Procedures
Gastric bypass
(Gastroplasty with intestinal deviation in “Roux-en-Y”)
Studied since the 60’s and popularized at the 80’s, for the work of researchers Raphael Capella and Mathias Fobi, Gastric Bypass (also known as Fobi-Capella technique) is the most practiced bariatric technique in Brazil, which is due to both its safety and its effectiveness. In this procedure, part of the stomach is stapled (which reduces the available space for the food from 2000 ml to 50 to 80 ml), as well as a deviation from the initial part of the small intestine (which reduces food absorption, causes satiety earlier and promotes hormonal changes that reduces hunger and causes other changes in the metabolic profile of patients).
This summation of mechanisms is what leads to weight loss and contributions to the control of diabetes and other diseases such as hypertension, hepatic steatosis (liver fat) and sleep apnea.
Sleeve
(Vertical Gastrectomy)
In this procedure, the stomach is transformed into a tube with a capacity of 80 -100 ml. There is no approach on the intestine, but this intervention also causes good weight loss, comparable to that of the Gastric Bypass. It is a procedure practiced since the beginning of the year 2000. It has good efficacy on the control of hypertension, cholesterol and triglycerides. Sleeve Gastrectomy is the most practiced bariatric technique in USA.
Other operations
In addition to the Gastric Bypass and the Sleeve, there are other types of procedures that can be adopted in the treatment of severe obesity, such as the disabsorptive surgeries (Duodenal Switch and Scopinaro Surgery) and the adjustable gastric band. However, they are little used in Brazil.
Remember that all surgical techniques have their characteristics, advantages and disadvantages that will be clarified in the medical consultation.
And what are the risks of the operation?
The risk of complications associated with bariatric surgery depends on several factors, including age, degree of obesity, presence of comorbidities, as well as the procedure used. The main complications are:
- Venous thrombosis and pulmonary embolism;
- Fistula;
- Myocardial infarction;
- Infection;
- Bleeding;
- Hernia;
- Nutritional and metabolic disorders;
- Psychological changes.
Patients who have a very high body mass index are at increased risk. Usually, all patients are already asked to lose some weight before surgery, but this is especially important for super obeses (BMI above 50 kg / m2). Some patients should stay in the ICU during the postoperative period, but this procedure is not routine and is usually related to respiratory issues such as severe sleep apnea.
Mortality in this type of surgery is less than 0.5%. Therefore, it is important to clarify that the risk of treatment is small when compared to its advantages for the patient.
Preoperative
We can arrange all the preoperative exams and medical evaluations that are required for a safe procedure if you want to do it in Brazil.
Surgery scheduled, what to do next?
After setting the date for the surgery, one should consider some questions:
- Check the acquisition of pre-operative medication;
- Use the medications and respect the dietary guidelines and the fasting schedule, as prescribed by the surgeon and anesthesiologist;
- Take all the examinations and reports to the hospital, as well as the Informed Consent Form;
- Bring the compressed stockings to the hospital: they will be used from the time of your surgery and can only stop using it with the surgeon’s authorization (which usually takes about 20 days).