Laparoscopic Ileal Interposition

Although all other Bariatric Surgical procedures result in weight loss and resolution of Diabetes, Laparoscopic Ileal Interposition is a procedure which results in minimum weight loss and better resolution of Diabetes as compared to other procedures..

Ileal Interposition position is a novel operation, first originated in Brazil for the treatment of Type II Diabetes. This surgery involves reducing the size of the stomach and in addition a distal or final segment of small intestine (Ileum) is brought forward and connected to the initial or proximal small intestine (duodenum). In this operation not only the weight loss is minimal, but the problems of malabsorption are resolved as it does not result in bypassing any segment of small intestine from the process of digestion.

The insulin resistance hormones – Ghrelin (stomach), GIP (duodenum) and glucagon (pancreas), are excreted from the initial parts of the digestive system and the insulin sensitivity hormone, called GLP-1, is released from the L cells in the last part of the intestine. GLP-1 is a hormone that increases the effects of insulin and stimulates insulin production by the pancreas. Basically, the goal of this procedure is to leave the resistance hormones aside and increase the sensitivity hormones.

The objective in removing a part of the stomach in the Ileal Interposition surgical operation is not to reduce the volume of the stomach. The objective, in this respect, is to bring down the excretion levels of the ghrelin hormone triggering the feelings of hunger and to prevent the state of gastric dilatation that may emerge subject to a displacement at the intestine and occurring together with resistant nausea-vomiting. The stomach is left wider than the ‘tube stomach’ surgical operation (sleeve gastrectomy) that is done for morbid obesity. Each step that is applied in the Ileal Interposition surgical operation has a hormonal target.

Therefore this operation results in better resolution of Diabetes Mellitus then other surgeries particularly in low BMI Diabetic patients.

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