Resection of the stomach for weight loss. The price, as is the procedure, types of obesity, diet after reviews

Excess body weight is associated with infertility, diabetes, hypertension and other common diseases. Opportunity to give a slimming diet and exercise, drug therapy.

Surgical treatment (including gastric resection) is the most effective way to combat obesity, but associated with a high risk of severe complications, and the price is not always available.

What is gastric resection, operations are

Gastrectomy - surgery to partial or complete (gastrectomy) removing stomach body. Depending on the disease there are different types of gastroplasty. Slimming is a longitudinal gastrectomy (PHM). It provides for the removal of 60-80% of the volume of the stomach followed by reduction of the continuity of the gastrointestinal tract.

As a result, the stomach takes the form of a narrow sleeve, so the procedure had the alternative name "sleeve gastrectomy". Surgical intervention is aimed at limiting the admission of dietary energy by reducing the amount of a single food intake.

benefits of the procedure

The main positive aspect of the method - efficiency. During the first 2 years after surgery the patient's body weight, the excess is reduced by 60-65%.

Additional advantages include:

• Possibility of resection laparoscopically (sleeve-operation) avoids lane operation.
• Prolonged effect of the procedure. Weight does not rise for several years.
• Gastrectomy does not affect the intestines. This reduces the likelihood of complications, and maintains patency of the intestine's ability to absorb nutrients from food.
• The possibility in the future if necessary, to supplement resection bypass.
• Decreased appetite.
• No prerequisites are required food discipline.

Sleeve gastrectomy is characterized by low-traumatic, so patients recovering from it in the short term.

disadvantages

Resection of the stomach for weight loss, the price of which - disability healthy body is a non-physiological method that can cause difficulty in eating. For sleeve gastrectomy is characterized by the risks and inconveniences that accompany any surgical intervention: the likelihood of bleeding, inflammation or joint discrepancies.

A particular danger is the long vertical seam leakage at the stomach. Although the effect of the procedure lasts long enough, it will not last forever. Over time, the stomach stretches again and requires re-suturing.

Recently, it has the ability to capture the shape and volume of the stomach by placing it on top of the implant is made of neutral material - permakola. This hinders the expansion of the volume of the stomach, but the method has drawbacks: the presence of a foreign body in the body, the high cost of the material.

Comparison of methods with other methods of reducing the stomach

Resection - is not the only method to reduce stomach volume.

The following operations are used for this purpose, and to reduce suction surface of the gastrointestinal tract:

• ballonirovanie;
• Laparoscopic adjustable banding (constriction) of the stomach;
• gastroptyxis;
• gastric bypass (gastroshuntirovanie).

Procedures characterized by different degrees of interference in the body, each has advantages and disadvantages.

Sleeve gastrectomy - one of the most complicated types of surgery that involves serious irreversible consequences for the organism. Superior to its complexity and the degree of infestation only gastric bypass. The easiest method not involving surgery - ballonirovanie.

Ballonirovanie

Ballonirovanie - introduction into the stomach of the silicone bladder with saline followed by filling it. The balloon creates a sense of fullness in the stomach, thereby reducing appetite.

Comparative characteristics ballonirovaniya and resection:

Criterion	Ballonirovanie	sleeve gastrectomy
The need to stay in hospital	No	3 days.
Efficiency	Loss of 40% of excess weight	Loss of 60-65% of excess weight
The complexity of the method	Simple manipulation, which does not require surgery	Complicated surgery
probable complications	Possible nausea and vomiting in the first balloon wearing days, the cylinder gap	Bleeding, inflammation of joints discrepancy
The duration of effect	After 6 months. the balloon is removed. If the body is not accustomed to the new diet, the weight will return.	The effect lasts for several years and then may re-suturing.

banding

Gastric banding - compression of the upper part of the silicone ring. The stomach is divided into two sections: an upper (small) and lower (main volume of the stomach). Upper division due to small sizes quickly filled with food, so that the feeling of fullness comes with a small amount eaten.

Comparative characteristics of the banding and resection:

Criterion	banding	sleeve gastrectomy
The need to stay in hospital	1 day	3 days
Efficiency	Loss of 40-50% of excess weight	Loss of 60-65% of excess weight
The complexity of the method	It can be conducted minimally invasive technique	Complicated surgery
complications	The presence of a foreign object (shroud) in the body	Bleeding, inflammation of joints discrepancy

Resection of the stomach for weight loss, the price of which is comparable with the cost of banding - a quick way to reduce body weight. Weight loss in the fitted bandage is slower than after sleeve gastrectomy. It creates additional inconvenience silicone ring, which must be periodically fill fluid.

gastroptyxis

When gastroptyxis stomach is folded by the large curvature and sewn on a particular technique, so that it takes the form of a tube.

