Laparoscopic Sleeve Gastrectomy: What to Expect?

How Is Sleeve Gastrectomy Performed? 

The laparoscopic sleeve gastrectomy is a surgical weight loss procedure performed to reduce the stomach size by about 25% of its original size. This procedure will reduce the stomach size permanently and this an irreversible procedure.

During this procedure, your surgeon will make a longitudinal resection of the stomach beginning from the antrum at the point 5 to 6 cm from the pylorus and ending at the fundus closer to the cardia. This results in a tube or sleeve like structure which is calibrated with a bougie. Often the surgeons prefer using a bougie of 36-40 Fr with this procedure. The ideal remaining size of the stomach post sleeve gastrectomy is nearly 150mL.

In this procedure, the doctor will make five or six small incisions in the abdomen and then insert a video camera called laparoscope through these incisions. LSG (Laparoscopic Sleeve Gastrectomy) takes nearly one to two hours to complete.

laparoscopic sleeve gastrectomy - weight loss surgery

How Does Sleeve Gastrectomy Cause Weight Loss?

This is a restrictive procedure which greatly reduces the size of your stomach such that it limit the amount of food to be eaten at a time. This procedure does not reduce the absorption of the nutrients instead you’ll feel full very quickly after eating a small amount of food.

Patients who undergo this procedure will have decreased appetite. Sleeve gastrectomy will reduce the size of the stomach as well as decrease the production of “hunger hormones” by the stomach. Thus, the laparoscopic sleeve gastrectomy will contribute to weight loss.

How Much Weight-loss Occurs after LSG?

The amount of weight loss in the region is about 70% of excess weight. Often this weight loss occurs over the period of the first 9 to 12 months post LSG. Patients who had undergone this procedure should adopt healthy eating habits and should follow physical activity to achieve excess weight loss.

Who Need to Undergo Laparoscopic Sleeve Gastrectomy?

Usually, sleeve gastrectomy is performed as a part of a two staged approach for a surgical weight loss. Later this procedure was performed as first part of the two stage bypass operation on extremely obese patients for whom the risk of performing the gastric bypass surgery was higher.

Patients having higher body mass index (BMI) or who are at higher risk for longer procedure due to lung or heart problems or who are at risk to undergo anesthesia will benefit from LSG.

Risk Factors of Laparoscopic Sleeve Gastrectomy:

The risks of LSG are rare and major complications are reported less than one percent. Some of the common risks of Laparoscopic sleeve gastrectomy include infection and bleeding.  The operative risks for LSG is lower than the risks related to gastric bypass. 

Benefits of Laparoscopic Sleeve Gastrectomy:

  1. In this procedure, the function of the stomach is preserved because the nerves of the stomach and the outlet valve are not altered.
  2. It significantly decreases the hunger by removing the part of the stomach which produces the hunger stimulating hormones.
  3. It allows the normal food ingestion which results in reduced risk for developing lack of minerals and vitamins as well as eliminates the dumping syndrome.
  4. Reduce the risk for developing ulcers.
  5. More than 75% of patients undergoing LSG have reported improvement in hypertension, abnormal cholesterol levels, diabetes and obstructive sleep apnea.

Is Laparoscopic Sleeve Gastrectomy A Good Choice For Me?

Today, the laparoscopic sleeve gastrectomy is the fastest growing and effective weight loss surgery. This surgery is more effective as compared to the gastric bypass surgery for weight loss. It is advised to talk with your doctor to understand about this procedure.

References:

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Laparoscopic Ovarian Drilling: Know the Facts!

The ovarian drilling is usually performed during laparoscopy. In this procedure, an electrosurgical needle or a laser fiber punctures the ovary for four to ten times. This treatment results in a dramatic reduction of male hormones within days. Usually this procedure is performed in women suffering from polycystic ovary syndrome (PCOS). As per the studies, nearly 80 percent of patients benefit from this treatment.

Women who fail to ovulate with Metformin therapy or clomiphene will respond well to these medications after undergoing ovarian drilling.

Laparoscopic Ovarian Drilling

How does ovarian drilling work?

The laparoscopic ovarian drilling is a surgical treatment that triggers ovulation in women suffering from PCOS (polycystic ovary syndrome). In this process, a laser will be used to destroy some parts of the ovaries. Although this surgery is not used commonly, yet this is an option for women who are trying fertility medications or for those women who are still not ovulating after losing weight.

Usually, the ovarian drilling is performed through a small incision with the help of a laparoscopy. The patient will be administered with a general anesthesia. Your surgeon will make a small cut at the belly button of the abdomen. Then he will place a tube such that it inflates the abdomen with a small amount of carbon dioxide gas. This will help him insert the viewing instrument also called as laparoscope without damaging your internal organs.

The surgeon will then look at the internal organs with the help of the laparoscope. Then he will insert his surgical instruments either through the same incision or through the other small incisions made in the pelvic area. The size of the incisions are so small that the laparoscopy is also called as “Band aid surgery”.

