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All Posts in Category: Surgery Videos

BARIATRIC SURGERY – : Mr. PAPI REDDY’S REVIEW

I performed LAPAROSCOPIC SLEEVE GASTRECTOMY WITH LOOP DUODENOJEJUNAL BYPASS (BARIATRIC SURGERY/ METABOLIC SURGERY) on Mr. Papi Reddy on 06th November 2015. Please listen to his review in English – Dr. V. AMAR, www.drvamar.com.

Sleeve Gastrectomy with Loop Duodenojejunal Bypass (SG LDJB) is a loop modification of Bilio-pancreatic Diversion with Duodenal Switch with gastro-jejunal anastomosis in place of gastro-ileal anastomosis.

It can also be considered as a combination of Sleeve Gastrectomy (SG) and Mini-gastric Bypass (MGB). Since diversion is present, hormonal changes are more. So it is more effective in terms of weight loss and resolution of type II diabetes compared to Sleeve Gastrectomy alone. Compared to Mini-gastric bypass, there is no at risk gastric remnant, risk of calcium and iron deficiency is less due to presence of first part of duodenum in food pathway and risk of dumping syndrome is less due to presence of intact pylorus.

Bariatric surgery is a scientifically proven, safe and highly effective method for permanent weight loss. Weight loss and resolution of type II diabetes after bariatric/ metabolic surgery is due to hormonal changes and not due to food restriction or malabsorption.

For information on obesity and diabetes surgery 

Dr. V. Amar

Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Institute
Hyderabad.
? www.drvamar.com
? www.obesitydiabetessurgery.com
?+91 9676675646
? drvamar@gmail.com

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SINGLE ANASTOMOSIS SLEEVE ILEAL BYPASS SURGERY VIDEO – Dr. V. AMAR

Sleeve Gastrectomy with Loop Gastro Ileal Bypass (SG LGIB) is a novel bariatric/ metabolic surgery. It is known as Single Anastomosis Sleeve Ileal (SASI) Bypass or Sleeve Gastrectomy with Loop Bipartition (SG LB). It is a loop modification of Sleeve Gastrectomy with Transit Bipartition (SG TB), which in turn is a modification of Bilio-pancreatic Diversion with Duodenal Switch (BPD DS).

Procedure – Sleeve gastrectomy is done starting 6 cm proximal to pylorus. Terminal ileum at 300 cm point is anastomosed to antero-inferior aspect of pyloric antrum, horizontally in a loop fashion using hand sewn or stapled method Anastomosis is ante-colic.

Physiology – In this surgery sleeve has two outlets. Undigested food entering terminal ileum across the anastomosis results in distal gut hormonal changes (Increased GLP 1, Peptide YY etc). So weight loss is more, weight regain risk is less and chances of resolution of type 2 diabetes are more. Since duodeno-jejunal pathway is also intact, part of the food goes through proximal intestine leading to reduced risk of malabsorption.

Main advantage is that endoscopic access to biliary tract is maintained and there is no at risk gastric remnant. Since food also enters duodenum, anti incretin effect is intact, and as a result, risk of hypoglycaemia and dumping syndrome is less. This surgery is very easy to perform. Learning curve is short. Surprisingly there is no risk of diarrhoea. Its effect on weight loss and diabetes resolution is comparable to that of BPD DS.

SLEEVE GASTRECTOMY WITH LOOP GASTRO ILEAL BYPASS (SG LGIB)
SINGLE ANASTOMOSIS SLEEVE ILEAL (SASI) BYPASS
SLEEVE GASTRECTOMY WITH LOOP BIPARTITION (SG LB)
PLEASE WATCH THIS VIDEO IN 1080p HD FORMAT (Go to Settings, Change to 1080p in Quality)

For information on obesity and diabetes surgery 

Dr. V. Amar

Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Institute
Hyderabad.
? www.drvamar.com
? www.obesitydiabetessurgery.com
?+91 9676675646
? drvamar@gmail.com

Read More

SLEEVE GASTRECTOMY WITH DUODENOILEAL INTERPOSITION Surgery Video

Sleeve Gastrectomy with Duodenoileal Interposition (SG DII) is also known as Diverted Sleeve Gastrectomy with Ileal Interposition (DSG II). It is a very effective metabolic surgery to resolve type II diabetes.

It is a modification of Biliopancreatic Diversion with Duodenal Switch (BPD DS). In both procedures, there is gastric sleeve, 1st part of duodenum is transected, food empties into terminal ileum. But the difference is that common channel is only 100 cm in BPD – DS, where as in SG DII, it is very long since food empties into jejunum 50 cm from DJ flexure. So addition of one extra anastomosis (ileojejunostomy) converts BPD DS into SG DII, of course with slight modifications in the lengths of each intestinal limbs.

It is a scientifically proven, safe and highly effective method for resolution of type II diabetes. Weight loss and resolution of type II diabetes after bariatric/ metabolic surgery is due to hormonal changes and not due to food restriction or malabsorption.

For information on obesity and diabetes surgery 

Dr. V. Amar

Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Institute
Hyderabad.
? www.drvamar.com
? www.obesitydiabetessurgery.com
?+91 9676675646
? drvamar@gmail.com

 

Read More

SLEEVE GASTRECTOMY WITH LOOP DUODENOJEJUNAL BYPASS Surgery Video

Sleeve Gastrectomy with Loop Duodenojejunal Bypass (SG LDJB) is a combination of Sleeve Gastrectomy (SG) and Mini-gastric Bypass (MGB).

Since diversion is also present, hormonal changes are more. So it is more effective in terms of weight loss and resolution of type II diabetes compared to Sleeve Gastrectomy alone. Compared to Mini-gastric bypass, there is no at risk gastric remnant, risk of calcium and iron deficiency is less due to presence of first part of duodenum in food pathway and risk of dumping syndrome is less due to presence of intact pylorus.

Bariatric surgery is a scientifically proven, safe and highly effective method for permanent weight loss. Weight loss and resolution of type II diabetes after bariatric/ metabolic surgery is due to hormonal changes and not due to food restriction or malabsorption.

For information on obesity and diabetes surgery 

Dr. V. Amar

Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Institute
Hyderabad.
? www.drvamar.com
? www.obesitydiabetessurgery.com
?+91 9676675646
? drvamar@gmail.com

 

Read More

Sleeve Gastrectomy Surgery Video By Dr. V. Amar

This is done as a solo restrictive operation or as a part of Lap BPD-DS mal-absorptive operation. It is also done as a stage 1 operation for super obese individuals to reduce their weight to the required level so that they can withstand more definitive Lap BPD-DS operation in future and surgical complications will also be less at that time. This became the most accepted and most popular solo restrictive operation in recent times. Using linear staplers 2/3 rd of the stomach is removed. Remaining stomach capacity is 60 to 120 ml if it is done as a solo restrictive operation or 150 to 200 ml if it is done as a part of mal-absorptive operation.
Fundus of stomach contains cells producing Ghrelin hormone which increases appetite. As fundus is removed during this surgery, appetite reduces after this operation. As stomach size is reduced, food intake is restricted. Because of loss of appetite and food restriction this operation gives reliable loss of weight. Weight loss is better after Lap SG compared to LAGB.

For information on obesity and diabetes surgery 

Dr. V. Amar

Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Institute
Hyderabad.
? www.drvamar.com
? www.obesitydiabetessurgery.com
?+91 9676675646
? drvamar@gmail.com

Read More