Gastric Resection for Morbid Obesity - Forum

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Kardashian surgeon

Gastric Resection for Morbid Obesity - Ärzteforum

Post#1 »

Recently a colleague of mine suggested that 75 - 80% gastrectomy has been used recently for morbidly obese patients to effect weight loss. Reason given for doing this over anterior gastric bypass is that the defunctionalized distal gastric pouch is "unreachable" (i.e. it can't be observed either endoscopically or radiographically). I understand that this operation would be a very effective operation for weight loss purposes, but question the necessity or advisability of a "subtotal" gastrectomy. Does anybody have any opinions or experience with this?


Re: Gastric Resection for Morbid Obesity - Ärzteforum

Post#2 »

I do not know about subtotal gastrectomy for morbid obesity but I know that the Scopinaro proceudre for morbid obsity includes partial gastrectomy + Roux en Y reconstruction with the entro-entro anastomosis low down - excluding a large segment of small bowel. Patients certainly lose weight and occasionaly their lives.

According the same line I suggest to the readers that total colectomy should be performed routinely on each patient with any colonic polyp to obviate the need for further colonoscopic follow-up or...

Such approach reminds me of a wise old surgeon who used to say: "Gee, man, after X finishes the operation the specimen in the bucket is heavier than the patient"


Re: Gastric Resection for Morbid Obesity - Ärzteforum

Post#3 »

I have not seen this done for morbid obesity. In my hospital there is a group with considerable experience in bariatric surgery (over 1000 cases) they have stopped doing anterio gastric bypasses because they had a few patients with ulcers and even cancer of the distal stomach and duodenum. They are now doing either SRVG or VBG. Both of these are effective in weight reduction, and a pediatric scope can be introduced into the stomach for visualization.

I would caution, however, that these operations are associated with significant morbidity and mortality. and that, IMHO, should be reserved to those few patients with life threatening complications of obesity, such as sleep apnea, pickwikian syndrome or uncontrollable hypertension or diabetes.

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A Doctor

Re: Gastric Resection for Morbid Obesity - Ärzteforum

Post#4 »

I would be surprised if you could rely gastrectomy alone for weight loss; the stomach has little to do with absorption of nutrients. Of course the combination of partial gastrectomy with biliary diversion (Scopinero procedure) is well-known and effective.


Re: Gastric Resection for Morbid Obesity - Ärzteforum

Post#5 »

I do a gastric bypass for weight loss. I agree that the excluded stomach is unreachable but one should also not underestimate the technical difficulty of doing a gastric resection in the morbidly obese. With a 380 pounder, I have all I can handle with the gastric division and intestinal bypass. And of course, once you take it out, there's no chance of reversing the operation. I think the chance of gastric cancer is quite low.

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