remote patient monitoring

AI/ML Innovations’ Health Gauge Partners with TaqTik Health to Address Obesity

TORONTO, ON / ACCESSWIRE / January 23, 2023 / AI/ML Innovations Inc. (CSE:AIML)(OTCQB:AIMLF)(FWB:42FB), a company committed to acquiring and advancing Artificial Intelligence/Machine Learning technologies that address urgent societal needs, is pleased to announce that its wholly owned subsidiary, Health Gauge Inc., has entered into a Letter of Intent with the Silicon Valley-based TaqTik Health, Inc to pilot an AI-enhanced health & wellness remote monitoring solution for obesity patients.

Upon the successful conclusion of the pilot study, Health Gauge and TaqTik intend to enter a commercial arrangement to continue to utilize the Health Gauge solution to help improve the outcome for TaqTik's patients.

Pilot Study: This multi-phased pilot is a collaboration between bariatric surgeons and specialists in Mexico and Asia, Health Gauge, and TaqTik Health - a global provider focused on supporting its 35,000 remote obesity patient subscribers at home with concierge health coaching. The pilot is already well underway in Mexico and will roll out with other bariatric partners in Asia in the months ahead, including patients being treated with bariatric surgery and other obesity treatments.

Health Gauge's proprietary digital health monitoring & management platform, which is provided through the HG Phoenix wearable and smartphone app, forms the technological backbone for the monitoring of the global bariatric patients involved in the pilot. The unique solution provides pilot participants with 1:1 support from TaqTik health coaches and Bariatric & Metabolic Surgeon Dr. Humberto Solis, who is the head surgeon at Gastro & Bariatric Clinic and co-founder of the Gastric and Bariatric foundation in Los Cabos, Mexico. The pilot patients in Mexico have had sleeve gastrectomy and bari-clip procedures.

The pilot objective is to support lifestyle modification and sustain weight loss for medical travelers and remote patients following weight loss surgery and other bariatric treatments. Determinants of program success will focus on overall engagement and weight loss.

Global obesity rates have tripled since 1975, with one billion people globally estimated to be living with obesity by 2030. In 2021, the American Society for Metabolic and Bariatric Surgery (AMMBS) still considered metabolic/bariatric surgery the most effective and long-lasting treatment for severe obesity resulting in significant weight loss and the improvement, prevention, or resolution of many related diseases, including type 2 diabetes, heart disease, hypertension, sleep apnea, and certain cancers.

"This innovative pilot brings together an experienced group of partners with interest in improving affordable accessibility for bariatric surgery (whether local or overseas) while leveraging tech and touch to streamline remote post-care support to improve obesity patient success rates," said TaqTik President, Mr. Yasuhiro Hashimoto, M.D.

"Access to digital health solutions that blend cutting-edge technology with personalized, human support is what we see as being the key to helping people reach and maintain health and lifestyle goals," added Randy Duguay, CEO of Health Gauge. "TaqTik and Health Gauge share a vision of making it easier for people to coordinate and stay engaged with their clinicians and healthcare support team no matter where they are, and that is why we're excited about this landmark pilot partnership. It's a great example of what can happen when the digital health sector works directly with consumer-facing companies to address and prevent global obesity."

AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture
AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture

About TaqTik Health, Inc.

TaqTik Health, Inc., through its consumer brands, Gorgeous Getaways, and Taqtik Health offers concierge services connecting international patients with high-quality and affordable surgery and treatments in collaboration with over 120 global clinical organizations. "Providing best-matched personalized treatments combined with health & wellness monitoring provides a unique value for remote and international patients," says Rachel Rowling, COO of TaqTik, "to consistently deliver long-term positive patient outcomes and experiences."

On-demand healthcare is where patients use and access healthcare services online in real-time via wearables, mobile apps or websites. From scheduling an appointment with a TaqTik health consultant, booking a vertical teleconsultation with a top surgeon or specialist to booking a surgery or treatment date in over 25 destinations, the purpose of on-demand healthcare is that patients can use these services instantly and easily whenever and wherever they want, through smart mobile devices.

"On-demand healthcare consumers are much more willing to pay private clinics and travel domestically or internationally to get access to life-changing surgeries and treatments," says Rachel Rowling, COO of TaqTik. "The alternative is waiting on long waiting lists for publicly funded surgery that further inhibits the quality of life, causing long-term costs for both patients and taxpayers".

AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture
AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture

About Health Gauge

Health Gauge's patented solution is a personal health monitoring & management system, which combines the latest wearable health monitors with sophisticated artificial intelligence software tools and proprietary cloud computing software, to help caregivers, patients, and healthcare professionals access and utilize relevant data, resulting in better recovery outcomes and healthy living objectives through the ability to make immediate and better health choices.

The Health Gauge platform provides the right balance of team and technology with the Health Gauge Phoenix wearable, the mobile Health Gauge App, and our VirtualCare solution that includes secured messaging, health information management and sharing, and virtual client engagement. It blends artificial intelligence with the latest sensors in non-invasive bio signal collection, including activity, sleep monitoring, HR, HR variability, and other rich personal health data through ECG & digital pulse analytics.

AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture
AI/ML Innovations Inc., Monday, January 23, 2023, Press release picture

About AI/ML Innovations Inc.

AI/ML Innovations Inc. has realigned its business operations to capitalize on the burgeoning fields of artificial intelligence (AI) and machine learning (ML), with an initial investment, focus on emerging digital health and wellbeing companies that leverage AI, ML, cloud computing and digital platforms to drive transformative healthcare management solutions and precision support delivery across the health continuum. Through strategic partnerships with Health Gauge (100% owned by AIML), Tech2Heal (up to 22% ownership rights, with 9.44% currently owned), AI Rx Inc. (70% owned by AIML), and other planned accretive investments, the Company continues to capitalize on expanding growth areas, to the benefit of all the Company's stakeholders. AI/ML's shares are traded on the Canadian Securities Exchange under the symbol "AIML", the OTCQB Venture Market under "AIMLF", and the Frankfurt Stock Exchange under "42FB".

On behalf of the Board of Directors

Tim Daniels, Executive Chairman

For more information about AI/ML Innovations:

For detailed information, please see AI/ML's website or the Company's filed documents at

For further information, contact: Blake Fallis at (778) 405-0882 or

Corporate video:

Official YouTube Channel:

Neither the CSE nor its Regulation Services Provider (as that term is defined in the policies of the CSE) accept responsibility for the adequacy or accuracy of this release.

For AI/ML Innovations Investors

Certain statements made in this press release that are not based on historical information are forward-looking statements that involve substantial known and unknown risks and uncertainties. This press release contains express or implied forward-looking statements relating to, among other things, AI/ML Innovations' expectations concerning management's plans, objectives and strategies, including strategies for defending the Company's intellectual property. These statements are neither promises nor guarantees but are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. AI/ML Innovations Inc. undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise except as expressly required by applicable securities law. Further information regarding the uncertainties and risks can be found in the disclosure documents filed by AI/ML with the securities regulatory authorities, available at

SOURCE: AI/ML Innovations Inc.

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Losing Weight

Most Common Types of Bariatric Procedures

The most common types of bariatric procedures are surgical procedures that help patients with obesity lose weight by limiting the amount of food they can eat or by decreasing the absorption of nutrients from the food they eat. The most common types of bariatric procedures are:

  1. Gastric Bypass: Gastric bypass surgery involves creating a small pouch at the top of the stomach and attaching it directly to the small intestine. This reduces the amount of food the stomach can hold, which helps patients feel full faster and lose weight.
  2. Gastric banding: This procedure involves placing a band around the upper part of the stomach, creating a small pouch that limits the amount of food the stomach can hold. Depending on the patient's needs, the band can be adjusted to allow more or less food.
  3. Sleeve gastrectomy: This procedure involves removing a large portion of the stomach, leaving a small, tube-shaped stomach about the size of a banana. This helps patients feel full faster and reduces the amount of food they can eat.
  4. Biliopancreatic diversion with duodenal switch: This procedure involves removing a large portion of the stomach and attaching the remaining portion directly to the small intestine. It also bypasses a portion of the small intestine, which reduces the number of nutrients the body absorbs from food.
  5. Gastric balloon: This procedure involves placing a balloon in the stomach filled with saline or air. The balloon takes up space in the stomach, helping patients feel full faster and eat less.

All of these procedures are major surgeries that carry risks and complications. They are typically only recommended for patients who are severely obese and have not been able to lose weight through other means. It is essential for patients to carefully consider the potential risks and benefits of each procedure before deciding which one is right for them.

Which Bariatric Procedure Is Right For Me?

