ObesityHelp

I had all kinds of trouble finding anything on OH, until Harris2 posted this:

If you every want to look up info. on ObesityHelp forums to get information quickly, here's how to do it. First, click on the red *My OH* at the top of this page (between Home and Photos listed horizontally above). A new page will open. Click *Customize* just to the left of your avatar picture area. Then click on the *+ Search* option. That will put a new field in on your My OH page. When you want to search OH info, just click the *ObesityHelp.com* option, and Not the entire *Web* option. Then fill in the blank with the topic you want to look up and click Search! If you want to try to narrow it down to information on just a particular forum, you can add that forum name in the search field , along with the topic of your search, and give it a try. It may, or may not help keep the entries you can choose from narrowed to that particular forum....but it won't hurt to try. Happy Searching! Oh, and after you have the search field set up on your *My OH* page, next time you want to search a topic, just go to your *My OH* page and fill in the search field, choose to search Obesity Help.com only, and hit search.

So thanks to Harris2!!!

I can't post the actual presentation, but here's a great link:

http://www.facs.org/education/gs2004/gs33lee.pdf

Laparoscopic Sleeve Gastrectomy as an Isolated Bariatric Procedure: Intermediate-Term Results from a Large Series in Three Austrian Centers.

Felberbauer FX, Langer F, Shakeri-Manesch S, Schmaldienst E, Kees M, Kriwanek S, Prager M, Prager G.

Department of General Surgery, Vienna Medical University, Waehringer Guertel 18–20, 1090, Vienna, Austria, franz.felberbauer@meduniwien.ac.at.

BACKGROUND: Gastric sleeve resection was initially planned as the first step of bilio-pancreatic diversion with duodenal switch but it continues to emerge as a restrictive bariatric procedure on its own. We describe intermediate results in a series of 126 laparoscopic sleeve gastrectomies (LSG) compiled from three bariatric centers in eastern Austria. METHODS: The stomach was laparoscopically reduced to a "sleeve" along the lesser curvature over a 48-Fr bougie. Special attention was placed on complete resection of the gastric fundus. RESULTS: After a mean follow-up of 19.1 months, patients had lost between 2.3 and 27 kg/m(2) or between 6.7% and 130% of their excessive weight. Sixty four percent of the patients lost >50% of their excess weight within an average of 20 months. Seven percent of the patients had an excess weight loss <25% and were therefore considered as failures. The only major surgical complication was leakage of the staple-line needing revision (three times). There were no operative mortalities. CONCLUSION: The final place of LSG in bariatric surgery is still unclear, but our results and those of others show that LSG can be a viable alternative to established procedures.

One Year After Laparoscopic "Tight" Sleeve Gastrectomy: Technique and Outcome.

Skrekas G, Lapatsanis D, Stafyla V, Papalambros A.

General Surgery, Iaso General Hospital, Mesogeion Av., Athens, 15433, Greece.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is currently gaining ground as a new option for the treatment of morbid obesity. The main advantages of this procedure are less postoperative food restrictions, no vomiting, and absence of late complications due to the lack of foreign implants. The aim of this study is to present our experience with this new bariatric technique. METHODS: Ninety three obese patients (65 females and 28 males) who underwent LSG between September 2005 and September 2007 were studied in terms of postoperative complications and weight loss. RESULTS: Mean age was 38.37 +/- 10.81 years (range 19-69) and mean preoperative weight and body mass index (BMI) were 139.12 +/- 24.03 kg (range 100-210) and 46.86 +/- 6.48 kg/m(2) (range 37-66), respectively. Mean follow-up was 12.51 +/- 4.15 months (range 3-24). There were no mortalities, but there were four major and four minor postoperative complications. The mean postoperative excess weight loss (EWL) was 58.32 +/- 16.54%, while mean BMI dropped to 32.98 +/- 6.54 kg/m(2). Mean EWL 3, 6, 12, and 24 months after the operation was 31%, 53%, 67%, and 72%, respectively. Superobese patients (BMI > 50 kg/m(2)) lost less weight. CONCLUSION: In the short term, LSG is a safe and highly effective bariatric operation more suitable for intermediate morbidly obese patients with BMI between 40 and 50 kg/m(2).

I'm probably not alone in feeling a bit confused by the wide variations in the post-op diet regimens given by different surgeons.  Frankly, it seems like most of them just use whatever diet they've been giving bypass patients.  Others are more liberal, and they hand you the diet they give lap band patients.  As a result, two people who had surgery on the same day can have very different experiences post-op.  One may leave the hospital on purees, while the other is stuck on clears for two weeks. 

Well, Cornell University has a bariatric program, and they have published their diet specifically for sleeve patients.  Either this will clear things up for you or make things more muddled, but here you go:

http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf

My suggestion is that you do what you can handle.  This suggests leaving the hospital on full liquids and purees, but if those make you sick, stick to clears until you can tolerate them.  Either way, before you depart your own surgeon's guidelines, show him this diet and see what he (or she) says.