Gastric band, bypass, sleeve? Compare procedures and costs abroad

GASTRIC BYPASS SURGERY IN 2023

Gastric bypass surgery (“Roux-en-Y gastric bypass”) is a weight loss surgery (also named bariatric surgery) performed that makes the stomach smaller and redirects the intestines. As a result of this, patients:

• Feel satisfied sooner when eating and consume less food
• Take less minerals
• Excess weight close to 67%is loss within 2 years
• There is a significant improvement in health

HOW GASTRIC BYPASS SURGERY WORKS

• Gastric bypass surgery reduces the size of the stomach which makes the patient feel full sooner while eating
• The surgery rearrange the intestines which results to the body absorbing fewer minerals
• Dumping syndrome symptoms prevent patients from eating unhealthy foods

 

OVERVIEW OF GASTRIC BYPASS

1. Insert Instruments: 4 to 6 small incisions are made and insertion of laparoscopic instruments is done.

2. Separation of the large portion of the stomach: Cutting and stapling of the top portion of the stomach which forms a small pouch at the end of the esophagus while the rest of the stomach is attached to the top of the small intestines.

3. Reduced hunger and weight loss: Separate the upper part of the small intestine from the lower part, and then attach the lower part to the smaller stomach pouch. Attach the free end of the upper part of the small intestine to the bottom of the “Roux limb.” This permits the digestive juices which are produced by the stomach to “meet up” with the food in the intestines.

4. Feel full sooner, absorbing fewer minerals, losing weight: a smaller stomach makes the patient to feel less hungry and get satisfied sooner while eating, and absorption of fewer minerals is caused by the rerouted small intestine. This combination results to significant, rapid, and long-term weight loss.

 

WEIGHT LOSS DURING GASTRIC BYPASS

• Up to 65% of excess weight is loss within 1 year of gastric bypass surgery

HEALTH BENEFITS OF GASTRIC BYPASS SURGERY

• Gastric bypass surgery cures or improves serious health conditions such as diabetes, sleep apnea, and hypertension among others.

HOW TO QUALIFY FOR GASTRIC BYPASS SURGERY

• Body mass index (BMI) must be greater than 30

INSURANCE

• Gastric bypass is covered if your policy includes bariatric surgery

 

RECOVERY AFTER GASTRIC BAND

• An Hospital Stay of 2 to 3 days
• Duration Off Work is 1 to 3 weeks
• Full Recovery time is between 4 to 6 weeks
• Pain: Manageable – same as any laparoscopic surgery
• Diet & Activity: Slow transition back to normal

 

DIET & LIFE AFTER

• Restricted diet with lifelong supplementation
• The patient feel full sooner while eating
• Steady exercise
• There may be changes in Personal relationship

 

SHORTCOMINGS

• Adequate risk of non-serious complications
• Digestion issues, dental problems, & sagging skin are some of the side effects of Bariatric surgery
• Possible weight gain

 

GASTRIC BYPASS VS. 6 OTHER WEIGHT LOSS PROCEDURES

• Gastric bypass is one of the best surgery for weight loss and health improvement
• Similar or greater risks as compared to other procedures which result in 50%+ excess weight loss
• GASTRIC BYPASS  is one of 3 non-reversible procedures

BEGINNING TO THE END

• It involves 7 steps to long-term weight loss

ADVANTAGES OF GASTRIC BYPASS

• Gastric bypass produces significant long-term weight loss (60-80% of excess weight loss)
• It limits the quantity of food that can be consumed
• It may lead to conditions that increase energy consumption
• Produces beneficial changes in intestinal hormones that reduce appetite and improve satiety
• Typical maintenance of >50% excess weight loss

 

GASTRIC SLEEVE SURGERY

Gastric sleeve surgery (vertical sleeve gastrectomy) is a weight loss surgery which removes about 80% of the stomach. As a result of this, patients:

• Are less hungry
• Feel satisfied soon after eating
• Close to 75% of their excess weight are loss
• There is an improvement or total cure of patients obesity-related health problems

 

HOW THE GASTRIC SLEEVE WORKS

• The procedure of Gastric Sleeve reduces the size of the stomach by 80%
• Because of smaller stomach, patient feels full sooner while eating
• The patient is less hungry because the smaller stomach secretes fewer hormones that cause hunger

WEIGHT LOSS DURING GASTRIC SLEEVE

• Nearly 70% of excess weight is loss within a year

Weight loss occurs quickly after stomach surgery:

• At the third Month, approximately 33% of excess weight has disappeared
• At the sixth Month: About half of the excess weight has disappeared
• At exactly twelfth Month, Up to 70% of excess weight disappeared

 

HEALTH BENEFITS OF GASTRIC SLEEVE

As a weight loss surgery, gastric sleeve provides its own health benefits which may include one or most of the following:

