Our Summary

This research paper discusses a surgical procedure called banded resleeve gastrectomy (ReSG), used for treating recurring severe obesity after an initial weight loss surgery called laparoscopic sleeve gastrectomy. The procedure involves placing a ring around the stomach to limit its size and reduce food intake, which aids in weight loss.

The paper provides a detailed account of how the procedure is performed, using a video of the surgery on a male patient with a body mass index of 44 kg/m2 (a measure of obesity). The ring used in the procedure, called the MIDCAL ring, is placed and attached to the stomach with two stitches.

The approach to the surgery is from the back, using three ports or entry points. The previous surgical line from the initial weight loss surgery is dissected or cut open, and the stomach is reshaped using a tool called a bougie. The ring is then placed and locked in place, and the stomach is stitched back together.

The results of the surgery were positive, with the patient losing 9% of his total body weight after a month and 27% after two years. The paper concludes that the banded ReSG is a safe procedure with promising short-term results. However, more studies are needed to confirm its long-term effects.

FAQs

  1. What is the purpose of the banded resleeve gastrectomy (ReSG) procedure?
  2. How is the MIDCAL ring used in the banded resleeve gastrectomy procedure?
  3. What were the results of the surgery and what conclusions were drawn about the safety and effectiveness of the banded ReSG procedure?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about gastrectomy is to follow a strict diet plan post-surgery to aid in recovery and ensure successful weight loss. It is important to eat small, frequent meals and avoid high-fat, high-sugar foods to prevent complications and promote healing. Additionally, regular exercise and follow-up appointments with your healthcare provider are crucial for monitoring progress and addressing any concerns.

Suitable For

Patients who are typically recommended for gastrectomy procedures include those with severe obesity who have not had success with other weight loss methods, such as diet and exercise. In particular, patients who have undergone a previous weight loss surgery, such as a sleeve gastrectomy, and have regained weight or not achieved their desired weight loss goals may be candidates for a banded resleeve gastrectomy.

Patients with a high body mass index (BMI) or comorbidities related to obesity, such as type 2 diabetes or hypertension, may also be recommended for gastrectomy procedures. Additionally, patients who have a history of obesity-related complications, such as sleep apnea or joint pain, may benefit from surgical intervention to aid in weight loss and improve their overall health.

It is important for patients considering gastrectomy procedures to undergo a thorough evaluation by a multidisciplinary team of healthcare providers, including a bariatric surgeon, dietitian, psychologist, and other specialists. This evaluation will help determine if the patient is a suitable candidate for the surgery and ensure that they are well-informed about the risks and benefits of the procedure.

Overall, gastrectomy procedures are recommended for patients who have struggled to lose weight through other methods and are in need of surgical intervention to achieve and maintain a healthy weight.

Timeline

Before the gastrectomy:

  • Patient undergoes initial weight loss surgery, such as laparoscopic sleeve gastrectomy
  • Patient experiences recurring severe obesity and unsuccessful weight loss after the initial surgery
  • Patient and healthcare provider discuss the option of banded resleeve gastrectomy (ReSG) as a treatment option

After the gastrectomy:

  • Patient undergoes banded resleeve gastrectomy (ReSG) surgery, involving the placement of a ring around the stomach to limit its size and reduce food intake
  • Patient experiences weight loss and improved health outcomes post-surgery
  • Patient is monitored for short-term and long-term effects of the procedure to assess its effectiveness and safety

What to Ask Your Doctor

Some questions a patient should ask their doctor about gastrectomy include:

  1. What are the potential risks and complications associated with gastrectomy surgery?
  2. How will my diet need to change after the procedure, and will I need to take any supplements?
  3. What is the expected recovery time after gastrectomy surgery, and when can I resume normal activities?
  4. Will I need to undergo any additional procedures or follow-up appointments after the surgery?
  5. How will gastrectomy surgery affect my ability to absorb nutrients and vitamins from food?
  6. What are the long-term effects of gastrectomy surgery on weight loss and overall health?
  7. Are there any alternative treatment options to gastrectomy that I should consider?
  8. How experienced is the surgical team in performing gastrectomy procedures, and what is their success rate?
  9. Will I need to make any lifestyle changes, such as exercise or counseling, to support the success of the surgery?
  10. How will gastrectomy surgery impact my quality of life and overall well-being in the long term?

Reference

Authors: Noel P, Eddbali I, Manos T, Nedelcu M, Nedelcu A. Journal: J Laparoendosc Adv Surg Tech A. 2020 Aug;30(8):912-914. doi: 10.1089/lap.2020.0367. Epub 2020 Jul 7. PMID: 32634342