Mini Gastric Sleeve. The Pros And Cons Full Detailed Review.

Mini Gastric Sleeve

There are lots and lots of people in the world who suffer from obesity. Often the person who doesn’t get desired results from regular workouts and diet tends to go for weight loss surgery. In the field of weight loss surgery, there are plenty of options for the patients like Gastric bypass, Gastric mini bypass, Gastric ring, Adjustable gastric banding, and many more.

Today we are going to talk about Mini Gastric Sleeve. There is a new, quicker, and easy alternative to bypass surgery nowadays. The process is called “Mini Gastric Sleeve/ Sleeve Gastrectomy“.FDA has even approved Endoscopic surgery devices for performing Sleeve Gastrectomy. In the mini gastric sleeve, the surgeon removes 80 to 85% of the patient’s stomach. This process of losing weight is been proven more efficient, easy, and less time-consuming by so many researchers and patients as well. In this article today we will see and check every fact and faqs about MGS(Mini Gastric Sleeve) in an easy language. so that everybody can understand what Mini Gastric Sleeve actually is.

Mini Gastric Sleeve

People often get so confused between Mini Gastric Sleeve and Mini Gastric Bypass. But there is a huge difference in the process of both operations. In the MGB the surgeon creates a pouch out of the patient’s stomach and gives a bypass to the food directly to the small intestine. Then the rest larger part of the patient’s stomach is left behind in the patient’s abdomen. This larger part of the stomach is not dead it still works and produces acid and enzymes which meet the food at the bypass point in the small intestine, But this larger part of the stomach is never gonna be in direct contact with food again.

Where in the Mini Gastric Sleeve surgeon creates a narrow sleeve by cutting the patient’s stomach and removing the larger part of the stomach from the patient’s body.

How does Mini Gastric Sleeve is Done?

The typical performing way of the Mini Gastric Sleeve is as same any other bypass surgery. The surgeon starts the surgery by doing 5 incisions into the patient’s body. Then the trocars are inserted into the patient’s body. Trocars are the tool through which surgeons inserts surgical tools into a patient’s body. After trocars, surgical tools are passed into the patient’s body trocars. Then the surgeon cuts down the patient’s stomach and creates a sleeve out of it. And 80 to 85% of the patient’s stomach is cut down. The rest larger part of the stomach is removed from the patient’s body through incisions. That’s it the surgery is done.

The McCarty Mini Sleeve.

The McCarty Mini Sleeve is invented by Dr. Todd M. McCarty from Dallas, Texas, U.S.A. Dr. McCarty is an excellent surgeon and collected his medical degree from the University of Texas Southwestern Medical School. Dr. Todd has experience of more than 20 years. Unfortunately, this amazing surgeon is not with us anymore. Dr. Todd passed away a few years ago. This surgeon made the way of Gastric sleeve too much easy for the patients and for surgeons as well. The main reason behind it is that the patient can return to work a lot sooner than in the other surgeries.

The process of creating a Mini sleeve out of the Patient’s stomach is not too much different from the regular Gastric Sleeve. It’s just a way of performing the same procedures using fewer or no incisions on the patient’s body. At the beginning of the operation, the surgeon starts the operation by inserting an endoscope or measuring device into the stomach through the mouth/throat of the patient. Now the surgeon will divide your stomach into two by turning the patient’s whole stomach into a sleeve using surgical tools. After creating the sleeve and dividing the patient’s stomach into two different parts the surgeon will take out the rest big part of the patient’s stomach through his mouth and that’s it, the surgery is done.

What is Mini Gastric Bypass?

now understand Mini Gastric Bypass. The Mini Gastric Bypass is the lower version of the Gastric bypass. The word mini indicates a less time-consuming and less complicated process. Mini words also represent fewer complications after surgery compared to regular Gastric Bypass Surgery.

Dr. Robert Rutledge invented Mini Gastric Bypass surgery in 1997. According to Austin Publishing Group, As a trauma surgeon, he was faced with an abdominal gunshot wound where a duodenal exclusion with a Billroth II anastomosis was an appropriate reconstruction. This was the inspiration that led Rutledge to the MGB on consenting bariatric patients, constructing a long lesser curvature channel that prevents reflux. In the USA, there was some skepticism against the MGB. But as time has passed the number of MGB surgeries has remarkably increased. In 2015 MGB became the third most common bariatric surgery internationally.

