Obesity - Bariatric Surgery

Morbid obesity has become one of the major issues in lifestyle TV shows, where experts characterize it as the "leading cause of death in the coming years".

Whether it is or not the leading cause of death in the coming years, the truth is that obesity is the main cause or trigger of other demanding diseases such as diabetes, hypertension, respiratory failure, sleep apnea, reumatoid problems, etc.

If we add to these health problems, the psychological and social burden, the reproduction and other medical implication an obese patient may face, obesity may be featured as the century scourge.

In such cases of "morbid obesity", surgery is globally recognised as the only accepted treatment option!
Surgical techniques include:

Gastric Banding: Gastric Banding is one of the most widespread bariatric surgical procedures worldwide. It is usually performed laparoscopically - i.e. laparoscopic gastric banding. As a procedure, there are over a million cases performed annually throughout the world and it's a very reliable procedure. It is recommended to patients that cannot control eating but not to those patients that love sweets.

In this procedure, a silicone band is placed around the upper part of the stomach to create a small pouch. The inner surface of the silicone band can be inflated with saline or can be deflated to change the size of the opening. The band is connected by a tube to a reservoir, which is placed under the abdominal skin and fat.

After the operation, the surgeon can control the size of the band by injecting saline into the reservoir with a needle. After procedure completion, the patient is recommended to stay one day at the hospital while he/she may return to his/her routine activities even the next day.

Gastric Sleeve: Gastric sleeve bariatric surgery includes laparoscopic removal of a large portion of the stomach, anywhere from 60% to 85% of the total stomach. The portion left behind is a slim tube or "sleeve" that will serve as your new stomach. This stomach is already connected naturally to the stomach inlet and outlet which means that no rerouting of the intestines is needed.

The primary features of gastric sleeve surgery are reducing the size of the stomach up to 85%, to restrict food intake while also reducing the hormones that create the craving for food due to the removal of the excess stomach portion.

This reduces the production of the Ghrelin hormone which in turn reduces the hunger sensation. After procedure completion, the patient is recommended to stay at least three days at the hospital. Gastric sleeve bariatric surgery is recommended to patients that show aggresive food consumption.

Gastric By-pass: A gastric bypass is an operation to make your stomach smaller and to shorten the length of small intestine that the food then passes through. This allows the food you eat to bypass most of your stomach and part of your small intestine - i.e. you eat less and that some of the food you eat won't be fully digested.

A gastric bypass operation is usually done using keyhole (laparoscopic) surgery. It can also be done through a single, longer incision. During keyhole surgery small cuts are made in your abdomen (tummy) rather than one large cut.

During a keyhole operation your surgeon uses small instruments, guided by a special telescope with a camera, to perform the operation. However, if you’re very overweight or have had surgery to your abdomen before, then your surgeon may recommend having an open operation, which is performed through a single larger incision.

The patient should make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of bariatric surgery.

The most important feature of bariatric surgical procedures is the proper and fruitful patient-surgeon communication.

The best and most optimal results come when the patient is shown the pros and cons of each available bariatric procedure and the surgeon has a thotough view of what suits best to each clinical case. The surgeon should not make any decision on his own.

For instance, if the patient consumes a lot of sweets and cannot avoi this habit in the future the gastric banding procedure will have no result.

Thus, patients shouls also be very careful when selecting a bariatric procedure just because they saw a great advert in TV, radio or even a magazine article.

As a patient, you should pay attention to your surgeon's overall surgical experience, knoweledge and education.

Bariatric surgical procedures cannot be performed by surgeons specialised only in bariatrics without broad general surgery experience.

Dr Apostolakos' training comes from the field pioneers in Austria, Belgium and Holland while Dr Apostolakos has got a great experience in all types of bariatric procedures.

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