A. How does surgery reduce weight?
Minimally invasive surgical procedures used to treat obesity are divided into three main types.
1.Restrictive surgery ;
2.Improper absorption surgery;
3.Surgery combining the two. Restrictive surgery reduces the volume of the stomach by creating a narrow channel between the fundus and the body of the stomach or by removing the greater curvature of the stomach, thereby limiting food intake and slowing down the rate of food passage through the stomach, thereby reducing the volume of the stomach and achieving weight loss. Malabsorptive surgery does not restrict food intake, but leaves much of the jejunum open, reducing the absorption of calories and nutrients. Combined surgery is a surgical procedure that restricts gastric volume and combines it with an intestinal bypass.
Is weight loss surgery right for you?
You may be a candidate for weight loss surgery if you meet the following criteria.
1. Simple obesity excluding endocrine disorders;
2. BMI ≥ 32kg/m2 or BMI less than 32kg/m2 but with degenerative joint disease, hypertension, hyperlipidemia, coronary heart disease, insulin-resistant diabetes, sleep apnea, lower limb venous lymphatic obstruction, obesity-related pulmonary hypertension and other comorbidities;
3.Age 16～65 years old;
4, by non-surgical treatment is not effective or can not tolerate;
5, no alcohol or drug dependence, no serious mental disorders, intellectual disabilities;
6.No obvious related physical and mental diseases by psychological assessment;
7.People who clearly understand the surgery and are determined to improve their lifestyles through surgery;
8.Willing to accept regular medical follow-up and have good medical follow up;
What are the benefits of laparoscopic bariatric surgery?
Traditional surgical weight loss surgery often requires an incision of about 15cm in the abdomen, which is traumatic, slow to recover and has many complications. In minimally invasive weight loss surgery with laparoscopy, the surgeon only needs to puncture 4-5 small 1-2cm holes in the abdomen, and slender instruments enter the abdominal cavity through these holes for surgery. The surgery is less invasive, bleeds less, has a shorter hospital stay, avoids huge surgical trauma, has a faster postoperative recovery, and has significantly fewer complications than open surgery. However, minimally invasive laparoscopic surgery requires longer training and may also have serious consequences if not performed correctly.
IV. What are the common laparoscopic bariatric surgery modalities and their advantages and disadvantages?
(A) LAGB surgery
1. What is LAGB surgery
Laparoscopic Adjustment Gastric Banding (LAGB) surgery is a restrictive weight loss surgery and the principle is simple. When you feel full, your hunger is more likely to decrease and you no longer feel like you haven’t eaten enough. This makes it possible for you to eat less. Restrictive weight loss surgery achieves weight loss by reducing the amount of food consumed in a meal. However, it does not interfere with the normal absorption (digestion) of food. Through the surgery, a smaller upper gastric sac is created. This sac has a volume of about 15 to 30 ml and is connected to the rest of the stomach by a small adjustable outlet. For patients with a cooperative attitude and who follow medical advice, the reduced gastric volume, combined with behavioral changes, can lead to a sustained reduction in calorie intake and non-rebound weight loss.
During LAGB recovery, patients must adhere to the restrictive and special dietary guidelines prescribed by their bariatric surgeon. If patients do not follow these guidelines, their gastric sac may be distended and/or cause the restrictive gastric band to slip, making the procedure unsuccessful. The effectiveness of the restrictive procedure can be diminished by patients eating consecutive extra meals or drinking a high-calorie, high-fat liquid diet. Failure to achieve the desired level of weight loss can result from patient non-compliance with recommended diets or behavioral changes such as increased exercise and regular support group meetings.
2. Indications for LAGB surgery
In addition to the indications for surgery listed in Article 2 above, the procedure is particularly suitable for younger patients due to the minimally invasive and adjustable nature of LAGB surgery, which can be adjusted as necessary to meet nutritional needs when patients have special circumstances, such as during pregnancy, when nutritional needs increase.
3.Procedure of LAGB surgery
Through a minimally invasive laparoscopic procedure, a low-pressure soft bandage is placed around the upper part of the gastric body to form a smaller upper gastric bursa. This gastric bursa has a volume of approximately 15 to 30 ml and is connected to the rest of the stomach through a small adjustable outlet. It is like putting a belt around the stomach. The gastric band is the equivalent of dividing the stomach into two parts, with a small opening between the two parts to allow food to pass through.
