Type II Diabetes Mellitus Surgery
Virtually, any abdominal and/or pelvic surgery can be performed through laparoscopic techniques and/or mini-laparoscopy.
Our medical team has extensive experience in both techniques and has completed more than a thousand successful surgeries.
According to the World Health Organization (WHO), being overweight and obese aredefined as "abnormal or excessive fat accumulation that can be harmful to health."
The Body Mass Index (BMI) is a simple indicator of the relationship between weight and height that is commonly used to identify overweight and obese adults.
See BMI here.
The WHO definition states:
• A BMI greater than or equal to 25 determines the person to be overweight.
• BMI greater than or equal to 30 determines the person to be obese.
Bariatric surgery is a gastrointestinal procedure that treats obesity. It is not a cosmetic surgery, but an option for people that suffer from severe or morbid obesity with a BMI over 35-40 kg/m2.
Bariatric surgery is recommended for patients that have failed to lose weight by traditional means or who have health problems related to obesity, such as:
- Hypertension
- Diabetes
- Sleep Apnea
- Dislipidemia.
Candidates for bariatric surgery must undergo evaluation and consensus by a group of professionals, including: surgeon, internist, psychiatrist, anesthesiologist, nutritionist, and undergo multiple laboratory studies and medical tests.
There are different procedures for addressing the problem of obesity, and the patient is advised to take the overall assessment of the medical team in charge, into consideration when making their decision.
Description
Gastric Bypass Roux-en-Y is a mixed surgical procedure, because it combines two mechanisms: Restriction, which creates a "smaller stomach," and Malabsorption, which bridges both intestines and bypasses the most absorptive portion of the small intestine. In addition, it has a metabolic effect that produces beneficial hormonal changes.
The procedure consists of dividing the stomach with staples, in order to create a small pouch of approximately 30 ml (1 ounce). Next, a portion of the small intestine is formed into a "Y" shape, making a series of cuts and joints between the small intestine and the newly-formed stomach pouch. This allows the food and nutrients to bypass the larger stomach and the upper part of the small intestine (known as the duodenum), the area where the majority of food absorption takes place, and instead continue through to the middle portion of the small intestine (known as the jejunum). Like any other bariatric surgery, this procedure is not a method of fat removal and is not cosmetic surgery.
Advantages
•It produces an initial rapid weight-loss.
• It offers a higher average total weight-loss compared to other techniques.
• Most patients undergoing gastric bypass surgery lose between 70-90% of excess weight within one year, and continue to lose close to 95% of excess weight within the next 5 years post-surgery.
• Reduces incidences of Protein-energy malnutrition (PEM) and malnutrition caused by diarrhea.
• Decreases risk of death caused by other obesity-related diseases, such as: diabetes, pulmonary arterial hypertension (PAH), dyslipidemia, and metabolic syndrome.
• Reduces appetite.
SEE IMAGE
Description
Mini gastric bypass is a variation of the classic gastric bypass surgery; It combines certain techniques used in a sleeve gastrectomy with that of gastric bypass. It is also a mixed surgical procedure, because it it combines two mechanisms: Restriction, which creates a "smaller stomach," and Malabsorption, which bridges both intestines and bypasses the most absorptive portion of the small intestine. In addition, it has a metabolic effect that produces beneficial hormonal changes.
Instead of creating a small pouch like in bypass, this mini gastric bypass surgical procedure creates a tube that has the capacity to stretch up to 100ml (approx. 3 oz) that is connected to the second portion of the small intestine by a single union, in a location overlooking the highly absorbent portion of the intestine, making no cut nor separation of the small intestine.
Advantages
•Shorter surgery.
• A single union means less risk of leakage.
• Decreases risk of death caused by other obesity-related diseases, such as: diabetes, pulmonary arterial hypertension (PAH), dyslipidemia, and metabolic syndrome.
• Reduces appetite.
• Reduces probability of causing dumping syndrome (compared to conventional gastric bypass surgery).
SEE IMAGE
Description
A sleeve gastrectomy is a restrictive type of procedure that diminishes the size of the stomach, besides having a metabolic effect that produces beneficial hormonal changes.
