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gastric bypass, sleeve gastrectomy… What are the surgical techniques?

This Saturday, November 16, 2024 in “It’s Going Much Better” on RTL, Dr Samy Chaibi, digestive surgeon and head of the visceral surgery department at hospital, detailed the different surgical techniques available to treat obesity. These interventions, although potentially life-saving, are not without risks and require rigorous evaluation.

Sleeve gastrectomy, or sleeve gastrectomy, is one of the most common procedures. “The principle is to cut the stomach longitudinally to make a tube,” explains Dr Chaibi. This operation reduces the volume of the stomach from 2-3 liters to approximately 150 milliliters, thereby decreasing the amount of food consumed. Additionally, it eliminates the part of the stomach that produces the hunger hormone, thereby reducing appetite.

Gastric bypass is another popular technique. “It’s a short circuit,” describes Dr. Chaibi. This procedure creates a small stomach pouch and redirects the food bolus so that it is less absorbed by the intestine. Although this method is effective, it requires lifelong vitamin supplementation, unlike the sleeve.

Operations accessible to all?

Bariatric surgeries are not for everyone. “We are targeting patients with very high body mass indices,” explains Dr Chaibi. Patients must have a BMI greater than 40, or greater than 35 with comorbidities such as diabetes. A multidisciplinary care pathway of at least six months is also required to assess eligibility.

Furthermore, the surgeon emphasizes the importance of understanding the associated risks. “There are 2% of serious hemorrhages requiring reoperation,” he warns. The risk of death is 0.1% in the event of a complication.

Additionally, careful monitoring is essential for long-term success. “The main risk factor for weight regain is loss of follow-up in post-operative patients,” underlines Dr Chaibi. Regular dietary and medical monitoring is crucial to avoid failures, which can occur in 20 to 30% of cases after 5 years.

Obesity surgery therefore offers several effective solutions for those who meet the strict eligibility criteria. However, it requires a long-term commitment to medical monitoring and lifestyle change. “The project must be matured in the patient’s mind.” to guarantee the success of the intervention, concludes the guest of the show.

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