Sleeve DJ Bypass
Sleeve Gastrectomy with DuodenoJejunal Bypass (SG-DJB)
What is it?
The Sleeve Gastrectomy with DuodenoJejunal Bypass is also a restrictive and malabsorptive procedure (like the Roux-en-Y Gastric Bypass and Mini Gastric Bypass) that not only reduces food intake, but also reduces the absorption of nutrients from the food. Absorption of nutrients is limited because a part of the upper small intestine is bypassed and not used for digestion.
Usually 4-5 small cuts of 0.5 – 1 cm are made on the abdomen. In the first step of a Sleeve + DJ Bypass, a Sleeve Gastrectomy is performed. The volume of the stomach sleeve is between 80-100 ml. The first part of the small intestine is then disconnected just below the stomach and the small intestine is then joint in continuity to this cut portion without disconnecting it.
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How does a Sleeve + D-J Bypass help me lose weight?
In a Sleeve + DJ Bypass, the amount of food you can eat in one sitting is reduced because of the small stomach capacity. Because of this, the brain utilises the fat stored in your body for its energy needs. This burns the excess fat in your body, thus helping you lose weight.
The malabsorptive effect because of the bypass of the small intestine in this weight loss surgery is very strong. It leads to markedly reduced absorption of fats from your intestine. This contributes greatly to the weight loss effect.
Also, in a Sleeve + DJ Bypass, the production of the hunger hormone Ghrelin is reduced, since the fundus of the stomach is excluded. Because of this, you do not feel hungry all the time, and are satisfied with the small amount of food you eat without feeling tired or weak.
Does a Sleeve + D-J Bypass help with my medical diseases like Diabetes?
Sleeve + DJ Bypass is associated very strongly with complete reversal of Type II Diabetes Mellitus in 90-95% of patients for 10-15 years. This means, that almost 95% of patients who were diabetic can STOP all medications (including insulin) for Diabetes after undergoing a Sleeve + DJ Bypass. This occurs due to beneficial effect of the bypass of the small intestine that causes major changes in the hormonal axis of the body for better control of blood sugar levels.
In addition, after a Sleeve + DJ Bypass, marked improvement is seen in many other medical problems which are caused due to obesity, such as hypertension, sleep apnea, Hypothyroidism, Osteoarthritis, PCOS, etc. (similar to those seen in other weight loss surgeries). A reduction in body weight is the key mechanism behind this improvement.
Who can undergo Sleeve + D-J Bypass?
Anybody with a BMI of > 37.5 kg/m2 or >32 kg/m2 with medical diseases can undergo a Sleeve + D-J Bypass. It is very beneficial in:
- Super obese (BMI > 50 kg/m2)
- Patients with Diabetes Mellitus, Hypertension and other obesity – related diseases
- Vegetarians
- Previously failed weight loss surgery.
In certain low BMI (27.5 – 32 kg/m2) patients with uncontrolled Type II Diabetes Mellitus, this surgery can be very benficial in reversal of Type II Diabetes Mellitus. However, these patients need to be carefully selected.
Are there any side effects of a Sleeve + DJ Bypass?
Rarely we may get a patient with nutritional deficiencies post Sleeve + D-J Bypass unlike the Roux-en-Y Gastric Bypass or Mini Bypass. All our patients are given regular multivitamin and multi mineral supplements soon after surgery. These supplements may have to be taken life long, since the malabsorptive effect of the weight loss surgery persists for life.
Can a Sleeve + DJ Bypass be reversed?
No, a Sleeve + DJ Bypass is not a fully reversible procedure. The small intestinal joint has to be disconnected and a new joint created between the small intestine and stomach without the bypass effect. This second surgery can again be performed by minimally invasive techniques (laparoscopically or robotically) to create a near normal architecture. It is a very complex surgery requiring a high degree of surgical skill and intensive post-operative care.
Quick Overview
- Pre Operative preparation
- Liquid diet (depending on your BMI)
- Pre Operative Tests
- Full body check-up
- Hospital stay
- 2-3 days
- Number of cuts (0.5-1 cm)
- 4-5 (Laparoscopy/ Robotics)
- Return to work
- In a week
- Expected Weight loss
- 70-80% of excess weight
