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Obesity surgery


What is obesity?
It is a treatable chronic disease characterized by an excess adipose tissue in the body, which combined with diseases, came to be known as morbid obesity and causes a life expectancy reduction of the patients.

Obesity is classified in two types: central or android and peripheral or gynecoid. The central obesity locates the fat in the trunk and predisposes the body to suffer metabolic complications (specially type 2 diabetes and dyslipemia). The peripheral obesity accumulates the fat deposit from the waist down and produces joint overloading problems.

Morbid obesity
We are talking about morbid obesity when there is a weight of 50 kg over the ideal weight of the patient or when exist a BMI higher to 40 kg/m2.

It is a chronic disease that requires treatment. When medical treatments and diets don’t achieve the appropriate weight loss surgery is suitable. It is usually associated to diseases such as diabetes, hypertension, sleep apnea, cardiovascular complications (specially coronary heart disease), and even relates to some types of cancer.


The metabolic syndrome
Set of metabolic alterations formed by the presence of central adiposity, cholesterol concentration (c-HDL) decrease, elevated triglycerides, arterial hypertension, and diabetes mellitus type 2.

To be diagnosed of metabolic syndrome there must be at least three of the following components:
1- Plasmatic fasting glucose greater or equal to 110 mg/dl or receiving antidiabetic treatment.
2- Systolic blood pressure greater or equal to 130 mmHg and/or diastolic blood pressure greater or equal to 85 mmHg or receiving antihypertensive treatment.
3- Triglycerides above 150 mg/dl or receiving antidislipemic treatment.
4- Cholesterol-HDL less than 40 mg/dl (men) or less than 50 mg/dl (women).
5- Central adiposity. Abdominal circumference greater to 102 cm (men) and greater to 88 cm (women).



Why surgery?
Surgery is the only treatment that achieves a sustained and significant weight loss in patients with morbid obesity. The weight loss achieved improves diseases associated with obesity such as diabetes mellitus type 2, arterial hypertension or sleep apnea.

Surgery allows greater survival of life by reducing the risk of cardiovascular or cerebrovascular diseases; it improves quality of life and self-esteem, as the body image improves.


Bariatric techniques by laparoscopy
At present, we are able to do any technique by laparoscopy. Choosing between one or another technique depends on the patient’s characteristics. The surgeon will recommend the patient to a particular technique considering BMI, eating habits and associated diseases that will be able to be improved.


Laparoscopy advantages

• Without opening the abdomen
Currently it is the approach of choice in obese patients. We can perform any type of bariatric technique by laparoscopy.

• Safety and short duration
The laparoscopic approach consists in avoiding major incisions. Surgery is performed trough some tubes placed through small wounds (of 5 mm or 12 mm). We have at our disposal all the instruments needed for its development, videolaparoscopes, blood vessels sealers to ensure the haemostasis, stapling and cutting machines to join the intestines. Those materials make techniques safe and brief.

• Faster recovery
Those minimal wounds allow good aesthetic results. They make the pain related to the traditional surgery disappear. There is a faster recovery, permitting an early mobilization and a premature start of the diet getting a quick return to usual activities.
Facing the open surgery, it prevents infections, surgical wounds hernias, and prolonged recoveries.