Will ovarian drilling work for me?

If you are having PCOS (polycystic ovary syndrome) and having fertility issues, then your doctor will recommend you to undergo LOD (laparoscopic ovarian drilling). This is a minor surgical procedure which will treat the fertility problems in women having PCOS.

You will not know the happenings during this surgery, since you will be under general anesthesia. Your doctor will perform this surgery by making a small cut in the tummy and pass a long, thin microscope through it. Since the incisions created are very small, so there will be less scars after surgery. Also the recovery time required will be very less. Your hospital stay will also be reduced and you can resume your normal activities post surgery.

The laparoscopic ovarian drilling will lower the testosterone and the luteinising hormones (LH) and also boosts the FSH (follicle-stimulating hormone). In other words, this surgical procedure will destroy the tissues produced by the male hormones called androgens using laser or heat. Hence, LOD help to correct your hormonal imbalance, thereby restores the normal functioning of your ovaries.

Is ovarian drilling safe?

The ovarian drilling is quite safe. The side effects of this treatment are rarely reported.

Weighing risks and benefits:

The side effects of ovarian drilling are very rare. The risk factors related to complications during the laparoscopic ovarian drilling are ovarian failure or adhesion formation.

Benefits:

It is performed on women with PCOS who are unable to ovulate even after taking fertility medications or reducing weight.

This procedure helps to restore the regular ovulation cycles in women.

Women may be able to become pregnant after they undergo ovarian drilling surgery.

Conclusion:

Ovarian drilling is an effective treatment for women having fertility issues. It helps to regulate the normal function of the ovaries. This procedure is quite safe and aids women to become pregnant. India offers excellent ovarian drilling treatment at quite reasonable rates.

References:

Laparoscopic Surgery Facts: What To Expect?

What is Laparoscopic Surgery?

This surgery is also called as minimally invasive surgery (MIS) or keyhole surgery in which operations are performed far from the location through smaller incisions elsewhere in the body. The small incisions made by the surgeon usually are 0.5-1.5 cm. In key element used in this surgery is a laparoscope which is long fiber optic cable that allows your surgeon to view the affected area and make it easily accessible.

Laparoscopic Surgery

How laparoscopy is carried out?

Your surgeon will make small incisions of about 1 to 1.5 cm usually near the belly button. Then a tube is inserted via the incision along with a tube that pumps carbon dioxide gas to inflate your tummy. This allows your surgeon to see through organs more vividly and provide them room to work. This is followed by insertion of a laparoscope through the tube. It will relay the images to a television monitor that will provide a clear view of the area to your surgeon.

Based on the surgical treatment you are required to undergo, your surgeon will make further incisions in your abdomen. This will allow insertion of small, surgical instruments through these incisions which in turn will guide your surgeon with right place using the view from laparoscope. Once the instruments are in place, they are used to carry out the required treatment.

After completion of this procedure, the carbon dioxide gas is let out from your abdomen. Then your surgeon will close the incisions with clips or stitches and apply dressing.

If laparoscopy is used for diagnosing your condition, then the procedure may take about 30 to 60 minutes. Depending on the type of surgery it may take longer time if your surgeon is treating a condition.

What are the advantages of Laparoscopic Surgery?

  1. Smaller incision reduces the pain and hemorrhaging which lower the need for blood transfusion.
  2. It shortens the recovery time which results in less post-operative scarring.
  3. Reduced pain leads to less pain medication.
  4. Hospital stay is less and often patients are given discharge the same day.
  5. Reduced exposure of internal organs lowers the risk of acquiring infections.

What are the disadvantages of Laparoscopic Surgery?

There are not many disadvantages of laparoscopic surgery as most procedure done laparoscopically is performed under general anesthesia. The patients who undergo laparoscopic surgery are put to sleep which means they are hooked to a breathing machine during this procedure. Few patients experience sore throat post operation. Overall, most patients have much pain after going through this surgery.

Is Laparoscopic Surgery safe?

The laparoscopic surgery is regarded as safe since it is performed under general anesthesia. So the patient will be unconscious during the procedure and will have no memory about it. Serious complications are rarely reported. The patient can often go home on the same day of the surgery.

Final Verdict:

Laparoscopic Surgery is a safe procedure with less pain and reduced hospital stay. The recovery time required for the patient is quite less compared to the traditional open surgery.

References:

  • Mirhashemi R, Harlow BL, Ginsburg ES, Signorello LB, Berkowitz R, Feldman S (September 1998). “Predicting risk of complications with gynecologic laparoscopic surgery”. Obstet Gynecol 92 (3): 327–31.
  • Mayol, Julio; Julio Garcia-Aguilar, Elena Ortiz-Oshiro, Jose A. De-Diego Carmona, Jesus A. Fernandez-Represa (June 1997). “Risks of the Minimal Access Approach for Laparoscopic Surgery: Multivariate Analysis of Morbidity Related to Umbilical Trocar Insertion”. World Journal of Surgery 21 (5): 529–533.