When eating, food is quickly collected in the smaller upper part and most patients experience an immediate feeling of satiety and eat less. During the procedure, a syringe made of titanium is placed under the patient’s skin and secured to the surrounding tissue. The syringe is connected to the gastric band through a thin catheter, and the surgeon can inject or withdraw fluid from the mouth of the syringe into the band to adjust the tightness, depending on each patient’s condition and requirements. The biggest advantage of laparoscopic surgery over traditional surgery is that patients recover faster and experience significantly less pain after surgery.
Diagram of LAGB surgery
4. Advantages of LAGB surgery
1)The amount of food eaten per meal is limited
2) The process of food passing through the digestive tract is not changed, so it can be completely absorbed
3) It can be done through minimally invasive surgery (laparoscopic surgery)
4) Food restriction can be increased or decreased by regulation
5) The surgery is reversible (basically, it can be restored to the pre-surgical state)
5.The efficacy of LAGB surgery
Morbidly obese patients after LAGB, on the one hand, through the binding band regulation control weight slowly and continuously decline, at the same time to give scientific dietary guidance, can achieve significant results and avoid the occurrence of malnutrition. For patients with cooperative attitude and obedience to medical advice, the reduced gastric volume combined with behavioral changes can make the calorie intake continue to reduce, and can lose more than 65% of the overweight weight, and obtain the effect of weight loss without rebound.
6. Risks associated with LAGB surgery
There are always certain risks associated with surgery, and even the most skilled surgeons cannot guarantee that every surgery is a complete success, so patients and their families should be fully aware of the complications and risks associated with surgery. In addition to the risks that may be associated with general gastrointestinal surgery, such as anesthesia, there are.
1) Infection and displacement
Infection can occur both at the syringe site and in the abdominal cavity. Sometimes infection can cause the band to enter the stomach, at which point the procedure must be repeated. Most cases of displacement are due to the gastric band being filled with too much water. It is recommended that no more than 9 ml of water be injected into the gastric band, and avoiding excessive water injection into the band will greatly reduce the incidence of displacement. Displacement can also be caused by infections that are not clinically apparent. Although this is rare, it is important for you to avoid having someone inject you without skin sterilization.
2) Leakage
A leak in the adjustable gastric band or a leak in the tubing connecting the balloon to the syringe may require a second surgery. The balloon is a delicate material and leaks can occur shortly after surgery or years after surgery. If this happens, a new band can be surgically replaced. Complications are now rare, but in the long run there is still a risk of having to replace the band with a new one.
3) Displacement of the gastric band and small gastric dilatation
The gastric band may shift, causing the upper bursa of the band to become too large, which may require reoperation.
4) Silicone band perforation and syringe displacement
The syringe may be displaced and there is a risk of perforation of the silicone tube during each injection, but
Once the above happens, it will only require a minor surgery under local anesthesia to adjust it.
No one can guarantee that your adjustable gastric band will last a lifetime without fail. However, since the inception of the adjustable gastric band in 1987, instances of failure have been very rare. Even if none of these complications occur, the risk of reoperation will still be present. It is important to understand that reoperation may be part of the overall treatment of very severe obesity. In some cases, reoperation is a necessary technical measure. Overall, the chances of reoperation after adjustable gastric banding are very small, and the fact that some reoperation is necessary does not mean that this approach has failed. These problems can usually be solved and the patient can return to normal soon after treatment.
7. Possible side effects of LAGB surgery and main recommendations
1) Vomiting
Post-operative patients may experience vomiting or pain after eating. This may be caused by your poor eating habits or the narrowing of the passage of the gastric band after balloon injection. By eating quietly and slowly, you will learn to listen to your stomach’s signals. Regular vomiting is a warning that you may need to have your gastric band readjusted by your doctor.
2) Vitamins
Vitamin supplements are essential during your rapid weight loss phase. It is generally recommended that you take a liquid multivitamin, especially B complex, for at least 6 months after surgery.
3)Pregnancy
The period between surgery and weight loss to a stable state is often referred to as the starvation period. Pregnancy is not recommended during this time. If you are still pregnant, it is recommended that you ask your doctor to completely drain the gastric band so that your diet can return to full normal again. You should wait until your weight is stable before you start your pregnancy plan.
4) Medication
Before taking the medication, make sure to cut the tablets into small pieces or crush them into powder. Usually medications like those for high blood pressure, diabetes, asthma, etc. need to be reduced in dosage after surgery. If necessary, consult a specialist.
