Our Summary

This research paper discusses a rare case where a 62-year-old man with severe obesity and metabolic syndrome was undergoing a specific type of weight loss surgery called one anastomosis gastric bypass, but the surgeons encountered an unexpected problem. They found that the patient’s intestines were completely twisted or malrotated, which made it difficult for them to proceed as planned.

As a result, the surgeons had to change their approach mid-surgery. Instead of continuing with the bypass, they decided to perform a different weight loss surgery called a sleeve gastrectomy. This involves removing a portion of the patient’s stomach to reduce its size, which can help the patient feel full sooner and therefore eat less.

The surgeons were able to successfully complete the sleeve gastrectomy, and the patient recovered well after the surgery with satisfactory weight loss. The paper suggests that switching to a sleeve gastrectomy can be a successful alternative when unexpected complications arise during a one anastomosis gastric bypass procedure.

FAQs

  1. What is intestinal malrotation and how can it affect bariatric surgery?
  2. What measures were taken during the procedure when the unexpected intestinal malrotation was discovered?
  3. How was the patient’s recovery and weight loss following the conversion of the one anastomosis gastric bypass to a sleeve gastrectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric sleeve surgery is to be aware of the potential for unexpected complications during the procedure. It is important to trust your surgeon and be prepared for the possibility of a change in the surgical plan if needed for your safety and success of the surgery. Communication with your healthcare team is key in ensuring the best outcome for your weight loss journey.

Suitable For

Patients who are typically recommended for gastric sleeve surgery include those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea. Additionally, patients who have not been successful with other weight loss methods such as diet and exercise may also be recommended for gastric sleeve surgery.

Timeline

Before the gastric sleeve procedure:

  1. Patient consults with a bariatric surgeon and undergoes pre-operative evaluations, including physical exams and tests.
  2. Patient receives counseling on the risks and benefits of gastric sleeve surgery, as well as dietary and lifestyle changes required post-surgery.
  3. Patient may be required to follow a pre-operative diet to shrink the liver and reduce surgical risks.
  4. Patient undergoes the gastric sleeve surgery, during which a large portion of the stomach is removed and a smaller sleeve-shaped stomach is created.

After the gastric sleeve procedure:

  1. Patient is closely monitored in the hospital for a few days post-surgery to ensure no complications arise.
  2. Patient is given instructions on a liquid diet for the first few weeks post-surgery, followed by a gradual transition to solid foods.
  3. Patient is advised to make long-term dietary and lifestyle changes to support weight loss and maintain a healthy lifestyle.
  4. Patient attends follow-up appointments with the surgeon and a dietitian to monitor progress and address any concerns or complications.
  5. Patient experiences gradual weight loss and improvements in obesity-related health conditions, such as diabetes and hypertension.

What to Ask Your Doctor

  1. Can you explain the potential risks and benefits of gastric sleeve surgery compared to other weight loss procedures?
  2. How will my diet and lifestyle need to change after gastric sleeve surgery?
  3. What is the expected timeline for recovery and weight loss after the procedure?
  4. What are the potential complications or side effects of gastric sleeve surgery?
  5. How will my existing medical conditions or medications be affected by gastric sleeve surgery?
  6. Will I need to take any supplements or medications long-term after the procedure?
  7. How often will I need to follow up with you after the surgery?
  8. What support or resources are available to help me both before and after the surgery?
  9. What are the long-term effects of gastric sleeve surgery on my digestive system and overall health?
  10. Are there any specific warning signs or symptoms I should watch for after the surgery?

Reference

Authors: Jayarajah U, Sathasivam K, Kumarage S, Wijeratne T. Journal: SAGE Open Med Case Rep. 2024 Jun 19;12:2050313X241263445. doi: 10.1177/2050313X241263445. eCollection 2024. PMID: 38903182