1. The left portion of stomach is where the hunger hormone “ghrelin” is produced. During gastric sleeve surgery, this part is almost completely removed which results to significant reduction in hunger, often even than in gastric bypass.
2. Patients that undergo gastric sleeve surgery lose weight at a slower rate. This may results to less saggy skin and lesser stretch marks.
3. Gastric sleeve surgery helps to cures or improves some health conditions such as diabetes, sleep apnea, and hypertension among others.
4.  Gastric sleeve leads to complete “resolution” (cure, as long as weight loss is maintained) of many health problems associated with obesity

HOW TO QUALIFY FOR GASTRIC SLEEVE

You may be a good candidate for gastric sleeve surgery if you meet up with the requirements listed below:

• If you have a body mass index (BMI) of 40 or more, OR
• If your BMI is between the range of 30 and 39.9 and you have a serious health problem related to obesity such health problems may include: High blood pressure, High cholesterol, Type 2 diabetes, and Sleep apnea among others

BMI alone seems not enough to qualify for the surgery. There are some other tests which your physician may likely to order in other to ensure that your body can handle the surgery and also to be sure that your weight isn’t related to a medical condition that can be treated without surgery. These other tests include:

• blood tests such as complete blood count (CBC), red blood cell (RBC) count, white blood cell (WBC) count, platelets, hemoglobin, and hematocrit
• fasting blood glucose
• lipid profile 
• serum chemistries such as tests for kidney and liver function
• thyroid test

 

INSURANCE

Your gastric sleeve is covered if your insurance policy includes bariatric surgery

• Completed a medically supervised diet program
• A body mass index (BMI) greater than 35 with health problems or more than 40 without health problems

 

PREPARING FOR GASTRIC SLEEVE SURGERY

Accurate preparation decreases your surgery risk, results to more weight loss, & saves you money.

Should you wish to compare costs of gastric sleeve in some countries, check the sleeve gastrectomy in Europe.

Your surgeon will work more closely with you during the weeks prior to surgery, including:

• Health assessment, which can be questions regarding your medical history, medications, and surgical history
• Order some tests such as an ECG, x-ray, and blood tests
• Establishment of pre-surgery diet regimen, including:

2 Weeks Before

• No sugar
• Lower carbohydrates
• Increased protein
• High Vegetables
• Lots of fluids

2 Days Before

• Clean fluids, broth, one protein shake per day only
• Discuss with your surgeon to find out if you should stop taking drugs.

 

12 Hours Before

• No to both food or drink and tobacco

On the day of the surgical procedure, you will perform a typical pre operation routine:

• Get rid of all clothing and jewelry
• Wear your hospital gown
• Get to know your nurse and anesthesiologist
• Begin your IV
• Take medication for relaxation and sleep

RECOVERY

Gastric sleeve surgery recovery includes:

• Timeline: 4 to 6 weeks for complete recovery
• Hospital Stay: 2 to 3 days
• Time Off Work: 1 to 3 weeks

DIET & LIFE AFTER GASTRIC SLEEVE SURGERY

• Restricted diet with supplementation
• Regular exercise
• Less hungry than before surgery
• Personal relationships can be changed

 

How to compare gastric sleeves with other weight loss procedures?

• Gastric sleeve surgery is one of the best surgical procedure for weight loss & health improvement
• Its 1 of 3 procedures which makes patient feel less hungry
• There is lower risk compared to other procedures which result in large amounts of weight loss
• It is 1 of 3 procedures that is non-reversible

COMPLICATIONS OF GASTRIC SLEEVE SUREGRY

The common serious gastric sleeve complications are listed below:

• Staple line leaks – 2.1% of patients on average (between 1.09% and 4.66%, depending on the study) experience staple line leaks
• Bleeding – 1.2% of patients
• Stenosis/Strictures – 0.6% of patients

SIDE EFFECTS & CHALLENGES OF GASTRIC SLEEVE SURGERY

The most common side effects and challenges of gastric sleeve may include the following:

• Digestive problems
• Sagging skin
• Weight recovery

ADVANTAGES OF GASTRIC SLEEVE SURGERY

• The small stomach is still working normally, so you can tolerate most foods, only in small quantities
• It can, if desired, be turned into a Roux-En-Y gastric bypass
• Removes the upper part of the stomach that produces hunger-stimulating hormones (ghrelin), so appetite is often reduced
• Less acid secretion, so less risk of ulcer
• Due to the fact that intestine remains intact, there is lower chance of intestinal obstruction (blockage), anemia, osteoporosis, and protein and vitamin deficiency
• There is no adjustments or foreign bodies (like with adjustable gastric bands) which may results to obstruction, slippage or erosion

 

 

GASTRIC BAND SURGERY

Gastric band surgery is a surgical procedure that wraps an adjustable band around the upper part of the stomach. This forms a small stomach pouch above the band that fills up quicker after eating.