There are several factors to consider when deciding which bariatric procedure is right for you. Some of the most important factors include:

  1. Your overall health: Some bariatric procedures may not be suitable for patients with certain medical conditions, such as liver disease or heart disease. Your doctor will consider your overall health when determining which procedure is right for you.
  2. Your weight loss goals: Different bariatric procedures can help patients lose different amounts of weight. Your doctor will consider your weight loss goals and whether a particular procedure is likely to help you achieve them.
  3. Your lifestyle: Some bariatric procedures may require more lifestyle changes than others. For example, gastric bypass surgery typically requires significant changes to your diet, while gastric banding may be more flexible. Your doctor will consider your lifestyle and whether a particular procedure is a good fit for you.
  4. Your motivation and commitment: Success after bariatric surgery depends heavily on a patient's motivation and commitment to making lifestyle changes, such as following a healthy diet and getting regular exercise. Your doctor will consider whether you are likely to be successful with a particular procedure based on your motivation and commitment.

Ultimately, the right bariatric procedure for you will depend on your individual circumstances and needs. It is essential to discuss all of your options with your doctor and consider the potential risks and benefits of each procedure before making a decision.

Bariatric and obesity

Remote Monitoring For Bariatric Patients

Remote Monitoring For Bariatric Patients

Using remote monitoring for bariatric patients can be a very useful way to reduce hospitalizations and length of stay. Remote monitoring for bariatric patients can also help bariatric patients adjust to a new way of life, and it can help physicians identify health problems early.

Long-Term Weight Loss

Performing bariatric surgery is an effective treatment for obese patients, but the long-term impact is unclear. In fact, there is evidence to suggest that up to 30 percent of bariatric patients are likely to regain some of their lost weight. This may obstruct the health benefits of the operation.

A sleeve gastrectomy, in particular, has garnered a lot of praise for its potential to improve a patient's health. This is in part due to its efficacy in reducing hepatic and visceral adipose tissue, a known contributor to insulin resistance. However, the weight loss associated with the procedure is often minimal, and the benefits of bariatric surgery are limited to a few select patients.

A better way to determine the actual weight loss achieved by a bariatric procedure is to perform a prospective observational study over an extended period of time. This may be best achieved by performing the surgery in an inpatient setting, where the patient is monitored closely for the duration of their stay.

Continuous remote early warning score

Using wearable devices to monitor vital signs is a potential solution to detect early deterioration in patients. It may prevent conditions such as sepsis. It could also reduce the cost of hospital care. Detecting the onset of cardiovascular deterioration could prevent cardiac arrest. In addition, it could help improve patient satisfaction.

Wearable devices can measure vital signs and send information to the console, Physician, or EMR system. These devices also feature automated early warning alerts when thresholds have been met or exceeded that prompt clinician with specific response actions based on the patient score.

Reduces hospitalizations and length of stay

Using Remote Monitoring devices with remote or international bariatric patients can reduce hospitalizations and length of stay. These devices allow patients to share their vital signs with remote physicians from their homes. The benefits of using these devices are two-fold. They reduce healthcare costs and increase patient satisfaction.

Remote monitoring devices also allow patients to share their vital signs with their primary care providers. Practice staff can then follow up with patients via an electronic medical record inbox to assess their needs. These devices can also be used to detect postoperative complications.

The results of some studies suggest that remote monitoring devices can reduce hospitalizations and length of stay for bariatric patients. The results showed that patients that were monitored had shorter hospital stays and used less intensive care. In addition, there was a decrease in hospital readmissions and hospital-acquired infections.

The study was published in JAMA Network Open. The study evaluated the safety of outpatient bariatric surgery supplemented by a wireless remote monitoring system.

Helps bariatric patients navigate new ways of life

Using a remote monitoring system, bariatric patients can keep track of their vital signs in their home environment. This can be helpful for remote patients who may have a hard time coping with their weight loss. It can also help improve the management of hypertension. The American Heart Association supports the use of remote blood pressure monitors.

Bariatric patients with diabetes can benefit from the monitoring of blood glucose levels. Hyperglycemia is a common, asymptomatic condition, but it can be dangerous if it is left untreated. Using a remote monitoring device, doctors can ensure that patients are able to follow their weight-loss goals and achieve them safely.

RPM solutions are easy to use and offer better compliance rates than traditional monitors. Using guided automation software, patients can receive step-by-step instructions, automatic reminders, and electronic consult requests. This software also allows for insurance information and education about bariatric surgery. A number of RPM devices don't require configuration, so patients can start using the device as soon as they are delivered.


