Ileal Transposition [IT]

This surgery developed by Dr Aureo-de Paula from Brazil, is performed as part of research at Bombay Hospital, Mumbai. It is performed through laparoscopy or key-hole route. It is expected to help glycaemic control in selected type 2 diabetes mellitus patients.
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[spectra_spoiler title=”Ileal Transposition” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””]
A segment of last part of small intestine (ileum) is interposed between 2 parts of small intestine (jejunum) just beyond stomach. No part of small intestine is removed or bypassed.
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[spectra_spoiler title=”Proposed Mechanisms of Blood Sugar Control:” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””] Blood sugar control may be achieved in responders within 10 days – 6 months. The suggested mechanism(s) of blood sugar control are

Early contact of undigested food (chyle) with interposed segment of ileum results in increased blood levels of GLP-1 hormone levels. GLP-1 is believed to have following effect:

  • Glucose even with severe ß-cell impairment
  • Stimulates insulin secretion
  • Exerts proliferative effect on pancreatic ß
  • This is believed to result in acute insulin response, which is usually lost in type 2 diabetics. This leads to blood sugar control immediately after a meal.

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[spectra_spoiler title=”Post-op Recovery” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””]

  • Immediate
  • Most of the patients are in recovery/intensive care for 1-2 days due to their medical limitations.
  • Most of the patients are allowed to have liquids within 24 hours of surgery.
  • Patients are encouraged to walk by evening on the day of surgery.
  • Delayed
  • Usually patients are sent home on the 5th day after surgery.
  • Patients can resume normal work 2 weeks after discharge from hospital.

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[spectra_spoiler title=”Diet Recommendation ” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””]This includes liquid diet for 1-2 days after surgery, soft diet for another 2-3 days & then normal diet. It is strongly recommended that diabetic diet is followed.[/spectra_spoiler]
[spectra_spoiler title=”Physical Activity Recommendation” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””]Patients are strongly advised to resume physical activity after surgery to ensure maintenance of body metabolism at high levels. All recommendations are in relation to time after surgery.

  • Long walks: 10 days later
  • Aerobic activities like swimming: 20 days later
  • Weight training etc.: 30 days later
  • Abdominal exercises: 3 months later

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[spectra_spoiler title=”Long Term Results” open=”no” style=”default” icon=”plus-circle” anchor=”” class=””]IT is based on Hindgut hypothesis derived from Roux-n-y Gastric Bypass surgery. Long term follow up data of gastric bypass has shown 80% – 100% blood sugar & insulin maintenance even after 14 years.

Ileal transposition [IT] is performed by expert surgeons at the following Alhilal Hospitals Centres. Click on the location to make an appointment.[/spectra_spoiler][/spectra_accordion]