How should the most appropriate technique be?
The most adequate technique must be:
1.- Easily performable.
2.- With a short surgical period of time.
3.- Without the need of an ICU hospitalization.
4.- With a brief hospitalization period.
5.- With a quick recovery period.
6.- With an early reincorporation to the usual or labour activity.
7.- Without or with the lesser postsurgical pain.
8.- With a quality of life improvement in the patient.
9.- Whit the lesser secondary effects.
How should a metabolic or bariatric technique be?
The metabolic surgery principles apply to the bariatric surgery principles. It is considered “ideal” the surgical technique that:
1.- Allows to achieve a loss of overweight (PSP) of more than 50% permanently.
2.- Benefits more than the 75% of the patients in the long term.
3.- Has an increased morbidity less than the 10% and a mortality less than 1%.
4.- Has a number of revisions or reoperations under the 2% annually.
5.- May be reviewable by laparoscopic approach.
Is there an ideal technique for all patients?
There is no ideal surgical technique. Each patient requires a personalized evaluation and the support of a multidisciplinary team familiarized in this type of treatments. Endocrinologists, nutritionists, psychologists, and surgeons select the most appropriate intervention in each case.
Currently all bariatric and metabolic techniques are related and allow to achieve the weight loss and the improvement or control of diabetes.
There is an indication for bariatric surgery when there is severe obesity (35-39,9 kg/m2) and diseases likely to improve accompany it. Also, in the case of morbid obesity (40 kg/m2 or more) even without associated diseases.
When you have reached morbid obesity, dietary treatments with or without medication or psychological support tend to be insufficient. Only bariatric surgery can guarantee good results in the long term.
Metabolic surgery relates to a diabetes improvement long before a significant loss weight exists. The action of surgery on diabetes is known as stomach surgery and currently there is a reason to find this effect in diabetic patients that don’t have a good response to medical treatment.
It has been observed that after surgery, there is a weight loss that goes with an improvement of accompanying diseases, such as hypertension or sleep apnea.
Metabolic surgery prolongs patients’ survival because it reduces the risk and mortality of cardiovascular and cerebrovascular events, among others, and improves your quality of life.