How to Prepare for and Recover From Bariatric Surgery

How to Prepare for and Recover From Bariatric Surgery


Getting bariatric surgery can be a life-changing experience, but the recovery can be long. You have to learn about what you can do to prepare for the procedure and how to recover once the surgery is complete.


Getting ready for bariatric surgery is a process that starts months before the actual surgery. It is important to prepare yourself physically, emotionally, and psychologically. A healthy diet, regular exercise, and a commitment to behavioral changes are all important factors in achieving success.

The goal of bariatric surgery is to provide lasting health benefits for people who are severely obese. During the preparation process, patients should be screened for conditions such as diabetes, cardiovascular disease, high cholesterol, obstructive sleep apnea, and other medical conditions.

The preoperative period is a time to learn about the surgical procedure and the post-operative lifestyle plan. Patients who have surgery in their home countries should be prepared to stay home and have a caregiver for at least a week. They should also prepare a healthy pantry and supplement supply. Patients traveling abroad for surgery will have a medical team around the following surgery to assist with recovery.

The post-operative diet is based on a plan designed for the patient's individual needs. It is important for the patient to eat small amounts frequently and to avoid foods that don't provide enough nutrients.

Surgical procedure

Surgical procedures for bariatric surgery are performed to change how the body absorbs energy. They can help you lose weight and improve your health, but they also carry a certain amount of risk.

Bariatric surgery is usually recommended when other weight loss methods have failed. It can be helpful in the short term, but it also requires a long-term commitment. If you're interested in bariatric surgery, there are several types to consider.

Gastric bypass is one of the most common types of bariatric surgery. It is a procedure that cuts out a portion of your stomach and creates a pouch. The new pouch restricts the amount of food that you can eat. It also reduces the number of calories and liquids that you absorb. The small pouch also decreases the hunger and allows you to feel fuller more quickly.

Surgical procedures for bariatric surgery are performed using minimally invasive surgical techniques. These techniques allow for smaller incisions, shorter hospital stays, and a better patient experience.

Side effects

Despite the great improvements that bariatric surgery can make to a patient's health, there are also possible side effects of this surgery. While they are rarely life-threatening, they can be frustrating. These effects can be prevented if patients follow their doctor's instructions.

One of the more common side effects of bariatric surgery is constipation. This is characterized by fewer than three bowel movements a week. The condition is typically caused by the loss of weight and the reduction of food intake.

Another common post-surgical effect is iron deficiency. This condition affects up to 40% of bariatric surgery patients. Fortunately, there are several methods to prevent this from occurring.

Bariatric surgery can cause your body to experience a variety of hormonal changes. This can have an impact on your tastes and cravings. You may even start to dread certain foods you used to love.

Bariatric surgery can also reduce your appetite. The procedure affects the hormone ghrelin which is responsible for controlling your appetite. This means that you will not feel hungry as often as you used to.


Whether you've had bariatric surgery or not, you should know that there are some basic steps you should take in order to ensure a smooth recovery. These include following your physician's directions and making lifestyle changes.

You will be on a liquid diet, which will be gradually replaced with a semi-solid diet. The diet is designed to ease your digestive system into the new lifestyle. You should also drink plenty of water. This is necessary to keep your body's organs hydrated, which is essential to the healing process.

You should also avoid lifting anything heavier than 10 pounds for at least a month after your surgery. You should also avoid sitting for long periods of time. If you do need to sit for a long period of time, try to move around regularly. This will help blood flow, and also keep your heart rate up.

You should also make sure you are eating a healthy diet. This will allow your body to heal faster. If you have trouble with your diet, you may want to see a nutritionist.

Bariatric Surgery & Remote Monitoring: The Paradigm Shift

Bariatric Surgery & Remote Monitoring: The Paradigm Shift

Bariatric Surgery & Remote Monitoring: The Paradigm Shift.  It is a reality that plenty of people in the world suffer from obesity despite their efforts of losing weight.  There are many options promoting immediate weight loss, from keto diets to yoga exercises, and extreme exercise routines. However, sometimes they do not work at all.  This is the reason why nowadays, bariatric surgeons are on the rise offering minimally invasive surgeries which produce dramatic weight loss in a couple of months.  Let's find out if these types of surgeries are the right fit for you.

What is Obesity?

