Dr. Kuo-Feng Hsu, Director of the Bariatric and Metabolic Surgery & Weight Management Center
Sleeve Gastrectomy (SG)
Also known as "gastric sleeve surgery" or "gastric sleeve resection," sleeve gastrectomy involves the removal of a portion of the stomach along the greater curvature, leaving behind a long, tube-like structure resembling a sleeve. This procedure significantly reduces the stomach's volume, thereby limiting the amount of food the patient can consume. Additionally, the cells in the removed portion of the stomach, which secrete hunger-stimulating hormones, are also eliminated, leading to a decrease in appetite post-surgery, which helps with weight loss. Furthermore, the surgery alters the motility of the gastrointestinal tract and the secretion of hormones. Recent studies have shown that sleeve gastrectomy can also be effective in controlling diabetes. However, further evidence is still needed to confirm its long-term effects, particularly in cases of severe diabetes.
Sleeve Gastrectomy with Bypass Surgery (Sleeve Plus, SG+)
As the name suggests, this procedure combines sleeve gastrectomy with intestinal bypass surgery, aiming to enhance weight loss and improve the treatment of diabetes. Various surgical techniques fall under this category, including sleeve gastrectomy with duodenal switch (BPD/DS, SADI-S, DJB-SG), sleeve gastrectomy with jejunal bypass/long limb (SGJB), and sleeve gastrectomy with intestinal bypass/bilateral bypass (SG+TB, SASI/SASJ), among others. The application of these combined procedures in both weight loss and diabetes management has been steadily increasing, with promising results.
Gastric Bypass Surgery (RYGB & OAGB-MGB)
Long considered one of the main procedures in bariatric metabolic surgery, gastric bypass surgery includes both the Roux-en-Y gastric bypass (RYGB) and the one-anastomosis gastric bypass, also known as mini-gastric bypass (OAGB-MGB). The procedure consists of two main parts: First, the stomach is divided into a small pouch (about 50 cc) and the remaining larger part. Only the small pouch receives food, thereby restricting the patient's food intake (even a small amount will make the patient feel full). Second, a bypass is created, where 200-300 cm of the small intestine is excluded from the digestive process, reducing nutrient absorption. This surgery has both a restrictive and malabsorptive effect, offering excellent long-term results in weight loss and diabetes management.
As with any surgery, the outcomes and prognosis for each patient may vary, and further consultation with the surgical team is required.
TSGH's bariatric and metabolic surgery techniques include the procedures mentioned above. However, each procedure has its own set of advantages and disadvantages, and obese patients should consult with a bariatric surgery specialist to choose the most suitable surgery for their needs.