• Heart disease
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Type 2 diabetes
• Stroke
• Infertility

Sleeve gastrectomy is done only after a person tried to lose weight by improving diet and exercise habits but fails to do so.

In general, sleeve gastrectomy surgery could be performing:

• If body mass index (BMI) is 40 or higher than 40.
• If BMI is 35 to 39.9 (obesity), and if a person has a serious weight-related health problem, like type 2 diabetes, high blood pressure or severe sleep apnea.

A person must be willing to make changes to live a healthier lifestyle which includes long-term follow-up plans, monitoring nutrition, your lifestyle and behavior, and your medical conditions. And any major surgery like sleeve gastrectomy poses potential health risks and both in the short term and long term.

Risks associated with the sleeve gastrectomy can include:

• Excessive bleeding
• Infection
• Adverse reactions to anesthesia
• Blood clots
• Lung or breathing problems
• Leaks from the stomach

Long term risks of gastrectomy surgery can include:

• Gastrointestinal obstruction
• Hernias
• Gastroesophageal reflux
• Low blood sugar (hypoglycemia)
• Malnutrition
• Vomiting

Sleeve gastrectomy can provide long-term weight loss. The amount of weight you lose depends on your change in lifestyle habits. This is possible to lose weight around 60 percent and even more which excess weight at least in two years.

To weight loss sleeve gastrectomy helps to improve conditions related to being overweight, including:

• Heart disease
• High blood pressure
• High cholesterol
• Obstructive sleep apnea
• Type 2 diabetes
• Stroke
• Infertility

Sleeve gastrectomy surgery helps to improve ability to perform daily activities and can help a person to improve his/her quality of life.

Mini-Gastric Bypass

The Mini-Gastric Bypass is also known as single anastomosis gastric bypass is an effective procedure which has properties of a gastric sleeve and a standard gastric bypass. The upper part of the stomach is divided into a tube, similar to the top three quarters of a sleeve and then joined to a loop of intestine.

The mini-gastric bypass is also used as a primary weight loss procedure. It is not ideally suited to patients with symptoms of reflux disease (severe heartburn that needs medication).

In this operation the top of the stomach is stapled to form a thin tube (30ml to 50ml in size). The thin tube becomes the new, smaller stomach and is completely separate to the rest of the stomach. This stomach is then sewn to a loop of the small intestine, bypassing the first part of the intestine called the duodenum and approximately 150–200cm of the bowel. The rest of the stomach and upper part of the small intestine remains in the body but is no longer used for food digestion.

The mini bypass procedure can help to lose weight in many different ways:

• By reducing the feeling of having food through brain signaling
• By enabling the feeling of fullness when eating a meal and resulting in a healthy portion size
• Decreasing the amount of calories which a person absorbs from the food as a result of bypassing 150 to 200cm of the upper part of the small intestine

Rerouting of the food stream make changes in gut hormones which help in reversing one of the primary mechanisms by which obesity-induced type 2 diabetes occurs.

Long-term effects of the Mini-Gastric Bypass

Weight loss with mini-gastric bypass is as good, if not better, than that achieved with standard gastric bypass surgery in people with a higher BMI.

Many diseases connected to being overweight like sleep apnoea, type 2 diabetes, joint diseases, high blood pressure or polycystic ovary syndrome (PCOS) improve or disappear as a result of the surgery.

Complications after Mini-Gastric Bypass surgery

Any surgical procedure which include the mini-gastric bypass operation has a risk profile which is important to understand before proceeding. The following is a comprehensive list of issues which can occur. Most of these complications are very rare and 90–95% of patients have no issues. This list is extensive and is not intended to worry you, but simply inform you about the range of possible complications, regardless of how rare the issue may be.

Possible early complications:

Serious complications are those requiring emergency reoperation or any other intervention like endoscopy, transfusion of blood or blood components or mandating stay in the hospital for more than 7 days.

In our practice the most likely early complication has been postoperative bleeding (1% of patients). Usually the bleeding stops itself and isn’t so great that the blood transfusion is needed.

Other early complications (occurrence 0.5%) may be: peritonitis; thrombus of deep veins and lung artery; myocardial infarction; pneumonia; abdominal abscess; wound infections; hernias at the surgical site, ulcers.

Late complications & side effects after the mini gastric bypass performed

• Internal hernia – Risk of internal hernia is lower after mini-bypass (1:500) than after standard gastric bypass (2:100). The loops of bowel in the abdomen can become entangled and get stuck. If this occurs, a reoperation is required to fix the problem.
• Adhesions – Any procedure of the abdomen may result in adhesions (scar tissue). This can occur any time after the operation and can sometimes cause problems with the bowel getting stuck or twisted. This may require hospitalization and may even require re-operation.
• Gastro-esophageal reflux – If reflux occurs after the surgery some patients may require medication. This operation should be avoided for those people with severe symptoms of reflux prior to surgery.
• Dumping syndrome – Dumping syndrome is a group of signs and symptoms which occurs due to poor food choices. It is the result of high sugar foods passing too quickly into the small intestine. Symptoms can include cramping, nausea, dizziness, weakness and fatigue. Dietary advice to avoid dumping is provided by the clinic’s dietician.
• Malabsorption of vitamins and minerals – Low levels of iron, B12 vitamin and other micronutrients can occur even if recommendations for supplementation are followed.