According to Mayo Clinic, obesity is a "disease" due to excessive body fat. It is a medical condition that increases many health risks. As per the reasons behind obesity, they may be related to a variety of factors, whether inherited, psychological, or environmental factors.  Obesity is determined according to the BMI (Body Mass Index):

  • Obesity Class I: With a BMI of 31 to 34.9
  • Obesity Class II: With a BMI from 35 to 39.9
  • Obesity Class III: With a BMI above 40

When you suffer from obesity and your efforts of losing weight seem not to produce satisfactory results, you are a good candidate for bariatric surgery.

Types of Weight Loss Surgery

  • Restrictive Surgery - The goal of this bariatric and metabolic surgery is to shrink the stomach.  It will immediately slow your digestion process.   No more cravings. You will feel full after one ounce of food. Procedures: Sleeve Gastrectomy, Lap Band
  • Restrictive/Malabsorptive Surgery - The goal of this type of surgery is to reduce the size of the stomach and reroute the intestine.  The body will have less nutrient absorption which means more weight loss.  In order to compensate, you will need to take vitamin/mineral supplements to stay healthy. Procedures: Gastric Bypass, Biliopancreatic Diversion with Duodenal Switch

Gastric Bypass & Sleeve Gastrectomy: A cure for Type 2 Diabetes

  • Gastric Bypass - Also known as Roux-en-Y and is considered the Gold Standard in Bariatric & Metabolic surgery. It helps the intestines of diabetes patients get rid of excess glucose. After a gastric bypass, the intestine becomes the most important tissue for glucose use and this decreases blood sugar levels.”
  • Sleeve Gastrectomy - It is very popular because it also improves type 2 diabetes, independent of weight loss.  This procedure is performed by removing approximately 80% of the stomach.  Significant weight loss is quick and produces favorable changes in gut hormones that suppress hunger.

Virtual Health Coach - Remote Monitoring

After surgery, most likely you will have a 6-month support program with your bariatric surgeon.  It may include nutrition and exercise tips, as well as psychological guidance if needed.   Your body will go through significant changes when you start losing weight very quickly, and you will be supported every step of the way.  On the other hand, an innovative and integral part of your post-care support is our Wearable Monitoring Device, with next-gen technology specially designed for remote patients.

The Monitoring Device resembles a comfortable watch and monitors all your biometrics, as well as sleep patterns. Your health information is protected by HIPAA rules, meaning that it is strictly confidential.  When you regularly measure your biometrics, you can learn all about your body and improve your health. And the best part is that the device can be connected to other fitness and health devices.   For example, the monitoring device tracks and analyses the following:

  • Blood Pressure (without an inflatable cuff)
  • ECG & PPG
  • Oxygen Saturation
  • Pulse Wave Velocity
  • Heart Rate
  • Heart Rate Variability
  • Activity Levels
  • Calories Burned
  • And more

With this in mind, are you ready for an exciting and memorable bariatric journey?

Next Steps

Your next step is to book a free virtual consultation with a Taqtik Team Member or request a personalized quote.

Which patients should be offered bariatric surgery?

Which Patients Should be Offered Bariatric surgery?

Which patients should be offered bariatric surgery?

The first-line management of obesity should include a multi-disciplinary evaluation with nutritional and medical counseling, according to the patient’s need, in collaboration with an experienced consultant and surgical team. Many of our global surgeons suggest that adjustable gastric banding not be offered due to unacceptable complications and long-term failure. Some bariatric specialists recommend that single-anastomosis gastric bypass not be routinely offered, due to long-term complications in comparison with standard Roux-en-Y gastric bypass (Level 4, Grade D).13 • Different surgical options exist (e.g., sleeve gastrectomy, gastric bypass, and duodenal switch), with different levels of effectiveness. We recommend patients considering bariatric surgery schedule a teleconsultation and have an extensive discussion with the surgical team before deciding which surgical option seems to be the best for them.  All surgeries have some adverse effects and potential risks and require lifelong management to follow-up, mineral and vitamin supplementation, and behavioral changes. well as behavioral modifications and increased physical activity. Post-surgery we highly recommend our remote monitoring service to maintain good vitals that can be measured when returning home.

Ideal Bariatric Candidates

Patients with a BMI between 35 and 40 kg/m² with at least one major obesity-related disease (e.g., T2DM, obesity-related cardiac disease, sleep apnea), or patients with a BMI ≥ 40 kg/m² with or without associated diseases, are potential surgical candidates. In addition, bariatric surgery may be offered to patients with obesity (BMI ≥ 30 kg/m²) and significant obesity-associated disease(s), when psychological and behavioral interventions and medical management are insufficient to achieve optimal weight loss and control of comorbidities.