As a result, successful Gastric band patients:

• Feel full sooner while eating
• Lose between 25% and 75% of their excess weight
• Improvement and curing of health problems that are associated with obesity

HOW THE GASTRIC BAND WORKS

• Adjustable band wrapped around the upper part of the stomach
• Smaller stomach ‘section’ above band fills up quicker after eating
• Patient feels full sooner while eating and consumes less as a result

Gastric band Insertion Techniques

There are two techniques your surgeon can use to insert the band which are:

• Perigastric Technique (PGT)
• Pars Flaccida Technique (PFT)

It was reported by three different studies that the pars flaccida technique (PFT) is safer and results in a lower rate of band slippage.

 

WEIGHT LOSS AFTER GASTRIC BAND SURGERY

After Gastric band surgery weight loss is rapid:

• 3 Month Average: About 20% of excess weight has disappeared
• 6 Month Average: About 30% of excess weight has disappeared
• 12 Month Average: About 40% of excess weight has disappeared
• 2 Year Average: More than half of excess weight has disappeared

 

BENEFITS OF GASTRIC BAND SURGERY

• long-term weight loss is possible in obese people
• rapid recovery
• lower risk of wound infections and hernias after surgery
• there is reduced risk of conditions related to excess weight such as diabetes, high blood pressure,  and urinary incontinence
• no loss of nutrient absorption
• improvement in the quality of life shortly after surgery in most cases

 

HOW TO QUALIFY FOR GASTRIC BAND SURGERY

Before you can qualify, the following are required:

• 30+ body mass index (BMI)
• If BMI is less than 40, there must be at least one obesity-related health problem

You can also be a good candidate for gastric band surgery if:

• You have a body mass index (BMI) of 40 or more, OR
• Your BMI is between 35 and 39.9 and you have a serious health problem related to obesity

Some serious health problems associated with obesity include:

• High blood pressure
• High cholesterol
• Type 2 diabetes
• Sleep apnea

INSURANCE

Gastric band surgery is covered if your policy includes bariatric surgery

In the United States, the Gastric band surgery System is covered under any insurance plan that includes weight loss surgery, as long as you have the following:

• Completed a medically supervised diet program
• A body mass index (BMI) greater than 35 with health problems or over 40 without health problems

PREPARING FOR GASTRIC BAND SURGERY

Adequate preparation reduces your surgery risk, leads to more weight loss, & saves you some money

Your surgeon will work close together with you amid the weeks leading up to your Gastric band surgery, most of which include the following:

• Encouragement on losing as much weight as possible
• Make a medical assessment, including questions about your medical history, medications, and surgical history
• Performing some tests like an ECG, x-ray, and blood tests
• Instituting a pre-surgery diet regimen, including:

2 Weeks Before

• No sugar
• Lower carbohydrates
• Increased protein
• Increased veggies
• Plenty of fluids

2 Days Before

• Clear liquids, broth, one protein shake per day only
• Discuss with your surgeon about whether you should put an end to taking any medications

12 Hours Before

• There is no food or drink, no tobacco

RECOVERY

Gastric band surgery patients usually:

• Hospital stay of up to one day
• Get back to work in a week or two

Full recovery happens within 6 weeks.

DIET & LIFE AFTER

• Restricted diet with supplementation
• Ongoing band adjustments
• Regular exercise
• Personal relationships may change

 

ADVANTAGES GASTRIC BAND SURGERY

1. Reduction in the quantity of food the stomach can hold
2. Gastric band surgery induces excess weight loss of approximately 40 – 50 percent
3. There is no cutting of the stomach or rerouting of the intestines
4. For gastric band surgery, hospital stay is short, usually less than 24 hours, with some clinics discharging their patient on the same day of the surgery
5. Gastric band surgery is reversible and adjustable
6. Gastric band surgery has the lowest rate of early postoperative complications and mortality among other approved bariatric procedures
7. There is low risk for vitamin/mineral deficiencies in gastric band surgery

How does gastric band surgery compare to Other Weight Loss Procedures?

• Gastric band surgery is one of the best surgical procedure for weight loss & health improvement
• Weight loss differs from patient to patient
• It is a reversible weight loss procedure
• It results in 50%+ average excess weight loss (EWL)
• Highest long-term ‘failure’ rate among 50%+ EWL procedures

 

Risks & complications that may occur

Potential complications include:

• Slippage - there is always the risk that as time goes by your stomach will change its position by moving up through the band and enlargement of the upper pouch occurs.
• Erosion - very slow, especially if the balloon is heavily inflated, the band can enter either through the stomach wall and stop being effective. In this case, the band will be removed and replaced if possible.
• Leakage - two of the band components can be separated because of the damage of the reservoir or tubing. This would require the replacement of the damaged part.
• Infection of the reservoir/port or tubing – you may need to replace your band if infection persists. With severe infections that are resistant to antibiotics, the band can be removed.
• You may have gastro-oesophageal reflux or GER when the stomach contents are raised into the esophagus

Updated 24 03 2023