La Manga Gástrica consiste en seccionar un 66% del estómago disminuyendo la capacidad del mismo.Al recortar dos tercios del estómago, el paciente tendrá la misma sensación de saciedad, con poco alimento. Este procedimiento es ideal para pacientes muy obesos que tal vez no resistirían una cirugía muy prolongada. Compite con la banda gástrica por ser restrictivo puro pero sin cuerpos extraños, sin calibraciones y sin tanto control por parte del cirujano. Usualmente, se realiza utilizando engrapadoras lineales y que disparan tres líneas de grapas a cada lado garantizando un sello impermeable.
Las ventajas reales de este procedimiento son varias: es un procedimiento que se realiza por laparoscopia, no se altera en nada la fisiología del estómago y es un procedimiento que se puede realizar tanto en pacientes con IMC elevados (mayor de 35) como en pacientes con IMC menores por ejemplo de 30 - 35.Las ventajas sobre cualquier otra cirugía es que el paciente come poco, sin atragantarse, ya que no hay anastomosis (uniones), están solamente los esfínteres naturales. No requiere desconectar y volver a conectar los intestinos. Es una operación técnicamente más simple que el By pass gástrico. Se reduce el volumen del estómago, pero puede ser consumido normalmente todo tipo de alimentos en cantidades pequeñas. Disminuye en forma considerable la Grelina que estimula el hambre. No se presenta síndrome de vaciamiento rápido porque se preserva el píloro. Reduce al mínimo la presentación de una úlcera. Se puede hacer laparoscopicamente en pacientes que pesan más de 250 Kg.De cualquier forma debemos recordar que no hay cirugía para adelgazar capaz de tener resultados perdurables si las personas no cambian sus hábitos alimentarios y hacen ejercicio.
Gastric Sleeve consists in a section of 66% of the stomach decreasing the capacity of it. Without two thirds of the stomach, the patient will have the same full sensation with less food. This procedure is perfect for very overweight patients that maybe don’t resist a very long surgery (High surgical risk). This technique competes with the gastric band because is restrictive but without strange bodies, band adjustments and with not too much control by the doctor and the nutritionist. Usually is performed with lineal staplers and shoot 3 lines of staples in every shot guaranteed that the surface has an impermeable seal. In this surgical technique We always perform continuous lineal stitches outside of the stomach staple line with surgical suture given an additional security for this procedure.
The real advantages of this surgery is that is performed by laparoscopy and the stomach does not be altered in the functionality. This procedure can be realized in patients with body mass index above 35 as in patients with less BMI (30 35). The advantages over any other surgery are that the patient eat less and do not exists surgical unions between the stomach and the small bowel and get the satisfaction with less food quantities, it has natural sphincters. In few words the sleeve gastrectomy is easier than Gastric By Pass, but with same results in losing weight usually until 130 pounds. The stomach’s volume is reduced, but the patient can eat all types of food in small portions. It decreases the Grelin that stimulates the meal sensation and a post-surgery characteristic consequence is that you will not feel a big hunger sensation anymore. It doesn’t present the fast empty syndrome, because the stomach has the pyloric sphincter. This procedure is recommended for patients with high surgical risk and can be realized in people with an overweight of more than 250 kilograms (550 pounds) with a less surgical risk compared with the gastric by pass or the biliopancreatic diversion .However, we must remember that if we want to loose weight as we expect with excellent results, we need to change our food habits and do some exercise.
