Bariatric surgery in Alicante by the best surgeons
Obesity constitutes an alteration of nutritional status, which often causes physical limitation and can even condition death. The most practical way to know the degree of obesity of an individual is to know the body mass index (BMI). The body mass index is calculated by dividing the patient's weight into kg by its height in meters high to the square.
When obesity is moderate, it can be controlled with conservative measures that include behavior and/or diet modifications, but for their advanced stages, various surgical solutions (interventions) have been proposed for treatment.
But when obesity is no longer moderate, it must be remedied radically and definitively such as bariatric or obesity surgery, thinking about all comorbidities that accompany it and, ultimately, that they can shorten life for several years.
Complications of obesity:
- Morbid obesity (BMI> 40 or BMI> 35 + comorbidities) seriously affects the circulatory system where its harmful effects are manifested through high pressure (hypertension) or heart failures (heart disease) due to an exaggerated increase in their work. in order to compensate for the blood needs of peripheral tissues. The presence of fat in the thorax and abdomen, makes it necessary for more effort for the lungs sleep apnea.
- Almost half of obese patients develop diabetes.
- Gastrointestinal alterations also increase such as gastroesophageal reflux and in particular the existence of gallbladder stones.
- Fat cells interfere with the synthesis of estrogenic hormones in women, which causes irregular menstrual periods, difficulty conceiving. In man produces decreased libido and can be cause of impotence
- Obean patients have uterus and breast cancer more frequently than Normopesas women. In general, obese have a greater predisposition to present hormonal and digestive cancers.
- Obesas people have more difficulty getting work and having fun, establishing a relationship life, couple life, etc. Statistically, in groups of obese there is a decrease in longevity that varies between 10 and 15%, compared to Normopese groups.
Situations in which bariatric or obesity surgery may be indicated:
- Morbid obesity: BMI> 40 kg/m2.
- Morbid Obesity: BMI> 35 kg/m2 + comorbidities (cardiovascular, pulmonary, metabolic or osteomuscular alterations of importance).
Indications for bariatric surgery
Patients with high BMI indices are considered candidates for surgical treatment.Patients who are more favored with surgery are those who also have diabetes, high blood pressure figures, joint problems, back pain, varicose legs, reflux and other alterations produced by overweight.
Metabolic surgery solves up to 80% of cases of type II diabetes mellitus. This high percentage of success does not mean that all diabetic patients should be operated, although those people who, for some reason, cannot correctly carry their medical treatment or those of difficult control that other metabolic problems associate despite following correct measures, They are candidates for this type of surgical intervention.
If, in addition, the patient candidate for metabolic surgery, presents other alterations such as high cholesterol, triglycerides or blood pressure values, they will significantly improve after surgery. In most cases, the patient may even need to take medication for these diseases.
Experts in Bariatric Surgery in Alicante
It must be taken into account that the morbid obese is a complex patient due to its anthropomorphic characteristics and associated comorbidities and requires specific preparation by a multidisciplinary team to be able to be subject to surgical intervention with the maximum possible safety. Our multidisciplinary team consists of specialists in general surgery and the digestive system with extensive experience in laparoscopic surgery, dietitian, nutritionist, psychiatrist and anesthetists with broad dedication to the management of this type of patients and their associated pathologies.
This multidisciplinary approach will also be key to the good result of bariatric surgery.It is essential that an approach from different psychomometic-nutritional areas be carried out to be able to intercede and help generate change in eating and hygienic-sanitary habits of patients, so that there is sufficient weight loss to improve comorbidities and increase The possibilities of survival of the patient, and so that there is no regional weight or recurrence of long -term comorbidities.
The patient candidate for bariatric surgery or obesity surgery will receive an individualized nutritional assessment by a specialist in dietary and nutrition that will advise the patient prior to the intervention for a prolonged period until the weight loss is stable and a correct adaptation to the new digestive situation.
How are the types of bariatric surgery interventions?
