorption in the body.
The success rate of the gastric bypass procedure is high and it results in significant improvement of obesity-related health conditions. Gastric bypass is usually recommended as a weight loss procedure for patients with acid reflux and is considered especially beneficial for patients with a 35+ BMI.
Benefits of gastric bypass surgery:
- Average of 73% excess weight loss within the first year.
- Likely to improve diabetes, high blood pressure, & sleep apnea.
- A new egg-shaped stomach pouch is formed.
- Slightly higher weight loss than gastric sleeve
- Creates nutrient deficiencies requiring vitamins.
Disadvantages of gastric bypass:
- It is a more complex operation than the gastric band or sleeve gastrectomy.
- Potentially greater complication rates
- May result in long-term nutrient deficiencies – specifically vitamin B12, iron, calcium, and folate
- Requires a longer hospital stay than the gastric band
- The patient needs to adhere to dietary recommendations, life-long nutrient supplementation, and follow-up care
Mini gastric bypass
This is a type of gastric bypass that works by both restrictive and malabsorptive procedures. It changes the amount of food a patient eats and the level of absorbed calories. Mini gastric bypass surgery allows the surgeon will create up to five small incisions in the abdominal region.
The surgeons now use laparoscopic technology to perform the procedure and resize the stomach followed by rerouting to the intestines. As a mini but gastric bypass surgery, it aims to restrict the capacity of the stomach, making the patient eat less as well as the process and absorption of food.
Other weight loss procedures such as gastric sleeve surgery only involve resizing the stomach to help the patient feel full faster. This is an effective long-term weight loss procedure that has helped many people. Mini gastric bypass surgery has been shown to have a lower risk of complications in comparison to a standard Roux-en-Y gastric bypass procedure. Many patients are increasingly opting for this method of weight loss.
A gastric balloon is a medical device that is placed in the body to help with weight loss. This procedure is a restrictive and non-surgical method in which a deflated balloon is inserted from the mouth and goes to the stomach. It is then filled with saline or gas. The procedure can help the patient lose up to 20-40 pounds within a period of 6 to 12-month. It can then be removed.
The balloon works by making it difficult to eat too much at once as it takes up a majority of space in the stomach. The patient feels full more quickly than normal. This is a short-term solution that helps patients get on track with a healthier diet and exercise habits.
Most patients are able to return home the same day or the following day after the balloon has been inserted orally into the stomach. Patients can expect to lose 20 to 40 pounds in total. Many people tend to choose gastric sleeve surgery after the balloon is removed, if they have not achieved the desired level of weight loss
Duodenal Switch Surgery
Biliopancreatic Diversion with Duodenal Switch (BPD/DS) surgery works by both restrictive and malabsorptive methods. Studies have reported one of the highest expected weight loss with this operation, in comparison to all other gastric surgeries.
During the procedure, the surgeon creates a banana-shaped sleeve of the stomach by removing almost 60% or more of the stomach (similar to gastric sleeve procedure). Then the surgeon works on the next phase which is the duodenal switch. It involves bypassing a major portion of the small intestines, – basically switching or rerouting the path to the new sleeve-shaped stomach.
Benefits of duodenal switch surgery:
- Morbidly obese people who have a minimum BMI of 40+ are suitable candidates for this procedure. It can also be performed to revise previous surgery
- Expect an average 80% excess weight loss in one year
- It has the highest success rate for improvement or treatment of health problems such as diabetes, cardiovascular, and hypertension.
Disadvantages of duodenal switch surgery:
- It has a higher complication rate and increased risk for mortality than other weight-loss surgeries
- A longer hospital stay than the sleeve gastrectomy and lap band procedure
- More potential of developing protein deficiencies and long-term nutrient deficiencies such as vitamin (A, D, B and others) and minerals, iron, calcium, zinc, fat-soluble
- Need commitment to follow-up care and scheduled visits. Strict adherence to dietary and vitamin supplementation guidelines – this is important to avoid serious complications such as protein and certain vitamin deficiencies
Adjustable Gastric Band
The Adjustable Gastric Band or Lap band (when laparoscopy is used) is a weight loss procedure in which an inflatable band is placed around the upper portion of the stomach. This results in the division of the stomach into a small stomach pouch above the band and the rest of the stomach below the band.
The procedure works by creating this smaller stomach pouch, which reduces the capacity of the stomach, making the patient feel satisfies with eating just a small amount of food. This promotes a feeling of fullness and it depends upon the size of the opening in the region between the pouch and the rest of the stomach created by the gastric band.
The gastric band is adjustable and therefore, the size of the stomach opening can be adjusted. The surgeon will inject sterile saline through a port placed under the skin and fill the band. The size of the opening is gradually reduced over time following repeated adjustments or fills with saline injections.
Benefits of the gastric band:
- Expected excess weight loss of around 40 – 50 percent
- Does not involve complex operation – cutting of the stomach or rerouting of the intestines
- A shorter hospital stay is needed, usually the same-day discharge from the hospital or an overnight stay in some cases
- It is a reversible procedure and can be adjusted over time
- Associated with the lowest rate of postoperative complications and mortality among the bariatric surgeries
- The lowest risk of developing vitamin/mineral deficiencies
Disadvantages of the gastric band:
- Weight loss is slower and delayed compared to other surgical procedures
- A significant percentage of patients fail to lose at least 50 percent of excess body weight with this procedure in comparison to the other bariatric surgeries
- Requires placement of a foreign device in the body
- A potential complication of band slippage or band erosion into the stomach in a small percentage of patients
- Possible mechanical problems with the band, tube, or port in some patients
- May causes dilation of the esophagus if the patient overeats
- A high rate of re-operation
Bariatric Surgery Revision
Revision weight loss surgery is becoming popular as various types of gastric surgeries are available. Revising a previous surgery is becoming more common as some surgical techniques can yield more effective results and high success rates. Studies have reported high success rates in converting Gastric Sleeve Revision to gastric bypass, mini gastric bypass, duodenal switch, or even sleeve gastrectomy.
Revision of failed RNY gastric bypass procedures involves lengthening the Roux limb part (distal bypass), adding a lap band, or reducing the size of the stomach pouch. Lap Band or a gastric banding procedure can be easily revised to gastric sleeve.