All potential bariatric patients are carefully evaluated by a bariatric surgeon once a second opinion or firmquote is completed. Following consultation, your bariatric surgeon may educate you regarding the risks, benefits, and alternatives to bariatric surgery. Patients should also understand the need for lifelong medical surveillance to prevent and correct potential long-term nutritional deficiencies after surgery. Contraindications for bariatric surgery include recent substance abuse (alcohol, drugs), non-stable psychiatric conditions (i.e., changes in psychiatric medications in the last six months), a diagnosis of cancer, or an expected life expectancy of fewer than five years.

Even though an age limit of 60 years is considered in the NIH recommendations, multiple studies have assessed the risks and benefits of bariatric surgery in the elderly. These are summarized in a systematic review that identified 26 articles encompassing 8149 patients.18 Pooled 30-day mortality was 0.01% and the overall complication rate was 14.7%. At the one-year follow-up, mean excess weight loss was 53.8%, diabetes resolution was 54.5%, hypertension resolution was 42.5% and lipid disorder resolution was 41.2%. The authors conclude that outcomes and complication rates of bariatric surgery in patients older than 60 years are comparable to those in a younger population, independent of the type of procedure performed.

Patients should not be denied bariatric surgery because of their age alone.

Next Steps

If you are considering bariatric surgery and would like to arrange a teleconsultation, or request a quote we would be pleased to support you with this and help you on your path to health and wellness. You can also review bariatric price guides here.

History of bariatric surgery

The History and Types of Bariatric Surgery

History of Bariatric Surgery Classification

Historically, weight loss surgeries were classified based on their supposed mechanisms of action. Adjustable gastric banding was considered as a purely restrictive surgery, but a high long-term complication rate associated with weight regain, slippage and erosions has led to a loss of interest in this procedure in favor of surgeries with a metabolic impact. Hypoabsorptive surgeries were thought to decrease the absorption of nutrients by bypassing portions of the small intestine (i.e., gastric bypass or duodenal switch). However, mechanistic studies have described many metabolic modifications, including changes in incretins, gut hormones, bile acids levels, and microbiota, which has led to referring to these surgeries as “metabolic operations.”

What Bariatric Surgery is Right for Me?

The decision for the type of surgery is made by your bariatric surgeon based on the patient’s medical condition, including weight, obesity-related diseases, expected adherence with supplementation and follow-up, patients’ personal goals and preferences in terms of expected weight loss, resolution of comorbidities, and side effects.

The goal is to find a balance between the complications and risk of mortality associated with obesity itself, to improve the patient’s quality of life (QOL), and reduce obesity-related diseases while aiming for acceptable short- and long-term complications and side effects related to the surgery itself. As a rule of thumb, early and long-term risks and side effects, but also maintenance of weight loss and remission of comorbidities, are proportional to the intestinal bypass. Other bariatric procedures such as single-anastomosis duodeno-ileostomy and single-anastomosis gastric bypass are becoming more popular, but are still lacking substantial scientific rationale.

Adjustable gastric banding

Adjustable gastric banding is one of the procedures that has evolved the most over the last 20 years, from a non-adjustable gastric band performed by laparotomy to laparoscopically performed adjustable gastric banding. Iterations of the technique have always aimed to reduce the complications that appeared over time. The procedure consists in placing an adjustable silicone band at the level of the cardia, creating a small stomach pouch above the band, with the rest of the stomach below the band. The gastric band is connected by a silicone tube to a subcutaneous reservoir. The reservoir can be inflated or deflated to control the opening between the pouch and the remainder of the stomach. Even though this procedure is associated with the lowest short-term complication rate, it is associated with a high long-term complication rate and weight regain, which has led to its progressive replacement by sleeve gastrectomy.

Sleeve gastrectomy

Sleeve gastrectomy was first used by laparoscopy as a staged approach in order to reduce peri-operative complications in high-risk patients. Interestingly, some patients experienced appreciable weight loss with the sleeve gastrectomy alone and did not require second-stage surgery, thus avoiding the side effects of malabsorption. Its relative technical simplicity and good outcomes led to a worldwide surge in popularity as a stand-alone procedure, starting around 2008. This procedure involves resection of the lateral part of the stomach to create a narrow gastric tube along the lesser curvature. It promotes weight loss through reduced meal volume and reduced appetite. It has become the most frequently performed surgical approach, representing 45.9% and 58.3% of all surgeries in the world and in North America. In addition, sleeve gastrectomy is typically easier to revise in case of weight regain compared with Roux-en-Y gastric bypass.