There are many types of interventions. Some are merely restrictive, that is, they reduce stomach size in order to hinder the large food intake. Others are jugortive, try that an important part of ingested food is eliminated without becoming absorbed by the digestive system and others are mixed techniques.
Our surgical team performs the following:
Gastric By-Pass of an Anastomosis (Bagua)
It is a mixed bariatric surgical technique that consists in making a reduction in the size of the stomach and, in addition, a by-pass to reduce the intestinal length through which food passes. After reducing the stomach size, according to calibrated measures, a derivation or “bridge” is performed to a thin intestine handle whose size depends on the patient and its previous nutritional history. It is a mixed technique: restrictive and jugortive, so that the results offered in the long term are better in terms of weight loss and improvement in diseases associated with obesity.Postoperative evolution is very good with few nutritional or digestive complications.
Reduction to a single anastomosis decreases surgical time, reduces the possibilities of anastomotic leakage and prevents the opening of the mesentery with the possibility of developing internal hernias behind it. The objective of this surgical technique is to reduce the intestinal handle where food is absorbed.
What results are expected of bariatric surgery?
After the intervention, there is a loss of 30 to 40% of the weight before surgery. For example the loss of 36 to 48 kg. In a patient weighing 120 kg., It will be considered satisfactory. This loss is generally fast at the beginning (from 4 to 5 kg per month) and a little slower later (2 to 3 kg per month). Although, in general, all patients lose weight, there is a great variation in the percentage of weight, depending on the degree of cooperation of the patient to follow the guidelines after surgery.
Obesity and Covid-19
The growing pandemic of the disease of the new Coronavirus 2019 (COVID-19), caused by the severe respiratory syndrome Severo Coronavirus 2 (SARS-COV-2), has become an in an evolving world health crisis. With the increase in the prevalence of obesity and diabetes, the awareness of its impacts on infectious-counts, knowing that there is a greater risk for the development of various infections, complications after them and mortality For critical infections.
The Covid-19 pandemic is extending rapidly worldwide, especially in Europe and North America, where obesity is very prevalent.Although the epidemiological and clinical characteristics of the COVID-19 have been constantly informed, the relationship between obesity and acute respiratory syndrome CORONAVIRUS-2 (SARS-COV-2) has not been completely documented until a few months ago, so that Numerous scientific studies have focused their objectives in determining whether there is a greater frequency of obesity among patients admitted to intensive care units by SARS-COV-2. Multiple scientific publications that are seeing light in recent weeks have established that the seriousness of the disease by Coronavirus increases with the BMI (body mass index). Obesity has proven to be a risk factor for the seriousness of the SARS-COV-2 and therefore requires greater attention to preventive measures in susceptible people.
Obesity plays an important role in the pathogenesis of Covid-19 infection. In fact, the immune system, which is a key actor in the pathogenesis of Covid-19, also plays an important role in inflammation of adipose tissue induced by obesity.
In diabetes, chronic exposure to an abnormal metabolic environment can lead to alterations of innate and adaptive immunity, aggravating the inflammatory waterfall and causing anomalies in pulmonary physiology and therefore increasing the infectivity and virulence of the coronavirus. Obesity and SARS-COV-2 share common elements of the inflammatory process (and possibly also metabolic alterations), which aggravates SARS-COV-2 infection in obese.
Severe obesity (BMI ≥ 35 kg / m 2 ) has proven to increase the risk of admission to ICU, while the background of heart disease and obesity (BMI ≥ 30 kg / m 2 ) They are associated independently with the use of invasive mechanical ventilation. Greater surveillance and aggressive treatment of patients with obesity and COVID-19 is justified.
Since it has been shown that obesity increases vulnerability to infections, it can be a mortality risk factor related to COVID - 19. This is even more true since there are no specific clinical signs that presume the progression of a mild infection by a mild infection COVID-19 to a serious way. Compared to non-obese patients, BMI was significantly higher in patients with a serious form of COVID-19 infection.
Therefore, we recommend additional care and precautions for patients with obesity during this epidemic. Whenever a COVID-19 infection is suspected, the screening should be systematic, especially if the patient has obesity.
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