6 by an expert bariatric surgeon. Bowel movements frequency depends on food consumption and hence it is important to have adequate dietetic consultation. This technique is, however, complex, and surgical complications can be quite dramatic, especially in the initial postoperative period. Long-term side effects can be vitamin related deficiencies, (especially fat soluble vitamins A, D, K and E), if patients are non compliant with supplementation. Other deficiencies such as calcium and iron deficiency are detailed as part of the risk factors associated with a malabsorption procedure. To reduce these side effects, adequate education and preparation of the patients is mandatory before and after the surgery. These include promoting healthy eating habits, exercise and the prescription of nutritional supplements. How Bariatric Surgery Helps You To Lose Weight Bariatric surgery can be both a restrictive and/or malabsorptive weight loss procedure, which, if used correctly, will assist most patients in achieving their goal for weight loss and health improvements. How a Sleeve Gastrectomy helps you to lose weight A Laparoscopic Sleeve Gastrectomy (LSG) helps you lose weight in two main ways. • Change in anatomy: You’ll have a much smaller volume of stomach (its new volume is about 20% of your original stomach) which only allows you to eat small amounts of solid food • Change in physiology: Changing the gastrointestinal hormones will reduce your overall hunger, as well as increasing satiety after meal. These hormonal effects of surgery however, do become attenuated with time and hence the importance of making good food choices long term. How a gastric bypass helps you to lose weight The Laparoscopic Gastric Roux-en-Y Bypass (RYGB), One Anastomosis Gastric Bypass (OAGB) and Laparoscopic Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) will help you to lose weight in three main ways. Laparoscopic Single Anastomosis Duodenal-Ileal Bypass With Sleeve Gastrectomy Laparoscopic Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S) is one of the most powerful bariatric techniques to achieve weight loss. It is a good option for patients with severe obesity, either as primary surgery or as a revisional procedure after weight regain from a sleeve gastrectomy. SADI-S is a laparoscopic procedure that can be performed with or without a robotic assistant. It consists of two steps. In the first one, called “sleeve gastrectomy”, the stomach is reduced and narrowed like a tube to reduce the stomach capacity (almost 80% of the stomach is removed). In the second step, a small bowel bypass is performed to reduce the surface for food absorption. Specifically, the middle part of the small bowel is excluded from food transit. After this second step, the first part of the small bowel, called the duodenum, is connected to the distal small bowel (named ileum). After this operation, the food now travels from the small new stomach to the distal intestine bypassing a long segment of the small bowel, which remains in the abdominal cavity, but is excluded from the food circulation. These anatomical changes decrease oral intake and reduce the absorption of the nutrients and calories eaten. Patients who undergo this procedure can lose up to 80-90% of excess weight. It is a procedure that has powerful effect on resolving resolution of Type 2 diabetes and other metabolic related disease. The SADI-S is generally well tolerated if performed
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