In what cases is it necessary to resort to surgery to treat obesity?
It is aimed at patients who have a body mass index from a certain figure, the body mass index, is the resultant, the result of dividing the weight of the patient, between the height in meters squared, that tells us if the patient is normal, in terms of weight I am talking, or has weight deficit, or is overweight. When we talk about overweight, it is considered an indication for strict surgery, based on a body mass index of 40 kilos per square meter.
From there, a patient is considered morbidly obese, what happens is that these limits are currently more lapses because it has also been discovered that variatric surgery, surgery for obesity, serves to treat other diseases even in patients who do not be morbidly obese. The main indication is diabetes.
What techniques are used?
Basically the surgical techniques are divided into restrictive and mixed. The restrictive, what they do is a difficulty for the patient to swallow, has a very narrow entry, are the tubular Gastroplasties, the laparoscopic ring, basically and also tubular gastrectomy.
And the other group of techniques are mixed. The mixed ones consist in making a small stomach not removed, most of it is not removed, but it becomes a stomach, it is as if we partitioned a room, to make it smaller, and we made a new door to exit, there is an entrance and an exit. Then a small stomach and small intestine is made, at a distance that one considers of the stomach or the duodenum. So he makes a section of that intestine, cuts it and splices it in that small stomach. There are two joints that exist.
Then there are other techniques that are endoscopic, that is, by inserting a tube through the mouth of the tube that is used to make the endoscopies and then either insert a balloon, the famous intragastric balloon, gets empty but filled with liquid , of serum, in the stomach, and left for a time, six, seven months usually.
What advantages does the use of surgery have?
As advantages, most of them, I refer basically to the bypasses, because they have very acceptable long-term results because the patient will lose, always more than 50% of the weight left over. They have the advantage that at present there is no medication, that definitively, get the patient to stop being obese morbid. In these moments the only thing that raises the possibility of stopping being morbidly obese is surgery. Variatric surgery offers many advantages in terms of curing diseases associated with obesity, of type, as we have said before, metabolic, cholesterol, uric acid, diabetes and hypertension. Hypertension, high cholesterol and diabetes, constitutes what was called syndrome X and currently the metabolic syndrome, this has many chances to disappear with surgery in the same way that improve the problems of osteoarthritis, there are less weights that support the joints, the risk of suffering from female cancers drastically decreases, the life expectancy increases much more, because the vascular risk practically disappears.
Should the patient be followed up after surgery?
Well, we advise the patients and in fact we try to see them after the operation, we see them two weeks after the operation, to go home, to the month, to the three months, to the six months, to the year, and Of course, whenever they need it, even if they are not mentioned.