Plastic Aesthetic Weight Loss Surgery

There are many techniques of surgery, and so many variations. The most common are described in the chapter “surgery” on this site. At a recent congress (American Society of Surgery Bariatrique ASBS, 5-9 June 2001, Washington), surgeons and specialists in nutrition have been able to review the various possibilities in this field continuous expansion. The main finding - it is hardly surprising - is the persistence of a large variety of techniques. Despite the emergence of new, habits peculiar to certain countries remain in effect or almost intangible. However, this is an area rapidly changing, and who has not finished evolving!
We can classify these different technical operations restrictive malabsorbtives and mixed according to their mechanism of action. Here is a summary of the main of them in 2001. It is noteworthy that all these interventions can be performed by coelioscopie, with varying degrees of technical difficulties depending on their complexity.

 The restrictive operations :

They are based on the principle of a severe limitation on the ability to ingest solid foods, through a gastric pouch the smallest possible (a few ml, 15 to 20 most often). You can to some extent to assimilate technology poses an intra-gastric balloon (see chapter), which is not strictly speaking an operation, but also aims to create a satiety (however temporarily).

A. The gastroplasties with adjustable rings:
They are detailed in the chapter on the surgical technique. Whatever the model ring, the procedures are very similar (only two models, marketed by companies Bioenterics and Obtech (diagrams No. 1 and 2), have been studied and publications since 1994, d ‘ Other models are being evaluated).
Their very popular today (especially in Europe) is mainly due to their feasibility almost constant coelioscopie.
We only mention the rings or non-adjustable gastric bands, operations and highly criticized only practised in some centres (USA, Czech Republic, Israel).

                     Figure 1                                                                                              Figure 2 
  

B. The gastroplasties Mason and relatives:
From the name of the surgeon promoter (Edward Mason) they are based on the principle of stapling the stomach, which creates a “gastric compartment” close s’évacuant by a small channel of about 9 mm in diameter. Past the adjustable rings, such gastroplasty remains a reference to “historic” and is still widely practised despite the rise of short-circuits gastric the USA and the flexible ring in Europe. Many alternatives have been described, which we will mention just three:

– Mason “standard” (Diagram No. 3): it involves the creation of a “window” into the stomach through an automatic clip, then the partition gastric staples (several rows) to create a 15 cc pocket, then the calibration of channel evacuation by a strip of cloth prosthetic.

– Mason “simplified” (Diagram No. 4), or silastic ring vertical gastroplasty (technical Eckout): by using a special stapling tongs, fitted with a notch, the initial gastric perforation is unnecessary. The grading is performed by a plastic ring from 4.5 cm to 5 cm in diameter.

– Mason with cross-section, or technical Mac Lean (Diagram No. 5): it avoids the very frequent failure by désagrafage of gastroplasties because the stomach is sectioned frankly here.

                    Figure 3                             Figure 4                                    Figure 5