5) Constipation
Many patients experience constipation after surgery. This is usually caused by a decrease in bowel movements due to a significant decrease in the amount of food you eat, which leads to a decrease in the amount of stool. If necessary, it is recommended that you stop eating those so-called canned foods and consume more laxative liquids, such as lactic acid drinks, etc.
8. Questions about medical costs
LAGB surgery is expected to cost around RMB 60,000-70,000 before and after the surgery, including banding, surgery, balloon gastric tube, golden finger, anesthesia, instrument use, medicine fees, various tests, treatments, medicines and hospitalization fees. In addition, patients are also responsible for the costs incurred in case of postoperative complications and all costs required for consultation, examination and treatment.
(II) LAGBP surgery
1. What is LAGBP surgery
Laparoscopic Adjustment Gastric Banding Plication (LAGBP, Figure 2) is also a restrictive bariatric surgery. The procedure combines an adjustable gastric band (LAGB) with a gastric folding procedure. In addition to the principle of adjustable gastric banding for weight loss, it also incorporates the reduction of gastric volume due to folding.
2. Indications for LAGBP surgery
In addition to the basic indications for bariatric surgery and the indications for LAGB surgery, LAGBP surgery is more suitable for obese patients with high BMI but unwilling to accept the more invasive sleeve gastrectomy and gastric diversion surgery and obese patients whose weight loss is not very satisfactory after receiving adjustable gastric banding surgery.
3.Procedure of LAGBP surgery
The surgery is performed along 3cm from the lesser curvature of the stomach, and the greater curvature of the gastric body from the left side of the cardia to 4-8cm from the pylorus is folded towards the gastric cavity and sutured to form a small gastric cavity of about 100-150ml. After the completion of the folding procedure, an adjustable gastric banding procedure is then performed.
4.Advantages of LAGBP surgery
(1) All the advantages of LAGB, but without the need for frequent water injection adjustment;
(2) The volume of the stomach is reduced, but the function is normal and the food can be digested normally;
(3) The pylorus is preserved, so there is no dumping syndrome;
(4) No intestinal diversion is performed, thus eliminating the possibility of intestinal obstruction, anemia, osteoporosis, protein deficiency and vitamin deficiency;
(5) It is a better choice for patients with anemia, Crohn’s disease, and other problems that prevent them from undergoing risky gastric diversion surgery;
(6) Better weight loss than LAGB or LSG alone and recovery of gastric volume;
Figure 2. Adjustable gastric banding + gastric folding (LAGB+Plication)
5. Disadvantages of LAGBP surgery
(1) The operation time is longer than LAGB or LSG alone;
(2) The cost is slightly higher than LAGB alone;
(3) The control of the degree of folding requires more clinical experience;
6, the efficacy of LAGB surgery
After morbidly obese patients undergo LAGBP, in addition to the weight loss effect brought about by LAGB surgery, the efficacy is 18% higher than that of LAGB alone due to the significant reduction of gastric volume caused by folding.
7. Risks associated with LAGBP surgery
LAGBP surgery faces all the risks of LAGB surgery, but the chances of its band slipping are relatively small. Also, due to the gastric folding suture, it can bring the possibility of narrowing of the gastric cavity and leakage at the suture, but by taking certain measures this risk is relatively small.
8. Possible side effects of LAGBP surgery and main recommendations
The possible side effects and main recommendations of LAGBP surgery are similar to those of LAGB surgery.
9. Questions about medical costs
LAGBP surgery is expected to cost around RMB 70,000-80,000 before and after the surgery, including banding, surgery, special sutures and related instruments, gold fingers, balloon gastric tube, anesthesia, instrument use, medicine fees, various examinations, treatments, medicines and hospitalization fees. In addition, the patient is also responsible for the costs incurred in case of postoperative complications and all costs required for consultation, examination and treatment.
