减肥手术

 

胃旁路术的优点包括:

• 平均减重是体重的60%到80%.
• Average weight loss is greater than the average achieved by two other weight-loss procedures, 袖式胃切除术和胃束手术.
• Studies show gastric bypass surgery alters the metabolism of carbohydrates and increases insulin sensitivity, 通常不需要糖尿病药物.
• 与肥胖有关的疾病，如胃酸反流, 高胆固醇, 高血压和睡眠呼吸暂停——手术后会改善甚至消失.

胃旁路术的缺点包括:

• 维生素B12, 铁, calcium and folate are less well absorbed because the duodenum (the first part of the small intestine) is bypassed. 预防贫血, 骨病和其他与营养缺乏有关的问题, 病人必须每天服用多种维生素.
• A condition known as "dumping syndrome" can occur after eating too quickly or after eating foods high in refined sugars, 碳水化合物或脂肪. 症状包括恶心、出汗、头晕、脸红和心率加快.
• The bypassed portions of the stomach and small intestine can't be easily visualized using X-ray or endoscopy. 如果患者在这些部位出现溃疡、出血或癌症，这可能是一个问题.
• 而并发症发生率低, complications are about twice as common in gastric bypass surgery as in sleeve gastrectomy, 这就没那么复杂了.

袖胃切除术

这种手术，通常被称为“袖”，只涉及胃. 一个小的袖子，或狭窄的袋，是用外科订书机创建的. After the sleeve is created, the rest of the stomach – about two-thirds of the stomach – is removed. 袖子会让人很快产生饱腹感，降低食欲. 一次只能有少量的食物通过套管. 这个过程还会引发肠道激素的变化，从而减少饥饿感, 增加饱腹感，更好地控制血糖.

袖式胃切除术的优点包括:

• 没有异物植入.
• 没有肠道改道.
• Average weight loss is greater than with gastric band but may be slightly less than with gastric bypass.

袖式胃切除术的缺点包括:

• 这个过程是不可逆转的.
• 关于袖式胃切除术的长期数据较少.
• 胃的主要部分有渗漏的危险.
• 大约30%的患者在手术后出现新的或更严重的胃灼热. 虽然大多数病例可以通过药物治疗来解决, 一些症状严重的患者可能需要额外的手术.

除带捆绑

腰带, 也叫可调节胃束带, is an inflatable band placed around the stomach to limit how much food can be eaten at one time. 患者可能会在膝束带置入后出现并发症, 包括带滑, 哪些会引起疼痛和恶心, 或者带蚀, 会损害胃组织.

因为并发症发生率高, 加州大学旧金山分校减肥手术中心不提供臀带插入术. 我们也会为出现腱带滑脱和腱带侵蚀的患者进行膝腱带移除手术, 还有不宽容, 感染或其他并发症. 除带捆绑 involves cutting and extracting the band and any surrounding scar tissue, 以及移除用于给腕带充气的接入端口.

去除膝带的优点包括:

• 它可以逆转大多数并发症，消除胃束带引起的副作用.
• 与切除手术相关的其他并发症的风险很低.
• 患者可以选择另一种减肥方法, 哪些可以在某些情况下同时执行.

去除膝带的缺点包括:

• 一旦食物摄入不再受到身体上的限制，病人可能会体重增加.
• Cases where the lap band damaged stomach tissue may require several months of recovery before another weight-loss procedure can be performed.

减肥手术

胃旁路和袖式胃切除术成功率高, 但在某些情况下, 需要进行第二次手术. Some patients experience undesirable side effects, such as severe heartburn or trouble swallowing. 其他人则面临医疗并发症, 包括一个伸展的胃袋, 不能愈合的溃疡或手术钉有问题. 矫正手术可能包括缩小眼袋的大小, 再造胃套, 或者把套管变成胃旁路.

我们通常可以使用微创技术进行这些修复, 减轻早期手术引起的不适或并发症的. 然而, some revisions are more complex than an initial procedure and may therefore carry a higher risk of infection or additional complications.

For patients who have experienced inadequate weight loss or weight regain after bariatric surgery, we recommend following a medically supervised weight-loss program for six months before considering a second surgery.

微创手术

在加州大学旧金山分校减肥手术中心, 我们使用腹腔镜手术, 微创入路, 超过90%的手术都是如此. Traditional "open" bariatric surgery requires the surgeon to make one long incision into the abdomen. 在腹腔镜手术中, the surgeon instead inserts a tiny camera and slender surgical instruments though several small incisions.

在某些情况下, 我们的外科十大赌博平台排行榜使用机器人辅助腹腔镜手术, 在高度复杂或精细的程序中，哪一种可以提高精度和控制. 了解更多有关 UCSF机器人手术项目.

The American Society for Metabolic and 减肥手术 recommends that laparoscopic weight-loss surgery be performed only by surgeons experienced in both laparoscopic and open bariatric procedures. 在加州大学旧金山分校减肥手术中心, our experts are trained in both traditional bariatric techniques and the advanced techniques of laparoscopy.

Studies show that laparoscopic weight-loss procedures have several benefits for patients when compared to open surgery, 包括:

• 术后疼痛减轻
• 减少伤口并发症，如感染或疝气
• 更快的恢复和恢复正常的活动

内镜手术

我们使用另一种微创方法, 称为上内窥镜检查, 为了解决某些减肥手术并发症和执行修正程序. In an upper endoscopy, we pass a small camera attached to a long, flexible tube into the throat. 这样我们就可以在不开切口的情况下检查胃. Medications and medical devices can also be inserted into the intestinal tract using this method. 了解更多关于 内镜下减肥选择.