Obesity Egypt !!! Dr. Khaled Gawdat

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Laparoscopic stomach bypass

admin — Fri, 10 Jun 2011 16:37:18 +0000

This is viagra most frequently performed obesity operation in the world today. With 140,000 morbid obesity operations performed in the US last year (most of them were stomach bypass cases). It is currently the gold standard obesity operation and when ever a new procedure arises, its success should be compared to the stomach bypass results were it gives very good short and long term results for weight control together with a very good life style and a comfortable eating habits. The operation is also accompanied with less hunger sensation than other operation is. It is very effective whether the patient likes sweets or regular food. Performing the operation laparoscopically since 1993 helped to tremendously boast the popularity of the operation were the approach added ease and comfort and early recovery to the already present advantages of the gold standard operation. The operation requires vitamin supplementation to avoid anemia. But with its great life style, great weight loss it is very unusual to have it reversed.

Frequently Asked Questions

Is diarrhea common after stomach bypass? Do we use the food that we consume after such surgery? Is anemia a problem after stomach bypass? Is the stomach bypass reversible? Is diabetes curable by these operations?

Is diarrhea common after stomach bypass? No it is unusual to have diarrhea after these operations.

Do we use the food that we consume after such surgery? Yes absorption is normal for all food elements except Iron, Ca and some vitamins and that is why we need the vitamin supplements after surgery.

Is anemia a problem after stomach bypass? It is unusual if the patient is compliant with vitamin intake

Is the stomach bypass reversible? Yes it is fully reversible but it should not be reversed because the patient will gain all the weight back.

Is diabetes curable by these operations? Yes diabetes is cured in 80 % of the patients after stomach bypass and treatment becomes much easier in the remaining 20%. Also hypertension is cured in more than 90 % of cases, High blood cholesterol is corrected in 100 % of cases.

Radiofrequency Non Surgical lifting proc

admin — Tue, 10 May 2011 17:50:34 +0000

Technological innovations in medicine in the last few years are impressive. A Japanese company in 2007 invented a radiofrequency machine with skin tucking capabilities. It is believed that this technology could change plastic surgery forever. Impressive skin tightening is achieved in the head neck breasts and arms. The technique is non invasive and leads to tightening of the collagen layer under the skin and makes the body form new collagen giving permanent results. Our patients are very pleased to have non surgical outpatient treatment for their redundancies.

Frequently Asked Questions

Does treatment sessions leave marks, discolorations on the area treated? Are these treatments painful? Other than after weight loss what other indications What is the difference between the radiofrequency for the face and neck and the surgical face lifting procedures ?

Does treatment sessions leave marks, discolorations on the area treated? Not at all and we have actresses go immediately to film and tv shooting sessions immediately after sessions

Are these treatments painful? Very slight discomfort during the sessions and we use local anesthesia creams to make it very comfortable

Other than after weight loss what other indications Old age effect on the face and neck, breast laxity after pregnancy and lactation, combined with plastic surgical procedures to help reduce the size of scars. On the face and neck it is called facial rejuvenation.

What can I eat after stomach stapling? Radiofrequency makes you look younger and healthier as opposed to surgery that will make your skin tight but you will look like a different person plus you get scars.

Laparoscopic Stomach Stapling

admin — Tue, 10 May 2011 17:44:27 +0000

More than 400,000 cases where performed to date. The key for success is to perform the procedure with the same exact measurements that Ed Mason described. The operation gives satiety after consuming a very small amount of food. Extra food will cause nausea and vomiting. The week point of this procedure is that it does not limit fluid intake so that if the patients takes high calorie fluids excessively (namely sweets and sugars) the operation will fail. The operation is done laparoscopically (4 small incisions, 1 day in hospital).

Frequently Asked Questions

What is the effect of stomach stapling on pregnancy and child bearing? Is Stomach stapling reversible? What are the side-effects and complications of stomach stapling? What can I eat after stomach stapling? Does stomach open after some time and I can eat more and gain weight again? Does stapling affect the stomach in any adverse way or cause tumors?

What is the effect of stomach stapling on pregnancy and child bearing? The operation increases tremendously the chances for conception and pregnancy. In our group of patients we have seen 40 full term pregnancies with normal weight babies and weight gain during pregnancy was 8-12 kilograms (normal weight gain). We usually advise birth control in the first 6 months after surgery except for cases with infertility, where we do not use any birth control.