Comparative characteristics of the plication and gastric resection:

Criterion	gastroptyxis	sleeve gastrectomy
The need to stay in hospital	2 days	3 days
Efficiency	30-55% loss of excess weight	Loss of 60-65% of excess weight
The complexity of the method	Laparoscopic surgery without incisions internal organs	Complicated surgery
probable complications	Problems with eating	Bleeding, inflammation of joints discrepancy
The duration of effect	The procedure is new, so the results of the data in the long term otsutsvuyut	The effect lasts for several years and then may re-suturing.

bypass

Gastroshuntirovanie - separation of a small part of the stomach and its connection with the small intestine to bypass gastric intestinal tract. The method helps to reduce the absorption and assimilation of nutrients.

Comparative characteristics of the bypass and resection:

Criterion	Gastroshuntirovanie	sleeve gastrectomy
The need to stay in hospital	3-4 days	3 days
Efficiency	Loss of 70-80% of excess weight	Loss of 60-65% of excess weight
The complexity of the method	A more complex operation than resection	Complicated surgery
probable complications	Insufficient absorption of vitamins and minerals, nausea, vomiting	Bleeding, inflammation of joints discrepancy
The duration of effect	Body weight decreased 1-2 years, and then stabilizes at a proper way of life does not increase	The effect lasts for several years and then may re-suturing.
The reversibility of the effects of (the possibility of a recovery in the anatomy)	there is	No

Indications for resection

The indication for surgery is severe obesity (body mass index greater than 40) in combination with comorbidities in the absence of patient discipline for performing therapeutic procedures correction of body weight.

Sleeve gastrectomy is assigned to the patient if it is accompanied by obesity complicate pathologies:

• diabetes;
• infertility;
• hypertension;
• phlebeurysm;
• diseases of the joints;
• cardiac or pulmonary insufficiency;
• apnea (a brief cessation of breathing during sleep);
• metabolic syndrome.

Gastrectomy is applicable in cases where the target weight loss is not more than 50 kg, and the price is available for the patient.

Contraindications to gastric resection

PHM has the following contraindications:

• ascites;
• diseases of the gastrointestinal tract (esophagitis, esophageal varices, liver cirrhosis, gastric ulcer and duodenal ulcer, pancreatitis);
• disturbances in the psyche;
• kidney disease;
• alcohol addiction;
• age under 18 years;
• receiving steroid hormonal drugs on a continuous basis;
• autoimmune connective tissue disease.

Gastrectomy is performed using general anesthesia, so it is subject to contraindications surgical procedures under general anesthesia: diseases of the cardiovascular system, lungs, disturbances in the system hemostasis. Timing conditions which cause failure of the operations - pregnancy, and infectious processes occurring in the body.

How to prepare for operations

Following the appointment of the date of the procedure should be:

1. Quit smoking for 6 weeks prior to surgery.
2. Preoperative diet by eating 2-6 weeks prior to surgery: consume more protein and less water and carbohydrates. The result is reduced during surgery risk of bleeding and facilitates the recovery process, the liver size is reduced, which facilitates the surgeon's work.
3. Increase motor activity.

Patient operate on an empty stomach. On the evening before the operation should be easy to have dinner and put a cleansing enema, take a bath. The reason for the transfer operation may serve as menses, slight cold. Before the surgery, the patient is fed on a special diet, which prevents contamination of the slag body.

Before the operation, you must:

• remove cosmetics, including nail polish;
• remove dentures;
• empty the bladder.

As is the operation

There are two variants of sleeve gastrectomy: open and laparoscopic. Both methods provide for general anesthesia. A laparoscopic method is more preferable because it has a less traumatic. The tube with the video camera on the end is introduced into the peritoneal cavity. The resulting image can be seen on the screen.

Focusing on the video shooting, the surgeon removes the stomach portion of special manipulators and connects the edge of the remainder of the body brackets. The seam is tested for tightness: stomach filled with a colored liquid, an additional flow space are fastened.

Laparoscopy is not applicable, if the abdomen were adhesions after previous surgery.

In such a case, the strip operation. The algorithm is similar to the action of the procedures for the laparoscopic method, with the difference that the incision in the patient's abdomen and the doctor works through it. At the end of manipulation of the abdominal cavity set drainage tube to drain fluid. It was withdrawn a few days later.

rehabilitation period

After the procedure the patient is placed on his back, head turned to the side, the pillow is missing. With this ensured a stable posture cerebral blood flow, eliminates the possibility of contact with mucus and vomit airways.

FIELD suture package cover sand or ice to prevent bruising. Operated under continuous monitoring to complete a discharge from the anesthesia. On the first day after the operation the patient is administered analgesic subcutaneously every 4-5 hours.

To avoid the formation of clots in blood vessels, measures have been taken:

• sufficient fluid intake;
• motor activity of the patient in the bed, including post-operative exercises;
• lifting the patient out of bed as soon as possible.

