Laparoscopic stomach bypass

This is 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.
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Laparoscopic Stomach Stapling

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).

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Lap. adjustable stomach banding

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.
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Laparoscopic Biliopancreatic Diversion

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.

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Mini incision obesity surgery

The main disadvantage of the laparoscopic approach is acheter viagra en ligne 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.

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Redo surgery for failures

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
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Total body lifting procedures

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.
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Laparoscopic Sleeve Gasterectomy

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 alone to achieve permanent weight loss.
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Surgery for Diabetes

Cure from diabetes is now possible: New era of diabetes treatment

A Breakthrough in the treatment of diabetes and Obesity

21st century diabetes treatment directions

Professor Dr Khaled Gawdat President of the Egyptian Society of bariatric surgery

Diabetes is a serious disease and the incidence is increasing worldwide very fast. The disease imposes a life of treatments, daily insulin injeffecting all body system. In that sense dictions, dietary restrictions and complications aabetes is a chronic incurable disease. This is buy cialis online about to change forever because science have discovered the most amazing discovery we can now cure diabetes.

Obesity surgery including the gastric bypass procedures have proven to the most effective weight loss remedy in medicine today and it is the only treatment that covers both phases weight loss and weight maintenance. These procedures started in 1980 and millions of such procedures were done worldwide. At the late 1990s all these procedures were done laparoscopically through very small incisions with very little pain and discomfort and 1 day hospital stay.

These procedures are effective in treating all diseases associating obesity with 80% cure from diabetes and 93% cure from hypertension and 100% cure from high blood cholesterol, breathing disorders, joint, back pains and female infertility. A surprising observation was that diabetes is cured before weight loss meaning that the intestinal rearrangement rather than weight loss alone cured the disease.

In 2007 an international consensus conference was held in Rome to launch the era of surgery for diabetes. These weight loss procedures can be used with some modifications to cure type 2 diabetes and improve type 1 diabetes in non obese patients. This break through treatment has been the subject of 4 sessions and 23 papers presented in the IFSO 2008 conference with a very high success rate in achieving a complete cure from diabetes.

A new era in treatment of diabetes has begun and it was found that the percentage of cure is higher with shorter duration of diabetes so if you have diabetes, consider having surgery early for better results.

Dr Gawdat’s pioneering work on treatment of type 2 diabetes using the laparoscpic gastric bypass proved to be a very effective tool even in normal weight people and preliminary results showed a 75% cure rate with patients completely off medications and the other 25% stopped insulin and take some oral tablets instead.

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