This procedure molds the stomach into the shape of a sleeve or tube, sectioning off the larger portion of the stomach with staples, reducing its size by 70-80%, with a capacity of 150 to 200 ml.
Advantages
•The continuity of the intestines is not altered, therefore the patient receives the full benefits that food and nutrients have to offer.
• Decreases food cravings.
• Increased weight loss, as compared to gastric band or gastric plication surgery.
• Less risk of complications, as compared to gastric bypass surgery.
• Decreases risk of death caused by other obesity-related diseases, such as: diabetes, pulmonary arterial hypertension (PAH), dyslipidemia, and metabolic syndrome.
SEE IMAGE
Description
Gastric plication is a new surgical laparoscopic technique that reduces the size of the stomach without making any incisions, only using stitches, shrinking it to approximately 100 ml.
This technique produces the same gastric restriction as a sleeve gastrectomy, but unlike the latter, it does not require removing part of the stomach.
Advantages
•Drastic decrease in risk of gastric fistulas or leaks.
• Drastic decrease in risk of gastric bleeding.
• Can be ambulatory.
• Can start liquid diet the day of the surgery.
• Less costly procedure.
SEE IMAGE
Description
Gastric band surgery, also known as lap-band surgery, is an adjustable and reversible laparoscopic technique used to achieve weight-loss in obese patients. It consists of placing a flexible silicone band around the upper portion of the stomach, in order to slow the consumption process and provide more control over food intake.
This band or ring is placed deflated, and is adjusted after 4 to 6 weeks after the initial surgery. The following adjustments are programmed according to the needs of the patient, or as recommendaded by the lead doctor and his medical team.
Advantages
•Promotes weight-loss in two ways: First, by restriction, in which the new gastric pouch limits the amount of food that is consumed. Second, by the sensation of "fullness" caused by the slow movement of food intake through the band.
• It is performed laparoscopically.
• It is the only adjustable and reversible bariatric surgery.
• It does not require cutting or stapling the stomach, and the normal physiology of the stomach is not altered.
• No artificial surgical connections are created (anastomosis), therefore, there is no risk of them closing (stenosis).
• Outpatient surgery.
• Shorter time under anesthesia.
SEE IMAGE
Description
Minimally-invasive surgery is a specialized technique. In traditional "open" surgery, the surgeon uses a single large incision to enter to abdomen. In contrast, laparoscopic surgery uses various 0.5 to 1 cm incisions where specialized instruments and a camera is passed through. The abdomen is inflated with a gas called carbon dioxide, in order to facilitate visibility and a space for the surgeon to work. This procedure allows the surgeon to perform the same operations as in traditional surgery, but with smaller incisions.
Advantages
Compared to traditional open surgery:
• Less pain.
• Shorter recovery period.
• Less time of hospitalization.
• Less risk of infection and post-operative hernias.
• Quicker return to daily activities.
SEE IMAGE
Description
A Nissen Fundoplication Laparoscopy is a surgical procedure to treat hiatal hernias. A hiatal hernia occurs when the normal opening in the diaphragm is too large, and the stomach or other abdominal contents can get out (herniate) into the chest (thorax), causing heartburn (gastroesophageal reflux disease), and serious damage to the esophagus.
Why is it performed?
Nissen Fundoplication Laparoscopic surgery is performed in order to alleviate symptoms from patients suffering from gastroesophageal reflux disease (GERD), caused by hiatal hernias, and to prevent future complications. It is a safe and effective operation, in which heartburn (gastric reflux) is greatly reduced or eliminated in 95% of patients, relieves pain, and prevents the onset or rupture of ulcers.
SEE IMAGE
Description
A cholecystectomy is performed when the patient has a pathology of the gallbladder, the most common being cholelithiasis (gallstones). These gallstones are formed by the build-up of cholesterol crystals, due to an alteration in the relationship between bile salts, calcium salts, bile pigments and cholesterol. Gallstones cause sharp abdominal pains, cramps, and even fever and vomiting.
Advantages
SEE IMAGE
Description
A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac passes through a small hole of weak area in the strong layer of the abdominal wall that surrounds the muscle, called the fascia.
