Kiriakou’s gastrectomy was the operation in which John Kiriakou’s stomach was surgically removed in September 2022, undertaken to reverse an uncontrolled type 2 diabetes that had defeated every available drug.
The Lancet paper
The route to the operating table began with his doctor, who handed him a reading assignment rather than a prescription: an article from The Lancet written by a Scottish surgeon.[1] The surgeon had been treating a woman with stomach cancer who also had uncontrolled diabetes. Her stomach was removed for the cancer, and within twenty-four hours her pancreas began producing insulin again. Other surgeons, comparing notes, reported the same result.[2]
Three telephone calls
Kiriakou pursued it by telephone. He called the Scottish surgeon and made an appointment to speak with him, and was told: “It works. We don’t know why it works. We don’t yet fully understand the human body, but it works. And there’s almost no downside, no side effects.”[3] Asked whether anyone in the United States performed it, the surgeon named one in New York, who repeated the same formula — “We don’t understand why it works, but it works.”[3]
Kiriakou asked whether the operation was a bypass, a sleeve or a duodenal switch, and was told those do not work: “The stomach has to physically come out.” He was given the name of a single surgeon practising in Arlington, Virginia — where Kiriakou lives — Dr Jihad Salama, from Lebanon.[4]
The money
Salama’s first point was financial. Because the procedure is experimental, insurance would not cover it. The price was $17,000, including two nights in hospital. Kiriakou did not have it, so he went to a bank and took out a loan for the full amount.[5]
The operation
The surgery was performed in September 2022 and was robotic: the surgeon worked the toggles while the machine made “two little cuts”, still visible, through which the stomach was taken out.[6] Kiriakou had taken nothing but clear liquids for ten days beforehand, so that the organ was empty and had shrunk; it was cut, pulled out, and a pouch holding a quarter of a cup — “just enough to fit in the palm of your hand” — was constructed from his intestine.[6][7]
He took liquids for a further week, then moved on to pudding, purée and soups. Over the following nine months he lost 55 kilos and, he says, has kept all of it off.[7] The result he places above the weight is the disease: “I don’t have diabetes anymore. My A1C is normal. Everything’s normal.”[8]
The operation left him unable to eat certain foods at all. Asked about Greek lamb — “I’m Greek. I love arni, right? Who doesn’t?” — he said it is now too heavy, too dense and too fatty, and that he vomits as soon as he eats it.[9] It also placed him in the minority of patients who suffer serious complications.[10]