Roux-en-Y gastric bypass

Roux-en-Y gastric bypass involves the creation of a small gastric pouch at the level of the cardia. This pouch is connected to the proximal small bowel by bypassing the first 75–150 cm and bringing a 100–150 cm alimentary limb onto the gastric pouch. Short-term metabolic and hormonal effects have been studied extensively in numerous studies.24 It has been considered as the gold standard in bariatric surgery until recently when it was supplanted by sleeve gastrectomy.

Duodenal switch

The duodenal switch combines moderate restrictive and hypoabsorptive mechanisms by creating a wider sleeve gastrectomy, while the duodenum is transected distal to the pylorus and anastomosed to a 250 cm alimentary limb, leaving a 100-cm common channel for nutrient absorption. Duodenal switch reduces morbidity and mortality, improves T2DM, and corrects many features of the metabolic syndrome in long-term studies. This operation compares very advantageously with the other surgical options available, offering the most pronounced and durable weight loss and 80–90% remission rates .

Yet, the technical complexity and the risk of long-term nutritional deficiencies have hindered its widespread use. According to the most recent data, duodenal switch represented 1.1% of the total number of surgeries worldwide.

Next Steps

If you are considering bariatric surgery and would like to arrange a teleconsultation, or request a quote we would be pleased to support you with this and help you on your path to health and wellness. You can also review bariatric price guides here.


The Risks Of Laparoscopic Adjustable Gastric Band Surgery

All surgical procedures carry risks and, while the laparoscopic adjustable gastric band, in general, carries fewer risks than many other forms of weight loss surgery, there are nevertheless risks which you must be aware of before deciding to undergo surgery. Here we look at some of the general risks but it should be emphasized that each patient will also encounter risks specific to their own case and these will be explained to you by your surgeon.

Gastric band risks can be broadly divided into two categories – the risks associated with the surgery itself and the risk of post-operative complications.

The first and most important risk is that of death which can occur either during or following surgery. In the case of gastric band surgery this risk is extremely low and indeed, during US clinical trials on laparoscopic gastric banding, no deaths occurred. Major surgery in any form, however, will always carry this risk and this should be borne in mind.

The second major risk during surgery is that of gastric perforation. A tear in the stomach wall can occur during surgery (and occasionally following and normally as a direct result of surgery) which will invariably require further surgery to correct the problem. Once again the risk is low in the case of gastric band surgery and can be expected to be seen in about 1 percent of patients.

Other surgical risks are those associated with surgery in general and will include such things as the risk posed by age, excessive weight and the presence of pre-existing conditions and disease. There are also risks associated with medication used during the procedure (including anesthesia) and the method used during surgery. It should be noted that while we talk about laparoscopic gastric band surgery as if it were one specific operation there are in fact many different ways in which the procedure can be conducted depending upon the medical facility in which the operation is carried out and the surgeon performing the procedure.

The majority of complications following surgery are not considered to be serious but there are some that may require hospitalization and, occasionally, further surgery. The most common postoperative complications are nausea and vomiting, which is seen in about half of all patients, regurgitation, which is seen in about a third of all patients, gastric band slippage and associated problems, which is seen in about a quarter of all patients and stoma obstruction, which is seen in about 1 patient in 7. Other commonly occurring problems seen in about 1 patient in 10 include poor esophageal function, constipation, diarrhea, and difficulty swallowing. Slightly less than 1 patient in 10 is likely to need a second surgery to adjust the gastric band or to correct other problems arising out of the initial surgery and a slightly smaller number are likely to require further surgery to correct post-operative problems with the banding system’s access port.

In addition to these common problems, there is also a very long list of minor complications which will be encountered by a small number (less than 1 in 100) of patients. These include such things as gastritis, hiatal hernia, dyspepsia, flatulence, dehydration and fever.

As with all forms of surgery, gastric band surgery is not without its risks and these must be fully understood and weighed against the benefits of surgery.




Gastric Bypass Surgery And Digestion

We tend to use the term gastric bypass surgery somewhat loosely these days and include both true bypass operations such as the Roux-En-Y and popular and less radical forms of weight loss surgery such as gastric banding. While both have a role to play in curing the problem of obesity, bypass surgery takes full advantage of the body to affect weight loss and, in order to understand just how gastric bypass surgery works, it is necessary to have a basic understanding of the digestive system.

