Dominican Bariatric Surgery
Over 20 years of excellence dedicated to your health
The Obesity
It is a chronic systemic disease characterized by excessive accumulation of fat in the subcutaneous tissue. Unspent calories are stored in the body as fat, which when exceeding a certain level is called obesity and becomes a disease.
This problem is the result of the changes we have suffered with modern life . On the one hand it has increased consumption of foods high in calories , sugar and moreover has lowered the consumption of foods low in calories and high in fiber beneficial to health. A sedentary lifestyle and lack of exercise contribute markedly to increase this disease.
La obesidad es considerada una epidemia del siglo 21, viéndose incrementada a nivel mundial. Entre el 50 y 65% de la población mundial tiene algún grado de obesidad. La Organización Mundial de la Salud [OMS] ha calculado que existen 1,600 millones de personas mayores de 15 años con sobrepeso, 400 millones de adultos son obesos.
WHO has determined that by 2015 there will be 2.3 billion overweight adults and more than 700 million obese adults.
Las Personas obesas tienen un riesgo mayor de enfermar o morir por cualquier enfermedad, lesión o accidente. La obesidad agrava, origina o complica por lo menos más de 20 trastornos de salud. Se vincula con un riesgo mucho más elevado de sufrir de enfermedad coronaria y con tres de sus principales factores de riesgos, como la hipertensión arterial, diabetes y trastornos del colesterol y demás lípidos. Ciertos tipos de cáncer son más frecuente en los obesos, como el cáncer de mama, de útero y ovarios, cáncer de colon, de recto y de próstata.
Menstrual disorders are more common in obese women and gallbladder disease three most common vedes . Other cardiovascular disorders such as atherosclerosis , metabolic disorders , respiratory disorders such as sleep apnea syndrome and Pickwick , musculoskeletal disorders , digestive problems, kidney , gonad , fertility , sexual problems , neurological , hematological, oncogenic , psychological, social , more overall mortality , suicide and skin disorders , are just some of the serious health conditions that can aggravate or cause obesity.
Various types of anthropometric measures to assess and determine the degree of obesity of a person are used, with the body mass index [BMI] the most practical and reliable.
Procedures
Currently they exist in different surgical techniques with good results in the treatment of obesity and that can be applied to the obese patient . All can be done through laparoscopic surgery. The technique to perform depend on the multidisciplinary assessment of the patient and its associated diseases .
In recent years, with the advancement of laparoscopic surgery, anesthesiology , many other specialties related and especially the improvement and the emergence of new techniques , bariatric surgery has taken an unstoppable momentum around the world.
Bariatric surgery according to its operating mechanism can be grouped into three:
Restrictive surgery
Gastrectomía de Manga o laparoscopic sleeve gastrectomy
This procedure involves removing 75-80% of the size of the stomach and is kind enough to significantly reduce the production of hormone hunger and satiety called ghrelin. This restrictive surgery is widely used today for its magnificent results, few complications, excellent patient compliance, ease of surgery and effectiveness.
It is currently the most popular bariatric surgery performed worldwide, and has displaced the gastric bypass.
Advantage
In this procedure the patient has no foreign body in your body and adjustable band, no intestinal anastomoses or intestinal connections, thus no vitamin deficiency occur as in other procedures.
This surgery is able to reverse co-morbidities such as type II diabetes mellitus, hypertension, dyslipidemia, sleep apnea and other disorders associated with obesity.
A great additional advantage is that the monitoring of patients who will perform a gastric sleeve has been simplified significantly, because among other things it is the bariatric procedure that less alters the normal physiology of the stomach.
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Malabsorptive surgery
These reduce intestinal surface area available for absorption of food.
Mixed surgery
Belongs to the mixed procedures, it is to divide the stomach to form a small gastric pouch or pouch in the entrance to the stomach or cardia and anastomose or attached to a loop of intestine, depending on the distance that is anastomose, will decrease intestinal surface area available for absorption. The more the anastomosis of the duodenum, increased nutrient malabsorption will be away.
The decision of these technical details is taken by the surgeon depending on the needs and clinical characteristics of the patient.
Advantage
This procedure is the goal of bariatric standard techniques, is extremely effective in producing weight loss and reverse co-morbidities. In the postoperative period the patient requires that you will supply vitamins, especially B12. Surgery is technically demanding and has higher morbidity rate.
This is another restrictive bariatric procedure that is still performed frequently every minor day, its popularity has been falling almost to disappear, represents less than 7% of surgeries due to complications presented, poor quality of life of patients and monitoring that requires much more checks and adjustments.
Every day in the congresses of bariatric and metabolic surgery is less talk about it. We believe that the adjustable gastric band has already played its historical role in bariatric surgery, many hospitals have practically ceased to perform the procedure.
Advantage
As its name implies, the gastric band can be adjusted depending on the patient's clinical condition. The band is a device that can be removed and become another bariatric procedure, as a gastric sleeve or bypass, if the results are not as expected. The band can be loosened or tightened to modify the size of the duct over time. Many consider it a obstrutivo procedure.
Contraindications
The surgery does not apply to patients with serious psychiatric illness, alcoholism and drug addiction active.
The surgery does not apply to patients who are carriers of health problems so severe that they can not withstand anesthesia or surgery , such as cardiovascular disease or severe respiratory , in some cases can conveniently be prepared by treatment of intensive support and preoperative it is operated despite the risks involved , because sometimes it is the only way to solve the serious consequences of their obesity.
Can I operate?
From the beginning it has been established well known criteria as requirements for surgery, for example have a body mass index of 40, and 35 if accompanied by a disease or caused by obesity, such as hypertension disorder, diabetes, dyslipidemia, obstructive sleep apnea, metabolic syndrome, polycystic ovary syndrome and other disorders of obesity itself.
Every day these requirements are being subject to review, in many countries in Europe and Latin America, patients are operated every day with lower index. In a congress of bariatric surgery they have presented work in person with less than 35 BMI, even without comorbidity in Chile and Brazil mainly.
- Age 15 to 65 years
- Psychological Stability (not having any psychiatric illness)
- Positive view toward treatment
- He has unsuccessfully tried other nonsurgical methods for controlling obesity
- Low or decreased surgical risk
- No drugs or alcohol addiction
- Complete understanding of all points of treatment.
- Complete readiness to follow all your doctor's instructions.
- In children with Prader-Willi syndrome.
Preparation
- Complete Assessment of the patient.
- General and specific preoperative tests including abdominal ultrasonography, endoscopy, psychological evaluation, cardiac, respiratory study and study or any other evaluation required for each particular case
- Once the study has been completed and according to the assessment team, the most suitable alternative surgical patient is proposed. These studies and evaluations are usually performed in a short time (24 to 48 hours)
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- After the Surgery the patient will be followed regularly by a multidisciplinary team including Surgeons, nutritionists, endocrinólogas, Psychiatrist and General Practitioners. Monitoring by Specialists from different areas of health approach allows a much more complete and is one of the factors that undoubtedly contribute to the success of our patients.
- At the time of discharge the patient will be given a post-operative guide with food and medical indications of place.
- Postoperative monitoring is simplified significantly in recent years, besides regular checkups in the first 10 to 12 days.
- The modifications made to your gastrointestinal tract require permanent changes in your eating habits, to be observed for weight reduction success, as well as the change of life that includes physical exercise progressively.
- The key to the success of your surgery is yourself. His perseverance in achieving adequate control of eating habits and exercise.
- Increase of self-esteem
- Acceptance and Social Reintegration
- Reemployment
- Most patients eliminate diabetes and hypertension
- Satisfactory sexual life