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How does it work?

Food travels from your mouth down the esophagus and then into your stomach. Currently, your stomach can hold about 40 ounces of food at a time. Once in your stomach, the food combines digestive juices containing acids and enzymes. That helps break it down into smaller particles. Once broken down the small particles are slowly released into the first part of your small intestine(Also known as Duodenum). Most of the calories and nutrients from the broken-down food are absorbed in the Duodenum and the Jejunum(The Second part of the small intestine). Food particles not absorbed by the small intestine leave the body in the form of waste.

How MGB Surgery is Done? Stage-1

The surgeon begins the MGB surgery by inserting five trocars into the patient’s abdomen. A trocar is a tool that has a hollow sleeve. It allows the surgeon to pass a laparoscopic video camera and other surgical tools into the patient’s abdomen. This allows the surgeon to perform the operation outside of the patient’s body. The surgeon will use an Endoscopic stapler to divide the patient’s stomach into two parts. The smaller part that connects to the Esophagus is reshaped into a long narrow tube. This new narrow tube will now serve as the patient’s new Mini stomach.

Now this new stomach will hold only four to six ounces of food. The larger portion of your old stomach will still remain alive inside your body. It will still produce digestive juices to aid in digestion, but it will no longer come in contact with food. Next, the surgeon will measure the length of the patient’s small intestine. That will be bypassed. This bypass section will include all of the duodenum and part of the jejunum. this part length is usually between 5-7 feet from where the small intestine connects to the larger part of the human body’s old stomach. The length of the bypass is determined by the patient’s specific physical condition and lifestyle

Stage-2

The surgeon will now connect the patient’s new mini stomach pouch to the bypass point of the smaller intestine using the endoscopic stapler. This connection point is called Anastomotic. Once this connection is completed, the surgeon will reinforce the outer circumference of the anastomosis with a suit. Now the new mini stomach of the patient will hold much lesser food than before. It will easily make the patient feel full more quickly than usual.

Stage-3

Now once the food leaves the patient’s mini stomach. It will bypass the duodenum and some part of the jejunum. This simply means now the patient will consume fewer calories. However digestive juices from a large portion of the old stomach and enzymes from the gallbladder will still travel through the duodenum. These juices and enzymes will meet up with the food at the bypass point. These acids and enzymes will aid in the digestion process as food travel through the remainder of the small intestine. Finally, certain hormones that regulate the human body’s appetite will be affected after surgery. As the result, the patient will eat less not only because his stomach is physically smaller but also because these changes in hormone levels will suppress his appetite.

The Benefits of Mini Gastric Bypass

This is one of the most frequent questions asked by patients to their surgeons. The main point I would like to explain first is the word “Mini” does not represent the effects of the surgery. Instead, the word “Mini” in Mini Gastric Surgery represents fewer side effects and fewer complications of the surgery. Regarding the metabolic effects and also weight loss effects Mini Gastric Bypass is definitely a stronger operation than a regular Gastric Bypass Surgery. This has also been proven in many studies.

The Difference Between Mini Gastric Bypass and Bariatric surgery.

MGB has some similarities to two other bariatric procedures. The Sleeve Gastrectomy and Roux-En-Y Gastric Bypass. There are also some important differences. The Sleeve Gastrectomy is a restrictive-only procedure. Like MGB, Sleeve Gastrectomy also creates a stomach pouch along the lesser curve. Unlike the MGB however, the sleeve Gastrectomy completely removes and discards the larger bypass portion of the old stomach. This procedure makes Sleeve Gastrectomy a completely irreversible procedure.

While the MGB and Roux-En-Y Gastric Bypass both create a small stomach and bypass a portion of the small intestine. The MGB has only one anastomosis. When the other one has two anastomoses in it. In MGB the stomach pouch is created along the lesser curvature of the stomach as opposed to the top greater curvature in Roux-En-Y Gastric Bypass Making it less likely to stretch out over time. Finally, these two features, The single anastomoses and the long stomach pouch along the lesser curve make the MGB easily reversible or revivable bypass surgery.

Why Mini Gastric Bypass is Better Than Other Bypass Procedures?

