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Sleeve Plus surgery method for bariatric surgery, Dr. Sathirapong Chantawiboon, a surgeon who specializes in laparoscopic surgery and weight loss surgery Obesity Clinic Rajavithi Hospital



What is obesity?Obesity is a condition in which the body has an abnormally large amount of fat accumulated. This will cause various problems such as diabetes, high blood pressure. Fatty liver disease Sleep apnea Coronary artery disease or cerebrovascular disease GERD osteoarthritis of the spine or knees, etc. It also increases the risk of breast cancer. Colon cancer as well
Drug treatment Exercise or eating a low-calorie diet Can lose weight But it is not possible to maintain or maintain weight for the patient all the time. Patients often gain weight back. Therefore, surgical treatment was performed. This can reduce more weight and can maintain weight for a longer period of 7-10 years or more. In patients with a low body mass index, weight loss can be considered by controlling diet and exercising.
However, if the patient has a very high body mass index, there are often limitations in exercising due to obesity-related congenital disease. Moreover, exercise and diet alone often cannot reduce weight enough to cure obesity-related medical conditions such as diabetes and high blood pressure. Sleep apnea Osteoarthritis Hypercholesterolemia Fatty liver disease, etc.


What is obesity surgery?
Gastric surgery to reduce the size of the stomach together with reducing absorption in the stomach or small intestine In addition, hunger hormones produced in the stomach will decrease after surgery, causing appetite to decrease after surgery as well.
The purpose of surgery is to treat obesity and treat co-morbidities that come with obesity, such as diabetes and high blood pressure. Fatty liver disease Sleep apnea disease, etc., makes the patient healthy after surgery. Be strong and live a normal life


Who is bariatric surgery suitable for?
Gastric bypass surgery for weight loss is not suitable for all overweight people. Before surgery, the doctor will give the patient detailed information. Physically check for readiness and screen appropriate patients. which has the following indications


Those who have lost weight through other methods but have not been successful 1. Body mass index (BMI) > 27.5 kg/m2 along with uncontrolled obesity-related illnesses. 2. Body mass index (BMI) > 32.5 kg/m2 along with obesity-related diseases such as diabetes, high blood pressure, high blood fat, sleep apnea, fatty liver, etc. 3.Body mass index (BMI) > 37.5 kg/m2


A new surgical treatment for obesity, Sleeve Plus (Sleeve Gastrectomy Plus Proximal Jejunal Bypass). Traditional surgery still has some areas that need to be developed. Therefore, a new surgical method was developed to achieve better results. Gastric bypass surgery
Sleeve Plus (Laparoscopic Sleeve Gastrectomy with Proximal Jejunostomy Bypass) is a new surgical technique. It has been made since 2010 and has become more and more popular due to its good weight loss results. It treats diabetes well and the risk of surgery is low.It is a laparoscopic surgery that combines a sleeve gastrectomy with a passage from the duodenum to the middle intestine to reduce absorption and stimulate satiety hormones (GLP-1, PYY) faster. Makes the patient feel full faster. Together with a smaller stomach size, the level of the hunger hormone (Ghrelin) will also decrease.In addition, the food connection between the duodenum and middle intestine is made. It is also easier to do and there is no risk of wounds at the junction, which is different from bypass surgery where there are wounds at the junction of the stomach and small intestine.


As for the results in weight loss and diabetes treatment, it was found that It's no different from bypass surgery, with less risk of complications and a better risk of vitamin and nutrient deficiency than bypass surgery. Good weight loss with less excess weight. 70-80%

It can also be considered for patients who have had previous sleeve surgery. But there may still be unsatisfactory results, such as less than 50% of excess weight lost or in cases where weight regain is found after sleeve surgery. Or in cases where diabetes has not yet disappeared, additional Sleeve Plus surgery can be considered.

From the current information of Dr. Sathiraphong Chantawiboon, a surgeon who performs advanced laparoscopic surgery and bariatric surgery, found that in more than 50 cases of surgery patients were able to lose weight very well and treat diabetes well without being found. Any complications after surgery, which are compared with foreign medical report data since 2010

It was found that the treatment results were satisfactory as well and no severe complications were not found. In summary, obesity is treated with Sleeve Gastrectomy Plus Proximal Jejunal Bypass surgery.


It is a new option for treating obesity, suitable for patients who are overweight and have diabetes. It is recommended to consult a specialized surgeon. This is because it is still a new technique that requires surgical expertise and selection of treatment methods to suit each patient. If interested, follow more information on the Facebook page. Obesity can be operated by Dr. Fong

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