(III) LSG surgery
1.What is LSG surgery
Schematic diagram of LSG surgery
2.The advantages of LSG surgery
1) The volume of the stomach is reduced, but the function is normal, so most of the food can be digested normally with a small amount of food;
2) Part of the gastric tissue, including the fundus, is removed, thus reducing the secretion of the hunger hormone Ghrelin;
3) The pylorus is preserved, so there is no dumping syndrome;
4) Minimizing the incidence of ulcers;
5) No intestinal rerouting, thus eliminating the possibility of intestinal obstruction, anemia, osteoporosis, protein deficiency and vitamin deficiency;
6) It is a better choice for patients with anemia, Crohn’s disease, and other problems that prevent them from undergoing risky intestinal bypass surgery;
7) The procedure can be done laparoscopically;
3. Disadvantages of LSG surgery
(1) Inappropriate weight loss or weight regain may occur;
(2) Patients with high body mass index may need a second surgery to better lose their excess weight. However, in patients with a high BMI, a secondary procedure may be safer and more effective than a primary procedure;
(3) Absorption of soft calories from foods such as ice cream and shakes may slow down the weight loss process;
(4) This surgical operation is performed by using a cutting closure device to remove the stomach, which may lead to complications such as bleeding, leakage and stricture of the incision margin;
(5) As part of the stomach is irreversibly removed, it may lead to a series of other weight loss syndromes;
4. Indications for LSG surgery
In addition to the indications listed in the second article above, LSG surgery is particularly suitable for patients with a lot of weight and complications due to the minimally invasive nature of the surgery and the absence of foreign bodies such as intra-abdominal girdles, and can be used as a pre-operation for definitive surgery for patients who cannot temporarily undergo risky surgery such as gastric diversion.
5.Procedure of LSG surgery
LSG surgery is guided by laparoscopy combined with intraoperative gastroscopy to remove 3/5 of the gastric body on the side of the greater curvature of the stomach. After the surgery, the residual stomach is in the shape of a “sleeve” about the diameter of the gastroscope, with a volume of about 100mL. Therefore, the operation does not change the physiological state of the gastrointestinal tract and does not produce a lack of nutrients.
6. Efficacy of LSG surgery
After this surgery, it is expected to lose more than 60% of the overweight portion in 6 to 12 months.
7.Risks associated with LSG surgery
There are always certain risks associated with surgery, and even the most skilled surgeons cannot guarantee that every surgery will be a complete success. In addition to the risks that may be associated with general gastrointestinal surgery, such as anesthesia, there are.
1) Bleeding, gastric leakage and stricture
Since LSG surgery is performed by cutting the large portion of the greater curvature of the stomach using a cutting closure, this cutting and suturing is done by means of a U-shaped titanium staple, and therefore may lead to complications such as bleeding, leakage and stricture at the cut edge leading to reoperation for salvage;
2) Other risks such as anesthesia
LSG surgery is performed laparoscopically and, like other minimally invasive laparoscopic surgical procedures of the gastrointestinal tract, general anesthesia is used, thus posing a series of risks associated with general anesthesia.
3) Infection, adjacent organ damage, etc.
Since gastrointestinal surgery is not an absolutely sterile procedure, there is a possibility of infection in both the abdominal cavity and the surgical incision; in addition, due to factors such as extreme obesity and anatomical variation of the patient, surgical risks such as injury to adjacent organs and hemorrhage due to vascular injury can occur. The risks of injury and bleeding that may occur during the perioperative period of the relevant gastrectomy surgery will be separately informed before the surgery; the emergence of these complications will require anti-infection and re-operation to stop the bleeding and repair the damaged organs and other salvage work.
8. Possible side effects of LSG surgery and main recommendations
1) Vitamins
Vitamin supplementation is essential during the phase of your rapid weight loss. It is generally recommended to take liquid multivitamins, especially vitamin B complex, for at least 6 months after surgery.
2)Pregnancy
Since LSG surgery is a non-recoverable procedure, we do not recommend this type of surgery for young women who have not had children.
9. About medical costs
The cost of LSG surgery is about RMB 70,000-80,000, including the laparoscopic use of a cutter and staple gate, surgery, anesthesia, instrumentation, medication, various tests, treatments, consultations, and hospitalization fees. In addition, the patient is also responsible for the costs incurred in case of postoperative complications and all the costs required for consultation, examination and treatment.
(IV) LRYGB surgery
1. What is laparoscopic gastric diversion surgery (LRYGB)
Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is the most common and successful combined weight loss surgery in the United States. The surgery builds a small gastric pouch that restricts food intake. A Y-shaped section of the small intestine is anastomosed to the small gastric pouch, allowing food to bypass the large portion of the stomach, duodenum, and first jejunum thereby reducing the body’s absorption of the vast majority of calories and nutrients. It is more effective in patients with severe obesity. This procedure has been used to treat type 2 diabetes with good results.