Murat Üstün, MD, Istanbul Bariatric Centre has explained three major reasons why MGB is better than regular Gastric Bypass.

Reason-No.1

  • Regarding the Metabolic effects and Weight loss Effects, MGB has been proven more successful in hundreds of studies.
  • The main difference between MGB and regular bypass is surgeons create a very small gastric pouch approximately two centimeters of the gastric pouch.
  • After that Dr. cuts the small bubble, after 150 centimeters. Then surgeons reconnect on top of the small bawl to the stomach and the other one to a small bowl.

Reason-No.2

  • The second reason is the pouch. The pouch is very different in the MGB and regular Gastric Bypass.
  • In regular bypass, surgery surgeons create a mini gastric pouch. Which makes this operation mainly restrictive an operation instead of malabsorptive.
  • In MGB surgeons creates a long narrow tube, like a sleeve gastrectomy. This makes a huge difference in eating comfort.
  • After the mini gastric bypass patients eating comfort will be definitely better.
  • Because MGB is not only or mainly restrictive operation.
  • It’s mainly a malabsorptive operation and because of the size of the pouch mini gastric bypass is a more convenient method than the other ones.
  • In classical bypass surgery, patients are struggling to consume solid foods, like vegetables, meats, and many more like these.
  • Where in MGB eating comfort of the patient is definitely higher

Reason-No.3

  • The third main reason is that Dr. Murat likes MGB more than any other standard bypass surgery.
  • The main reason Dr. Murat prefers MGB is that it only contains one anastomosis instead of two in the regular bypass.
  • This process decreases the chances of post-surgery complications to half than regular bypass surgery.
  • It’s because of the complex anatomy of Roux-En-Y surgery. Surgeons often face the problem of internal herniation. It’s because surgeons cut the small bawl, and small bawl vessel and then creates a new shape.
  • In some cases, some patients have internal herniation problems.
  • Where in MGB it’s very very rare Because there are no cuts to the mesentery and there are no cuts to the small bawl.
  • These complications sometimes cause emergent operations. In the long terms some times it also causes chronic abdominal pain.
  • Patients often can’t understand the main reason behind this pain. The reason is internal herniation

So according to Dr. Murat Üstün, these are the major reason that surgeons always prefers MGB over any other standard method for bypass.

Why McCarty Gastric Sleeve is Better than Other Weight Loss Surgery?

In regular bypass or weight loss surgery, surgeons use to make five incisions on the patient’s abdomen. When in a McCarty Gastric sleeve there is no requirement for any incisions into the patient’s body. So the patient can easily have a quicker and less painful recovery. Also doing the same procedures and using different methods the surgeons reduce the damage to the tissues of the patient’s body. It also helps in consuming fewer painkillers after the surgery for the patient. There is also very less risk of developing incisional hernias, so the patients can get back to working or their daily routine much faster compared to other surgeries.

Issues with McCarty Gastric Sleeve/Mini Gastric Sleeve.

Everything in this world which is good is also bad. It applies the same on the McCarty Gastric Sleeve. The main reason for not taking MSG is the danger of damage. Yes, the risk of getting your thought damaged is high in this process.

According to NCBI Bleeding, leakage, and gastric fistulae are the most common intraoperative complications and post-operative complications after sleeve gastrectomy. The methods surgeons use for finding leaks in the staples post-surgery are also not standard. These leaks often stay undetected and untreated. According to the studies, most of the leaks in the patient’s body after the surgery are caused by staple misfires. There is also a major issue with the gastric sleeve is that the process is irreversible. The surgeon takes the larger part of the patient’s stomach out of their body, this process can not be undone.

Conclusion

Every weight loss surgery or method has its pros and cons. It is very mandatory for every patient to consult a doctor first before taking any serious step toward their new life. McCarty Gastric Sleeve is a very advanced and acceptable surgery nowadays. In this surgery, the patient does not have to wait for weeks to get back to normal life because there are no wounds on the abdomen which you need to recover. According to Dr. McCarty patient can get back to work on the next day of surgery. The patient also does not have to wait for months to start doing work out or lifting heavy weights. where in the bypass surgery there are no take-outs from the patient’s body. The stomach is not separated it’s just been divided into two different amounts. so search well consult a good dr. and choose the right surgery for you.

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