The type of hernia the patient has, depends on the hernia's location:
- Femoral hernia: A bulge in the upper thigh, just below the groin. This type is more common in women than in men.
- Hiatal hernia: Occurs in the upper stomach. A portion of the stomach goes into the chest cavity (thorax).
- Surgical hernia: Can occur through a scar if the patient has previously undergone abdominal surgery.
- Umbilical hernia: A bulge around the naval. This type is more common in men than in women. It can even travel down into the scrotum.
- Hernia inguinal: es una protuberancia en la ingle. Este tipo es más común en los hombres. Puede bajar hasta el escroto.
Why is it performed?
There is no clear cause for a hernia. Sometimes they are caused by:
-Lifting heavy objects.
-Constipation.
-Any activity that increases abdominal pressure or muscle strain.
Hernias may be present at birth, but may not be noticeable until later in life.
Surgery is the only treatment that a hernia can be repaired permanently. Surgery can repair the weakened tissue on the abdominal wall (fascia), as well as any other small holes.
SEE IMAGE
Description
A gastrectomy is a surgical procedure in which a portion or the whole stomach is removed.
Why is it performed?
LA gastrectomy is used to treat the following:
• Bleeding.
• Inflammation.
• Tumors.
• Polyps.
SEE IMAGE
Description
A colectomy is a surgical procedure in which a portion or the whole large intestine (colon) is removed for various reasons. The affected part of the large intestine is located and extracted.
Why is it performed?
The resection of the large intestine is used to treat many conditions, such as:
• Bowel obstruction.
• Colon cancer.
• Diverticulitis.
• Polyps.
• Injuries that damage the large intestine.
• Intussusception or invagination (sliding part of one intestine into another).
• Severe gastrointestinal bleeding.
• Twisting of the intestine (volvulus).
• Ulcerative colitis.
SEE IMAGE
Description
The appendix is a small, tube-shaped organ that extends from the first part (ascending cecum) of the large intestine. Appendicitis is one of the most common surgical problems. One in every two thousand people has an appendectomy at some point in life.
Why is it performed?
The appendix is extracted when it is inflamed or infected. This condition is called appendicitis. An appendix with a small perforation can leak, and infect the entire abdominal area, which can be fatal.
SEE IMAGE
Description
A colostomy consists of opening the abdomen in order to drain the stool into a bag. An ileostomy is used to carry waste out of the body when the colon or rectum are not working properly. A laparoscopic colostomy or ileostomy restores the appearance and function of the patient's intestines and rectum.
Why is it performed?
Generally, a colostomy or ileostomy are performed after an intestinal surgery to aid in recovery. The closure of a colostomy or ileostomy is performed when the physician determines that it has completed its function.
SEE IMAGE
Description
A splenectomy is a surgical procedure to remove a ill-stricken or damaged spleen.
Why is it performed?
Conditions that may require spleen removal include:
• Abscess or cyst in the spleen.
• Blood clot (thrombosis) in the blood vessels in the spleen.
• Hepatic cirrhosis.
• Any thrombocytopenic diseases or blood cell disorders, such as: idiopathic thrombocytopenic purpura (ITP), hereditary spherocytosis, thalassemia, hemolytic anemia and hereditary elliptocytosis. These are all rare conditions.
• Hypersplenism.
• Lymphoma, Dodgkin's disease, and leukemia.
• Other tumors or cancers that affect the spleen.
• Sickle cell anemia.
• Splenic artery aneurysm (rare).
• Trauma to the spleen.
SEE IMAGE
Description
An adrenalectomy is a surgical procedure in which one or both adrenal glands are removed. These glands are located just above the kidneys.
Why is it performed?
The adrenal gland is removed for various reasons:
• Cancer or malignant tumor.
• Pheochromocytoma (may cause high blood pressure).
• Cushing syndrome.
• Adrenal mass of unknown cause.
SEE IMAGE
Description
A laparoscopic pancreatectomy is a minimally-invasive technique that is used to remove part of the pancreas. Using this technique, the pancreatic function is preserved.
Why is it performed?
• Acute pancreatitis.
• Tumors and pancreatic cysts.
• Pancreatic cancer.
SEE IMAGE