Is Stomach stapling reversible? It is completely reversible (even laparoscopically) but of course reversal will be followed by weight gain.

What are the side-effects and complications of stomach stapling? Vomiting with over eating and weight gain with sweet consumption are the main side effects.

What can I eat after stomach stapling? You can eat any type of food in small quantities. No sugar during weight loss and mild sugar intake after weight loss. Protein (fish, chicken, meat) and salad are encouraged. Vomiting is uncommon.

Does stomach open after some time and I can eat more and gain weight again? The only way you will gain weight is if you increase high calorie liquid or semisolid food intake (Deserts, chocolate, ice-creamm frapes, etc). The stomach dilates in a calculated fashion to make you able to eat enough food to maintain and stabilize your weight.

Does stapling affect the stomach in any adverse way or cause tumors? 400,000 cases were done since 1980 and no effect on the stomach was seen.

Lap. adjustable stomach banding

admin — Tue, 10 May 2011 16:39:40 +0000

This operation started in the mid-nineties with the appearance of two types of bands in the market: The American (Lap-band) and the Swedish (SAGB). More than 90,000 cases were done so far. Most surgeons performing the procedure are new to morbid obesity surgery. The procedure is very attractive to surgeons because it is very easy to perform. The principle of the operation is through placing a band around the upper stomach, that band is lined with an inflatable balloon that is connected with a tube to a metallic reservoir that is placed under the skin. Later on the skin is pierced with a long needle to access the metal reservoir and inflate the balloon and thus control the diameter of the band. The operation is done laparoscopically using 4-5 small incisions and with a one day hospital stay. The operation has the same principle as stomach stapling giving satiety after eating a small amount of food and it also has the same week point of inability to control sweet or high calorie fluid intake so that a sweet consuming individual can fail the operation and gain weight despite having the band in place. Results of the band are very controversial were there are many reports of good results (these usually are reported by band only surgeons) and also there are many bad results for the band (these are usually reported by surgeons who perform other forms of obesity surgery). The United States experience with the band reported poor weight loss as compared to the stomach bypass procedure and also reported an unacceptably high rate of complications and band removal. In our experience in Egypt we compared the 4 types of obesity operations and we were surprised to see very slow and poor weight loss with the adjustable band as compared to the stomach stapling, bypass or BPD operations. Also the incidence of complications with banding tends to increase with time.

Frequently Asked Questions

Is it true that banding is the easiest operation to undo or cancel? The metal part that is placed under the skin: is it visible and how do we deal with it? Is there an estimated life span for the balloon lining the band? What are the chances for weight regain?

Is it true that banding is the easiest operation to undo or cancel? Banding is easy to undo if the patient has no side effects or complications. But in the presence of complications (as when the band penetrates into the inside of the stomach) undoing is then very difficult.

The metal part that is placed under the skin: is it visible and how do we deal with it? Yes, you can feel it as a hard lump under the skin. It becomes more visible as you lose weight and that is sometimes annoying especially for girls.

Is there an estimated life span for the balloon lining the band? The band has been in the market for only 7 years. No body knows how long will it function but it will definitely not function for ever. If the balloon stops functioning the patient will then rapidly gain the lost weight back. Then he will need a second surgery either to place another band or to have a more effective obesity operation as the stomach bypass.

What are the chances for weight regain? As mentioned before if the patient takes sweets excessively he will gain the lost weight back. Studies have shown high incidence of weight regain with banding after 5 years.

Laparoscopic Biliopancreatic Diversion

admin — Tue, 10 May 2011 14:12:23 +0000

This was invented in 1980 by Nicola Scopinaro from Italy and it is popular in Italy, Belgium and Canada. The operation affects absorption of certain food types so that the patient will eat normal food quantities but will absorb only proteins and some sugars. So the patient will have diarrhea when he eats fats and carbohydrates. The patient will need calcium and vitamin supplements after surgery for life. The operation was done laparoscopically since 2001 and this helped to boast the popularity of such operation. We see the operation useful with patients who refuse to cooperate after surgery and in patients with psychological disturbances.

