BARIATRIC SURGERY

Bariatric surgery or obesity surgery was born in 1950 with Kremen and Linner, who, in 1954, performed the first fasting – ileal bypass. From then to the present day, surgical techniques have been modified and perfected, achieving excellent clinical and aesthetic results.

HOW DOES BARIATRIC SURGERY WORK?

The methods used by modern bariatric surgery are essentially two:
* Reduction of the quantity of foods that can be ingested with “restrictive techniques”
* Reduction of intestinal absorption with “malabsorptive techniques”

Restrictive techniques work by reducing the capacity of the stomach in order to limit the amount of food that can be ingested.
Malabsorptive techniques prevent the absorption of substances by bypassing pre-established sections of the intestine responsible for this function.

In obesity, surgical treatment is used when there is a failure of dietary, behavioral and exercise patterns. Patients who turn to surgery for the treatment of obesity (bariatric surgery) must be motivated to do so.
Ideal candidates are patients with BMI (Body Mass Index) greater than 40. BMI (Body Mass Index) is the ratio of weight to height squared.

Other possible candidates are patients with a BMI (Body Mass Index) between 35 and 40 and who have comorbidities related to obesity (diabetes mellitus II, sleep apnea syndrome, pseudotumor cerebri); and amenable to improvement or healing for weight loss; or in those subjects in which obesity causes physical problems that interfere with a normal quality of life.

Surgery is used when the subject’s weight has stabilized and all medical, dietary and behavioral interventions have failed. When it comes to BMI in bariatric surgery, the thing to keep in mind is that the minimum BMI to undergo bariatric surgery is not so much that assessed at the time of the visit, but rather the maximum BMI (Body Mass Index) reached by the patient in the his medical history.

The recommended age to undergo surgery for the treatment of obesity (bariatric surgery) ranges from 18 to 60 years. Minor patients must be carefully evaluated. The patient who undergoes these operations is obviously sedated under general anesthesia. Almost as important as the intervention is the follow-up, that is, the patient must perform periodic post-operative clinical and nutritional checks. The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery.

The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke. Almost as important as the intervention is the follow-up, that is, the patient must perform periodic post-operative clinical and nutritional checks.

The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery. The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke. Almost as important as the intervention is the follow-up, that is, the patient must perform periodic post-operative clinical and nutritional checks. The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery.

The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke. that is, the patient must perform periodic post-operative clinical and nutritional checks.

The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery. The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke. that is, the patient must perform periodic post-operative clinical and nutritional checks.

The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery. The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke.

The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery. The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke. The key advice to all those who want to undergo surgery to reduce obesity is to contact highly specialized centers where there are surgeons who have a lot of experience in this type of surgery. The advice to be given to all patients who have undergone surgical treatment aimed at treating obesity is to eliminate alcohol consumption and not to smoke.

With the use of surgery, long-lasting results can be obtained, either because malabsorption can be induced, or because there is a restriction of the gastric volume, and therefore of the amount of food that can be taken.

Surgical interventions for the treatment of obesity can be performed in two methods:

* Laparotomy (traditional surgical technique)
* Laparoscopy The laparotomy involves the incision of the abdominal wall, and this incision can be of two types:
* Vertical (on the line which goes from the navel to the breastbone)
* Horizontal (on the left side of the abdomen below the costal arch).

The laparoscopic technique, on the other hand, consists in the incision of 5 or 6 small holes in the abdomen and the insufflation of the abdominal cavity with carbon dioxide. Special instruments and a video camera are inserted into these holes to guide the surgeon through the operation.

However, in the course of laparoscopic surgery, the surgeon may convert the surgery from laparoscopic to laparotomic if deemed appropriate.