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Obesity
Surgical
Options Tube
Gastrectomy
Obesity- Surgical options
:: Laparoscopic
Adjustable Gastric Banding :: Bilio
Pancreatic Diversion BPD
:: Tube
Gastrectomy :: Gastric
Bypass
Tube Gastrectomy or Gastroplasty
This is a relatively new approach. It is the first component
of the duodenal switch operation and
involves removing the lateral 2/3rds of the stomach with a stapling
device. It can be done
laparoscopically ( keyhole surgery) but is not reversible. It
basically leaves a stomach tube
instead of a stomach sack. 
This is the first component of a BPD-DS where the stomach is
reduced in size by removing the lateral 2/3rds leaving the stomach
in the shape of a tube.
Sometimes it is offered to patients as part of a two stage Bypass
operation particularly if they are
super obese ( BMI>60) because it allows good weight loss until
the patient gets down to a safe
weight and the more radical bypass can then be offered laparoscopically
when they are at a safer
weight.
The residual stomach capacity is about 200mls
so a generous entree should be possible.
Issues with Tube gastrectomy
1. Stomach tube may stretch up over time leading to late weight
regain. The extent of this is currently unknown
2. The amount of weight reduction is in the region of 40-60% of
excess wt lost over the
first 1-2 years.
3. It is a good option for people living in remote areas because
it is a "set and forget"
operation which requires little post op follow up
or nutritional supplements
4. There is no malabsorbtion to nutrients
5. If weight is regained the second stage of the BPD the
intestinal bypass can be added... often laparoscopically as well.
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