Diagram of LRYGB surgery
2. Advantages of laparoscopic gastric diversion (LRYGB).
1) In addition to the advantages of minimally invasive laparoscopic surgery, it also has the following advantages;
2)Great control of food intake and absorption, thus rapid weight loss;
3) Control of sweet intake by taking advantage of the dumping syndrome;
4) Although this surgery is considered a permanent one, it is reversible in case of emergency;
3. Disadvantages of laparoscopic gastric diversion (LRYGB).
1) The operation of this procedure is more complex and requires higher operating skills of the surgeon;
2) Because LRYGB surgery requires the diversion of the gastrointestinal tract, gastrointestinal transection, and the need to complete multiple anastomoses, the operation is complicated, the risk is relatively high, and the complication rate is higher than the other two types of weight loss surgery;
3) The length of hospital stay is relatively long;
4) In general, the operation is irreversible and the length of the bypassed intestine needs to be judged by experience. ;
4. Indications for laparoscopic gastric diversion surgery (LRYGB)
In addition to the indications for surgery listed in the second article above, because LRYGB surgery is a combined restrictive and malabsorptive surgery, it is particularly suitable for patients with a large body mass index, especially for obese patients with concomitant 2-line diabetes mellitus, with remarkable efficacy.
5.Procedure of laparoscopic gastric diversion surgery (LRYGB)
Laparoscopic gastric diversion (LRYGB) is performed by laparoscopically transecting the subcardia gastric body using a cutting closure and anastomosis, and placing the gastric sinus, duodenum and part of the jejunum, and anastomosing the small gastric sac (about 30 ml) with the distal jejunum, and performing a Y-shaped anastomosis of the proximal jejunum and ileum at a distance of about 1~1.5 meters from the anastomosis of the small gastric sac and distal jejunum.
6.The efficacy and advantages of laparoscopic gastric diversion (LRYGB)
LRYGB surgery integrates the principles of restricting food intake and selective fat absorption disorders, and is one of the best laparoscopic weight reduction procedures for weight loss. Patients can lose up to 95% of their overweight portion after surgery. It has remarkable efficacy in type 2 diabetes, with a cure rate of more than 85% and an effective rate of more than 95%.
7. Risks associated with laparoscopic gastric diversion (LRYGB)
Laparoscopic gastric bypass (LRYGB) has been performed since 1994, and its feasibility and safety have been greatly improved after more than 10 years of development. However, this procedure is more difficult, complicated to perform, requires more skill and experience, and the surgery alters the normal anatomical relationships, with more postoperative complications compared to the other two types of weight loss. In addition to the possible risks associated with general gastrointestinal surgery, such as anesthesia, there are.
1) bleeding, gastric leakage and stricture
Since laparoscopic gastric diversion (LRYGB) transects the fundus of the stomach by using a cutting closure, and this cutting suture is completed by a U-shaped titanium staple, it may lead to complications such as bleeding from the cut edge, leakage and stricture (due to removal of too much gastric body, etc.) leading to reoperation for salvage;
2) Infection, adjacent organ damage, etc.
Gastrointestinal surgery is not an absolutely sterile surgery, so there is a possibility of infection in both the abdominal cavity and the surgical incision; in addition, due to factors such as extreme obesity and anatomical variation of the patient, surgical risks such as hemorrhage due to adjacent organ damage and vascular injury can occur. The risks of injury and bleeding that may occur during the perioperative period of the relevant gastrectomy surgery will be communicated separately in the preoperative period; the occurrence of these complications will require anti-infection and reoperation to stop the bleeding and repair the damaged organ, among other treatment efforts.
3) Intestinal obstruction
Since the small intestine needs to be cut and closed and anastomosed, it may lead to intestinal obstruction caused by factors such as anastomotic stricture and intestinal adhesions, which may require reoperation to correct in individual cases.
8. Possible side effects of laparoscopic gastric diversion (LRYGB) and main recommendations
1) Vitamins
The volume of the small gastric sac established by LRYGB surgery is only about 30ml, which not only restricts food intake, but also the distal segment of the jejunum or ileum anastomoses with the small gastric sac, making food bypass the large part of the stomach, duodenum and large part of the jejunum thus reducing the body’s absorption of the vast majority of calories and nutrients, and can lead to vitamin and trace element deficiencies, therefore, vitamin supplementation is essential.
2 Pregnancy
Since LRYGB surgery is a non-recoverable procedure, we do not recommend this procedure for young women who have not had children.
9. Questions about medical costs
Due to the relatively long hospital stay, LRYGB surgery is expected to cost around RMB 70,000-80,000 before and after the surgery, including laparoscopic use of a cutting closure device and staple gate, surgery, anesthesia, instrumentation, medication, various examinations, treatment and hospitalization fees, etc.
