LAPAROSCOPIC SLEEVE GASTRECTOMY

1. APASICON 2010 VIJAYAWADA LAPAROSCOPICSLEEVE GASTRECTOMY Dr. G. SURESH CHANDRA HARI M.S FICS FAIS FMAS SIGMA HOSPITALS-SECUNDERABAD

17. Dr.Wlifred Mui Hongkong

18. Dr.Wlifred Mui Hongkong

21. Safe Major weight loss Easily performed Short operation times Short hospital stay Minimal blood loss Easily reversed Short recovery time Low risk of ulcer Few adhesion or hernia Lasting weight loss Low failure rate Minimal pain Rapid return to work Desirable Feature Of An “ideal” Weight Loss Operation

22. SLEEVE - INDICATIONS

23. Cont’d

24. RISKS • STAPLING SITE LEAKS – SEPSIS • BLEEDING • GASTRIC ISCHEMIA • PROLONGED VOMITINGS • PORT SITE INFECTION • PORT SITE HERNIA • GALL STONE FORMATION • THROMBOEMBOLISM • VITAMIN DEFICIENCIES

25. Obesity Surgery 2005;15:1469-1475Results of Laparoscopic Sleeve Gastrectomy (LSG) at 1 Year in Morbidly Obese Korean PatientsSang Moon Han, MD,et al.

26. SLEEVE GASTRECTOMY • BENEFITS: • Low rate of complications, • Avoidance of foreign material, • Maintenance of normal gastro-intestinal continuity, • Absence of malabsorption and the ability to convert to multiple other operations • Ghrelin Factor Sleeve gastrectomy for morbid obesity. Obes Surg. 2007 July17(7):962-9.

27. O R ROOM SETUP

28. PORTS POSITION

29. INSTRUMENTS

31. SLEEVE GASTRECTOMY

33. SLEEVE GASTRECTOMY - STEPS • MOBILISATION • INITIAL STAPLING • CALIBRATION • FINAL STAPLING • HEMOSTASIS • LEAK TEST • RETREIVAL

34. STEP I - MOBILISATION

35. STEP II –INITIAL STAPLING

36. STEP III - CALIBRATION

37. STEP IV – FINAL STAPLING

38. STEP V – INSPECT STAPLE SITE

39. STEP V –SPEC EXTRACTION

40. STEP VI – DYE TESTING

41. P.O.DIET • DAY 1 - NBM • DAY 2 – LIQUIDS ONLY • DAY 3 – 3 WKS – SOFT DIET • 3 WKS - NORMAL DIET • HIGH PROTEIN • LOW CARBOHYDRATES • NO FAT DIET

42. Kob Khun Kap Xie xie ni Ramba Nandri Salamat Po Terima kasih Shukran Dank U wel Merci beaucoup Thanks a million Gracias Arigato Gozaimasu DHANYAVAD