Prolonged fasting may cause a violation of saliva, which in turn provokes inflammation of the parotid gland. To avoid this, it is recommended to chew without swallowing, crackers or slices of citrus. Postoperative mode is determined for each patient separately based on the characteristics of the organism.

Possible early complications

Immediately after resection of the following complications may develop:

• Bleeding into the gastric lumen. Its symptom - intense vomiting blood. To overcome complications first conducted conservative treatment - cold applied on the stomach, blood transfusions, medications administered (menadione, calcium chloride). If the measures have had no effect, require repeated surgical intervention.
• Bleeding into the abdominal cavity determined by the following symptoms: rapid health deterioration, dizziness, tachycardia, decreased blood pressure, fainting. All these symptoms are caused by developing acute circulatory failure. emergency operation is performed to stop abdominal haemorrhage.
• The failure of the long longitudinal seam is fraught with the development of inflammatory processes in the peritoneum, which is a symptom of abdominal pain.
• Bleeding from the spleen., The spleen is removed to stop it.

Early complications seen in 4-6% of operated patients.

late complications

Approximately 6% of the patients showed the emergence or worsening heartburn. This is associated with damage to the valve during the procedure, which prevents Scored stomach contents into the esophagus. After sleeve gastrectomy operated on prescribers, reducing the acidity of the stomach.

6% of patients had discomfort in the abdomen in the stomach area. This is due to difficulties during the passage of food through the narrow sleeve. This complication does not require treatment and passes spontaneously within a few months after surgery. Very rarely observed such long-term effects of gastric resection as gallstones, constipation, diarrhea.

Power postoperatively

In the first 2 days after resection of the stomach can not eat and drink. Necessary substances are administered intravenously through a dropper. On the third day the patient begins to drink water in small sips rare. The amount of water is less than 2 cups per day.

Gradually, the first products are introduced:

• eggs in raw form;
• oil;
• vegetable broth;
• kefir;
• jelly.

Salt intake is limited. On the 6th or 7th day the patient eats, adhering a low-calorie diet of liquid and semi-liquid foods with a small amount of carbohydrates.

Gradually caloric intake can be increased to normal. Liquid food is replaced by pureed, cooking method which - boiling or steaming. Normalized ratio of proteins, fats and carbohydrates.

In the postoperative do not eat, causing increased production of gastric juice:

• nourishing fish and meat broths;
• mushrooms;
• fried, fatty foods;
• beverages containing caffeine;
• acute products;
• black bread;
• vegetable fibers;
• Alcoholic beverages;
• raw vegetables.

Recommended increased intake of vitamins B and C.

Turning to the normal diet, should adhere to certain rules:

1. eat small meals 5 times a day;
2. chew food;
3. not to drink during meals;
4. not take after a meal supine position;
5. do not drink high-calorie drinks.

Without complying with nutritional advice, weight loss will not be stable.

Price gastrectomy in clinics of Moscow, St. Petersburg, regions

Cost sleeve gastrectomy clinics may be indicated in 2 ways:

• costs only for the operation;
• costs of services.

If the clinic indicates the price only for resection of the stomach, it should be clarified include whether it on the fastener material costs. They occupy a significant share of the cost of sleeve gastrectomy - about 50%.

To find out how much it will cost the whole operation should be clarified prices of all the necessary procedures and instruments:

1. surgeon's advice.
2. Preoperative evaluation includes the required minimum laboratory tests: complete blood count and urinalysis, coagulation, blood chemistry and its research on HIV and hepatitis. Tests can be taken free of charge by contacting the clinic in the community. May be required and other tests, depending on diagnosis and related diseases.
3. Anesthesia.
4. The price of the operation.
5. Resuscitation.
6. Staying in the room, and postoperative management of the patient.

Resection of the stomach for weight loss, the price of which the complex is formed, comprising:

• anesthesia;
• surgery;
• stay in the room for 5 days;
• post-operative tests and examinations.

complex cost is:

• Moscow - 220-270 thousand. rub.;
• St. Petersburg - 200-220 thousand. rub.;
• in other regions - 170-200 thousand. rub.

Surgical consultation, preliminary tests and examinations, the intensive care unit would have to pay extra.

Comparison with other resection procedures reduce stomach

Resection of the stomach for weight loss, the price of which is second only to the cost of bypass surgery is one of the most expensive operations, bariatric surgery.

Prices for surgical methods to combat obesity vary a lot depending on the complexity and the cost of materials:

1. gastroshuntirovanie - 250-300 thousand. rub.;
2. gastroptyxis - 170-180 thousand. rub.;
3. banding based on the price band - 100-150 thousand. rub.;
4. ballonirovanie - about 65 thousand. rub. (Balloon removal - still 40-45 thousand. rub.).

Sleeve gastrectomy - one of the most expensive ways of correction of weight. Price due to the complexity of procedures and the high results in reducing weight patients. On the effectiveness of gastric resection is second only to bypass.

Useful video of gastric resection for weight loss, the advantages and disadvantages of this operation

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