V. About laparoscopic gastric diversion surgery (LRYGB) for type 2 diabetes mellitus
(I) Data about diabetes mellitus
According to the IDF (International Diabetes Federation), more than 300 million people are currently affected by the disease worldwide, and the expenditure in this area was at least US$376 billion in 2010, accounting for 11.6% of the world’s total health care expenditure. Another 344 million people are at risk of developing the most common form of diabetes, type 2. If nothing is done to stop the spread of diabetes, the IDF projects that by 2030, 438 million people worldwide will have diabetes and the cost of treatment will exceed $490 billion. China currently has 92.4 million people with diabetes, the highest number in the world, and more than 90 percent of those with diabetes are type 2. However, such a large group of patients has been forced to rely on a single medical treatment, which requires lifelong medication and insulin control, not to mention the huge medical expenses in exchange for the result that the disease is incurable, and the disease has thus become a chronic disease that is difficult to cure.
(B) Possible mechanism of surgical treatment for type 2 diabetes
In the 1980s, doctors discovered that gastric diversion weight reduction surgery could treat type 2 diabetes. The possible mechanism is that before surgery, the upper digestive tract of diabetic patients is stimulated by food to produce “insulin resistance factor”, which makes the body insulin resistant (this is also the main cause of type 2 diabetes). After surgical modification of the digestive tract, nutrients avoid the upper digestive tract with “resistance factor” and enter the middle digestive tract with insulin-producing function, thus reducing the release of “insulin resistance factor” and other substances, resulting in the reduction or disappearance of insulin resistance in type 2 diabetes. The insulin resistance of type 2 diabetes is reduced or disappeared. To prevent excessive weight loss after surgery, patients with a body mass index (BMI) = weight (kg)/height (m) squared of 28 or less should not undergo this procedure.
(C) Indications for gastric diversion surgery for type 2 diabetes mellitus
1.BMI≥35 in T2DM Asian population with or without comorbidities
2.Asian population with BMI 30~35 and T2DM, when it is difficult to control blood glucose or comorbidities by lifestyle and medication, especially when there are cardiovascular risk factors
3.Asian population with BMI 28-29.9, if they have combined T2DM and centripetal obesity (waist circumference >85cm for women and >90cm for men) and meet at least two additional criteria for metabolic syndrome: high triglycerides, low HDL cholesterol levels, and high blood pressure
4, for BMI ≥ 40 or ≥ 35 with severe comorbidities; and age ≥ 15 years, skeletal maturity, according to the Tanner developmental classification in 4 or 5 adolescents
5, BMI 25 ~ 27.9 T2DM patients, in the case of informed consent of the patient surgery, ethics committee prior approval, should not be widely promoted
6, T2DM patients aged <60 years or in good general health and with low surgical risk
(IV) Surgical treatment of diabetes mellitus
Theoretically, it is believed that various surgeries for the treatment of obesity have therapeutic effects on type 2 diabetes. Studies have shown that the complete remission rates of LAGB, LSG and LRYGB surgeries for the treatment of type 2 diabetes are about 60%, 70% and 90%, respectively. The efficacy is closely related to the patient’s age, disease duration and obesity, and is generally considered to be better in patients who are young, have a disease duration of less than 5 years, and have a BMI greater than 35.
The use of LRYGB surgery has become an internationally advanced and widely accepted procedure for the treatment of type 2 diabetes. In Europe and the United States, approximately tens of thousands of obese and diabetic patients are treated with RYGB each year. The American Diabetes Association proposed in 2009 that “gastric diversion surgery is an important treatment for diabetes”. The Chinese Medical Association’s Diabetes Division and the Endocrine Surgery Group of the Chinese Society of Surgery also recommended surgery as a definitive means of diabetes treatment in 2011, and all three procedures have certain efficacy, with gastric diversion surgery being the best. And laparoscopic gastric diversion surgery has the advantage of less trauma and faster recovery.
(E) Advantages of gastric diversion surgery for type 2 diabetes
1.Patients with overweight can get weight reduction effect;
2.Cure diabetes and restore normal blood sugar;
3.Avoid patients taking medication for life;
4.The relative cost is relatively low, which can reduce the burden of patients;
5.Patients can resume normal diet;
6.The complications caused by diabetes can be recovered;
7. The associated diseases such as hypertension, hyperlipidemia and fatty liver can be treated.