1. Gastric Tube via laparoscopy: A new obesity treatment procedure.

• In Spain, we pioneered the Sleeve Gastrectomy technique. We are experts in the ”Gastroplasty” procedure or “Sleeve Gastrectomy”.
  
  
• Since the first procedure in February of 2007, we have performed this surgery on more than 120 patients.
  
  
• Average hospitalization time is 3 days. Mortality rate 0%, Morbidity rate 2%.
  
  
• We have similar results to the Bypass surgery in 18 months:
  
  
  • Average weight loss = 47 Kg,
  • % excess weight loss = 71%

2. Advantages of the Gastric Tube:

• Stomach is functionally smaller but keeps its natural anatomy and functioning, normally digesting all types of food.
  
  
• Excellent hunger control due to the reduction of the Ghrelin hormone. Patients do not feel extreme hunger or food anxiety.
  
  
• Best quality of life since patients can eat everything.
  
  
• It eliminates the risk of having a foreign body that needs filling for life
  
  
• Patients do not suffer from Dumping, diarrhea or vitamin loss like with the Bypass surgery.
  
  
• Less surgical risk (no artificial unions between intestines).
  
  
• Less medical dependency.
  
  
• Attractive option for patients with anemia, Crohn’s disease or any other situation that discourages a higher risk surgery such as the Bypass (EXTREME OBESITY).
  

3. How is the “Gastric Tube” surgery or "Sleeve Gastrectomy" performed?

• The Sleeve Gastrectomy procedure is performed via laparoscopy, significantly reducing the conventional surgery’s complications:
  
  
• Less breathing, digestive, hernia and thrombosis problems.
• Faster recovery time and better cosmetic results: only 5 small incisions, without any suture that require removal.
• About 2 to 3 days of hospitalization.
• 5 small incisions; no stitching left.
• Hardly any pain and fast recovery time.
  
  
• We use surgical staplers with 3 rows of staples on each side which increase safety and avoid leakage.
  
  
• Moreover, there is a fourth line closing with a manual suture. We perform a leakage test with methylene blue.
  
  
• We make a small stomach of 80-120cc (regular stomach > 1.000cc), that includes all main parts.
  
  
• The stomach keeps its digestive function and its natural filling and emptying process.
  
  
• There is no crossing or bypass between intestines, reducing the risk of leakage and simplifying options to repair leakages if any occur.
  
  
• The procedure lasts about 100 - 120 minutes or occasionally longer. It is done via laparoscopy and using air.

4. Will I be in pain after the surgery?

The patient will:

• Stand and take short walks around the room 2-3 hours after surgery.
  
  
• Intake liquids 24 hours after the surgery, after taking a leakage test.
  
  
• The patient is released from the hospital 2-3 days after surgery.
  
  
• Goes back to work/active life 7 days after surgery (except for intense physical exercise that needs to wait for 4-6 weeks).

5. How does the Gastric Tube work?

• The patient has a much smaller stomach (approximately 80-100cc), and feels full after small quantities of food.
  
  
• The patient can eat everything because his/her stomach functions normally: sphincter entering food, digestive function, sphincter exiting digested food.
  
  
• Patients do not suffer from vitamin loss, dumping or diarrhea.
  
  
• Nothing gets “stuck” and the patient easily regulates the quantity of food to intake.
  
  
• All food gets absorbed.

6. How much weight will I lose after the Gastric Tube surgery?:

• Most of the weight loss happens over the first 6-10 months.

7. Is the weight loss permanent?

• This procedure has been performed over the last 5 years.
  
  
• Patients have been maintaining their weight loss over this timeframe. With this timeframe it is considered as a permanent weight loss.
  
  
• In cases where the patient’s diet is repeatedly excessive, part of the weight might be regained over the years.
  
  
• In the few cases of regaining weight, the patient can:
  
  
  • Switch to a Gastric Bypass surgery

     

8. What is the patient profile for this type of surgery?

1. Patients with BMI 35-45:
   
   Recent studies have shown that this procedure is a good option for this type of patient.
   
   This procedure is mostly appropriate for patients who:
   
   - Want to avoid the side effects from Gastric Bypass (intestinal obstruction, ulcers, anemia, lack of Ca++, proteins, vitamins…)
   
   - Patients who consider the adjustable gastric band but do not like the idea of having a foreign object introduced for life.
   
   - Patients who do not snack or eat sweets often.
   
   - Patients with a condition that prevents them from undergoing a Gastric Bypass surgery: chronic anemia, Crohn’s disease, previous abdominal surgery and other complex medical conditions.
   
   
   
2. Patients with EXTREME OBESITY (BMI > 55):
   
   - These are patients with a higher risk obesity type.
   
   - Gastric Tube is a more appropriate and safe procedure for these  patients because the probability of associated complications is much lower than the Bypass.
   
   
   
3. Patients who need to take anti-inflammatory drugs frequently.

9. Gastric Tube disadvantages:

• Hypocaloric foods and easy to digest foods like ice-cream, sweets etc…might mitigate the efficiency of the procedure. The small stomach does not prevent its ingestion and absorption.
  
  
• Patients with very high BMI (BMI>55), might need a second surgery with malapsorbtion (like Gastric Bypass), that helps with the excess weight loss.

10. Risks and complications of the Gastric Tube:

In the immediate post-operation:

• Deep vein thromboses: 0.5%.
• Pulmonary thrombo-embolism, not deadly: 0.5%
• Anastomotic leakage: <1%
• Hemorrhage <1%
• Mortality rate: 0,25% (Gastric Band : 0,10%, Gastric Bypass: 1%)

In the mid to long term post-operation:

• Gastric dysfunction.
• Gastroesophageal Reflux
• Gastric Stenosis.

11. Is the Gastric Tube an appropriate surgery for me?

• Please check our section “What treatment do I need?”.
  
  
• Read the advantages and disadvantages of each surgical technique and typical patient profile for each type (see comparative table)

12. What support does Clínica Obesitas provide to Gastric Tube patients?

• Follow up with the surgical team.
• Dietetic education given by the nutritionist.
• Lifestyle changes –physical exercise according to each patient’s limitations and needs-.
• Support from the psychologist –cognitive behavioral therapy.

Clínica Obesitas offers a set of consultations and follow-up visits over a 24 month period that the patient can take advantage of.