Obesity is a common problem that many people suffer from, and there are many people who suffer from the inability to tolerate diets and strenuous exercise, so they resort to surgeries to reach the required fitness and enjoy a harmonious body.
As the sleeve gastrectomy is an appropriate surgical solution to treat obesity problems, get rid of excess weight and reduce health problems that result from obesity, but sometimes there is a failure to achieve the goal of the first sleeve gastrectomy, and the person resorts to the process of re-sleeve gastrectomy again in the same place inside the abdomen. , Due to the failure of the first operation or other reasons, which we will mention in this article.
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What is the process of sleeve gastrectomy?
The gastric sleeve operation is a surgical procedure that depends on the removal of a longitudinal part of the stomach, to reduce its size and convert the stomach from the barrel shape to the tube shape, using the endoscope, where it loses approximately 75% of its size, as the barrel stomach needs a large amount of food to feel full, which exacerbates obesity And, the gastric sleeve operation eliminates a certain part of the stomach, which is the part that produces the hunger hormone.
Excessive obesity leads to many chronic diseases, such as diabetes, stress, rheumatism, and high cholesterol, and increases the possibility of heart attacks and shortness of breath, and it is not possible to return to before the operation because the part that was cut cannot return again.
When is the resort to sleeve gastrectomy?
- Being obese.
- Relieving and treating some chronic diseases that often accompany obesity, such as heart disease, diabetes and stress.
- When the stomach is infected with malignant or benign tumors.
- Stomach bleeding.
- Severe cases of stomach infections.
- Infection with a stomach ulcer.
- Lumps in the stomach.
Conditions for performing the sleeve gastrectomy
Knowing the body mass index and the rate of obesity, and the BMI is calculated by dividing the weight in kilograms by the square of the height in meters.
- If the result is between 18 and 24 the weight is considered ideal.
- If the result ranges between 24 and 30, there is an increase in weight over the ideal weight, but it is not considered obesity and does not need to undergo surgery, and it can be solved by exercising, and adhering to a diet under the supervision of a food specialist.
- When the body mass index exceeds 30, it is considered an indication that a person suffers from obesity, and needs surgical or medicinal interventions depending on the case and according to the doctor’s diagnosis, especially in cases that are accompanied by chronic diseases.
Reasons for re-sleeve gastrectomy
- The first operation did not achieve adequate weight loss, as it was found that despite the correct procedure, there is a rate of 5 to 7% that they were found to gain weight five years after the procedure.
- Some people who suffer from chronic diseases want to improve these diseases, which often accompany obesity such as diabetes, stress and heart.
- The first operation may result in complications, such as reflux in the esophagus, a chronic fistula, or a narrowing in the stomach, so the patient may resort to re-operation of the sleeve.
- Medical complications after surgery.
- The occurrence of an expansion of the stomach in the first sleeve.
Why do sleeve gastrectomy failures or complications occur?
There are several reasons that lead to the failure of the sleeve gastrectomy process and the need to repeat it again, either because of the incorrect choice of the surgery, its incompatibility with the patient’s condition, or because of medical skill errors by the doctor who performed the operation, and the reason could be technical, and in some Cases occur complications after the first operation and delays in their diagnosis and treatment, such as delay in using a gastroscope to treat cases of distress that occurs after the first sleeve gastrectomy.
Complications of re-sleeve gastrectomy
The complications that occur during the first re-operations are very important and can never be neglected, and the possibility of these complications four times more than the first time, but it is worth noting that the damages of the sleeve gastrectomy operation the first time is rare, as the probability reaches The emergence of the main symptoms of less than 1% in cases that undergo the operation, the most prominent of these complications:
- Injury and leakage of the small or large intestine.
- Exposure to bleeding during or after the re-sleeve surgery.
- General weakness of the body due to the loss of vitamins and minerals, as a result of a significant decrease in the amount of food that the body was accustomed to.
- Osteoporosis and hair loss, as a result of deficiency of some vitamins and minerals such as iron, zinc and folic acid.
- Feeling of nausea: Many people experience nausea after the re-sleeve gastrectomy, due to the change in the quantity and quality of food.
- Dehydration of the body due to a lack of fluid, so the patient must drink enough fluids during the period of weight loss.
- Feeling of hypothermia, especially in the early stages, due to a large loss of body fat.
- Increased risk of stroke during gastric sleeve re-procedure
The alternatives presented for obesity surgeries
1 – Use of a gastroscope
This is done by narrowing the link between the stomach and intestine using the endoscope, without the need to undergo surgery and enter the abdomen for the second time, and these alternatives are considered safer because they depend on dealing with the stomach from the inside, as there are no adhesions as a result of the previous operation.
2 – Pharmacotherapy
There are some internationally recognized medicines that help in losing weight and are considered in certain cases an effective treatment for surgeries, such as fructose, but this type of medicine must be taken under the supervision of a specialist doctor, and it should be noted that these types of medicines have become commercial. And it is not reliable, and it can cause severe complications, so it is necessary to ensure that it is internationally licensed and taken under medical supervision.
3- Surgical operations
Surgical alternatives depend primarily on the type of operation that was performed previously, and the patient’s symptoms, for example:
After failure in the first sleeve gastrectomy, there are several solutions that can be made according to the situation the patient needs, either by surgical sutures to fold the stomach, or the regular or miniature path by connecting the intestine directly to the duodenum, and it may also require re-cutting the stomach for a second time ( Re-sleeve gastrectomy).
Long-term damages of re-sleeve gastrectomy
The damages of the re-quantification process are relatively relative to a large extent, so it is not necessary for all cases to suffer from them, but in general there are damages that result from the re-quantification process in the long term, we will mention the most important and most common:
- Indigestion after performing the operation repeatedly.
- Gastroesophageal reflux disease, which causes heartburn, a feeling of bloating, nausea and a full stomach.
- A blockage in the stomach due to its narrowing after the operation, which makes digesting food more difficult.
- Low blood sugar.
- Malnutrition and anemia.
- Gastroesophageal reflux.
Information about re-operation of the sleeve gastrectomy
Carry all foods: The benefits of gastric bypass surgery are that you can eat most types of food,
As most obesity surgeries require abstaining from many types of foods, but this does not mean that it is not necessary to follow a proper diet after the re-sleeve surgery.
Stretching of the sleeves: After the operation in a few days, the stomach bags are very small, but with the passage of time the stomach bag becomes stretched and becomes more able to absorb a larger amount of food, but not adhering to the appropriate quantities and establishing a healthy diet can lead to a cessation of weight loss and in some Cases lead to weight gain again.
Tips before performing the sleeve gastrectomy
- Conducting comprehensive medical examinations.
- Confirming the patient’s psychological condition.
- Trying to lose weight by other methods, such as exercise or diet.
- Avoid taking some types of medications under the supervision of a doctor, such as blood thinners, anti-inflammatory drugs, and aspirin.
- Knowing the doctor who will perform the operation with all the medicines, vitamins and nutritional supplements that the patient takes.