The process of digestion begins as soon as you start to eat when, as you chew your food in your mouth, saliva, which contains the digestive enzyme amylase, is mixed with your food and starts to break down carbohydrates. Although it may not seem an important part of the digestive system, the saliva glands produce about 40% of the amylase used in the digestive process and so chewing your food properly is an essential part of the process.

Food is then passed down the esophagus and into the stomach where muscular contractions mix the food as digestive juices and pepsin are added. In adults the stomach typically holds the equivalent of about 3 pints.

Once thoroughly mixed the food is passed out of the lower end of the stomach through the pylorus, a circular muscle which opens and closes rhythmically to control the flow of food from the stomach.

Having left the stomach food enters the duodenum, which is about 2 feet in length and it the first of three sections that together form the small intestine. Here two other organs of the body come into play – the liver and the pancreas.

The liver passes bile, which is an essential enzyme used in the digestion of fat, into the duodenum and also receives essential nutrients from the duodenum through a series of veins known as the portal veins. The liver itself is thus also responsible for processing food products.

The pancreas, which is principally known as the organ which is responsible for producing insulin, also produces a number of digestive enzymes, including lipase, which mixes with bile in the duodenum to further assist in breaking down fat.

Once food has been mixed with various digestive enzymes in the duodenum it then passes into the jejunum, which is about 6 to 8 feet in length, and then on into the ileum, which is about 10 to 12 feet long, where the digestive process continues and nutrients are extracted.

Once digestion is complete the remaining waste products are passed into the large bowel which plays an important role in absorbing water to prevent excess water loss. Waste products are then held in the large bowel until they are released from the body.

Gastric bypass surgery by bypassing part of the small bowl (the duodenum, jejunum and ileum) restricts the body from absorbing calories from the food that is eaten which, in turn, leads to weight loss. However, it also restricts the absorption of a variety of necessary vitamins and minerals and this explains the need for life-long supplements following surgery.



Gastric Bypass – Commiting To Success

The number of individuals choosing to have gastric bypass surgery has risen dramatically in the last few years and will continue to rise as obesity sweeps across the western world. And there is little indication that this will reverse in the near future as we continue to eat more and more fast food and take little exercise. As if this is not bad enough surgical techniques to answer our weight problem are becoming better each day and insurance companies are even beginning to pay out for an increasing number of weight loss surgeries.

So, should we be concerned? Obesity surgery may seem like the simple solution to the problem of obesity but it remains a major surgical procedure and is not without its risks. Indeed, some forty percent of patients experience some form of problem in the six months following surgery and roughly one-quarter of these individuals will need to return to the hospital. Possibly the most significant difficulty, however, is the dramatic changes in lifestyle which are encountered following surgery. The majority of individuals know that they will need to change their eating habits after gastric bypass surgery to cope with the immediate effect of having a dramatically smaller stomach and to ensure that they do not begin to put on weight again once their initial excess weight has come off. However, what the majority of individuals do not realize is precisely how dramatic these changes are going to be. Not only will you discover that you are severely restricted in terms of exactly what you can eat, but you will also discover that your whole eating regime will need to change dramatically.

For those individuals who are severely overweight because they have a compulsion to eat and are effectively addicted to certain forms of food this can come as something of a shock. This, of course, is only the beginning of the problem as gastric bypass surgery marks a major turning point in your life and will also put you under a great deal of psychological stress will have you running from tremendous highs to deep lows for which you will need the help of your doctor, as well as friends and family. For anyone considering obesity surgery, it is vital to get hold of as much information as you can not merely about the surgical options open to you but also about the effects of surgery and what is going to be involved in helping you through the months following surgery.

You must then sit down and talk to your doctor and think very carefully about precisely how you will cope before you commit yourself to surgery. A critical person in the whole equation and somebody who will have a very significant influence on your success is your doctor as he will be the person you are going to need most in those critical weeks after surgery when the going begins to get tough. It is vitally important therefore that you pick your doctor with care and look for somebody who is not only a first-class surgeon and well qualified to carry out your procedure, but is additionally someone who you can turn to and lean upon for support when things are not going as you expected after surgery and you are down in the dumps. The gastric bypass may appear to be an easy choice but it most assuredly is not and is something which you have to prepare yourself for with care.