Mini incision obesity surgery

admin — Tue, 10 May 2011 14:10:01 +0000

The main disadvantage of the laparoscopic approach is the high cost of the laparoscopic equipment. To lower the cost we have a technique for performing stomach obesity surgery through a very small (5 cm incision) that is very comfortable to the patients and gives short hospital stay.

Redo surgery for failures

admin — Tue, 10 May 2011 14:08:35 +0000

All obesity procedures have failure rates or weight regain rates. These failure rates vary between low incidence with stomach bypass or BPD procedures to very high failure rates with stomach banding or stapling (VBG) especially long term and is usually because of excessive sweet consumption. It is technically challenging to perform another obesity operation on these patients to achieve the desired weight loss success. We have developed a large experience with failed gastric banding or gastric stapling procedure. We now perform most of these reoperations laparoscopically even if the surgery was performed through open surgery. If we need to perform the procedures through open incisions this is done through a mini incision (5-6 cm incision) Our usual technique to deal with failed or complicated gastric bands or failed gastric stapling is to convert the previous surgery into laparoscopic gastric bypass surgery . To deal with a failed gastric bypass procedure we convert them to our laparoscopic banded micropouch procedure. Reoperations-although having higher early complications rates- have excellent weight loss results postoperatively. Normally a laparoscopic reoperation can be performed with a 1-2 day hospital stay

Total body lifting procedures

admin — Tue, 10 May 2011 14:07:17 +0000

Plastic surgery and total body lifting procedures
About one third of the morbidly obese patients will need plastic surgery to remove excessive or redundant skin after weight loss. Some patients need only one operation as a tummy tuck or breast suspension or thigh reduction or arm reduction. Some patients-specially after massive weight loss- will need all three. Years ago we used to perform one procedure and the patient will recover and few months later he would return for another procedure and so on. This was both expensive and time consuming for these patients who need more than one procedure. for those patients who needed we developed what we call a total body lifting procedure whereby 3 teams of plastic surgeons work simultaneously to perform plastic surgery for the whole body including abdomen, thighs, arms, and breast lifting with or without a breast implant. the procedure takes 2-3 hours and is very well tolerated by our patients who are now very happy achieving a total body correction in one step. The patient usually stays in hospital for 2 days only.

Laparoscopic Sleeve Gasterectomy

admin — Tue, 10 May 2011 14:02:24 +0000

Laparoscopic sleeve gasterectomy is a surgical modality that is being used frequently in the past few years to treat morbid obesity. The operation is the first half of the duodenal switch operation. The duodenal switch is an operation that temporarily restrict the stomach capacity to give initial weight loss and by the time the stomach dilates and patients eat more the second part of the operation which is malabsorption helps the patient to maintain the lost weight. The principle of using sleeve gastrectomy alone was postulated in extremely obese patients to make the first operation easy and complete the second part of the operation after achieving some weight loss. Unfortunately patients are being told that it could viagra alone to achieve permanent weight loss.

Frequently Asked Questions

What are the long term results of sleeve gasterectomy as a definitive procedure to control morbid obesity? How many patients come back to complete the surgery to a duodenal switch? IS Sleeve gasterectomy reversible? Esophageal reflux is it a problem after sleeve gasterectomy? A failed sleeve gasterectomy can be fixed?

What are the long term results of sleeve gasterectomy as a definitive procedure to control morbid obesity? There are no long term results of such procedure but obesity surgery past experience with similar procedures (simple restriction LapBands, VBG) show that ultimately almost all patients gain the weight again. So few more years will show a lot of failed procedures.

How many patients come back to complete the surgery to a duodenal switch? Most of the patients did not come back to complete the operation and failed to lose enough weight.

IS Sleeve gasterectomy reversible? Theoretically sleeve gasterectomy is the only irreversible operation in obesity surgery( banding, stapling, bypass are all reversible) since most of the stomach is removed but in reality it is a self reversing operation and if you give it enough time it will dilated and then weight regain will happen.

Esophageal reflux is it a problem after sleeve gasterectomy? It is one of the major issues with the sleeve that can lead to severe heart burn.

A failed sleeve gasterectomy can be fixed? Yes a gastric bypass or a completion to duodenal switch laparoscopically is the treatment.