Bariatric surgery, by means of gastric bypass or vertical sleeve gastrectomy, are the most effective options for treating morbid obesity
WHAT IS BARIATRIC SURGERY?
Obesity surgery, or bariatric surgery, is a set of surgical techniques whose primary aim is to significantly alter the gastrointestinal anatomy to reduce food intake and absorption.
At Quirónsalud, we treat morbid obesity with minimally invasive techniques, using state-of-the-art medical technology and the most prestigious specialists in the obesity surgery field. Our surgeons are highly experienced and have over 20 years of expertise in the specialized surgical and laparoscopic techniques used in bariatric surgery.
Bypass gástricoTécnica: Cirugía Laparoscópica Mínimamente Invasiva
Estancia en UCI: 12-24h
Tiempo de hospitalización: 48-72h
Es una técnica mixta. Se realizan una serie de cambios quirúrgicos en el estómago y el aparato digestivo para conseguir así una menor capacidad gástrica y, a su vez, una disminución de la absorción de las grasas. Esta limitación provoca, además de adelgazamiento, la resolución de comorbilidades asociadas a la obesidad. También se le conoce como bypass gástrico en Y de Roux.
La intervención se lleva a cabo en dos fases:
- Reducción de estómago: creación de un pequeño reservorio gástrico (unos 20-50 cc) separado del resto del estómago para limitar la ingesta.
- Derivación gástrica: anastomosis gastroyeyunal en Y de Roux con longitud variable del asa yeyunal, que origina el componente malabsortivo.
Por medio del bypass gástrico se disminuye la absorción calórica y de nutrientes. Además, al tener un estómago de menor tamaño, se reduce la cantidad de comida que se ingiere y la sensación de saciedad es más rápida.
Con el bypass gástrico se obtiene una mayor pérdida de peso que con las técnicas restrictivas, y las enfermedades asociadas a la obesidad suelen remitir en mayor grado.
Manga gástrica (Sleeve gástrico)Técnica: Cirugía Laparoscópica Mínimamente Invasiva
Estancia en UCI: 12-24h
Tiempo de hospitalización: 48-72h
Es una técnica restrictiva. Se retira parte del estómago de la parte más distensible del mismo, y se crea un reservorio longitudinal más pequeño (de 60 a 100 cc.) para la comida, conservando su funcionamiento digestivo y el sistema de llenado y vaciado natural. Se extrae de esta forma el 80% del estómago, que sigue funcionando con normalidad.
La técnica de la gastrectomía vertical, también conocida como gastroplastia tubular, Sleeve o manga gástrica, consigue cambios hormonales y metabólicos que generan sensación de plenitud y saciedad, se pierde peso y se experimenta una mejoría de los problemas asociados a la obesidad.
Entre las ventajas de esta técnica se pueden destacar:
- Es la cirugía que menos altera la anatomía.
- Aceptable respuesta de las enfermedades metabólicas.
- Pérdida de peso del 80% del sobrepeso.
- Requiere menor aporte de suplementos vitamínicos post cirugía.
Por esto, tanto la recuperación como la vuelta a la vida normal, se acorta a una semana de postoperatorio.
(Infografías y vídeo de Medtronic con la intervención virtual)
YOUR TREATMENT, STEP BY STEP
APPOINTMENT WITH THE SURGEON
At your first consultation, you will be seen by doctor Salvador Morales Conde, Chief of Surgery and Director of the Center. He will be in charge of evaluating your baseline condition. After examining you, he will order a series of tests to determine whether you have any underlying conditions that must be treated prior to the diabetes surgery. In addition, he will explain which intervention best suits your needs and will answer all your questions or concerns.
While the tests requested during the surgical consultation are being performed, amultidisciplinary team comprised of endocrinologists, nutritionists, psychologists, and exercise and fitness educators will study your case to ensure a thorough assessment and to define the treatments needed to reduce the risk of experiencing any illnesses related to excess weight or to keep them under control.
The risk of anesthesia will be evaluated. This typically consists of blood tests, electrocardiogram, chest X-ray and examination by the anesthesiologist.
The procedure will be performed after the 3 weeks of treatment with the multidisciplinary team. Patients are typically admitted on the same day and a few hours prior to the procedure. The surgery is performed laparoscopically under general anesthesia. It is not necessary to open up the abdomen.
The 12-24 hours immediately following the surgery are spent in the Intensive Care Unit to ensure optimal patient safety and monitoring.
After a short stay in the hospital ward (approx. 48-72 hours), the drain is removed and the patient its discharged.
RETURN TO HOME
Treatment following obesity surgery does not end with the surgical intervention. It requires continued follow-up to monitor weight loss and nutritional status. This monitoring and follow-up by the multidisciplinary team helps guarantee the success of the procedure. This surgery entails significant changes in eating habits that require an adaptation period. Our specialists will support the patient at all times throughout this process.
WHEN IS OBESITY SURGERY RECOMMENDED?
- Patients with a BMI greater than 40 kg/m2.
- Some patients with a BMI between 35 and 40 kg/m2 with comorbidities associated with overweight.
- Patients with a BMI between 30 and 35 kg/m2 with metabolic problems (see metabolic surgery)
HOW EFFECTIVE IS IT?
- After the procedure, patients tend to lose around 30% of their total weight and between 70% and 85% of their excess weight.
- It guarantees better quality of life for the patient.
- It resolves comorbidities such as high blood pressure, hypercholesterolemia, dyslipidemia, diabetes, joint and vascular problems, OSAS, and more.
WHAT IS THE DIFFERENCE BETWEEN VERTICAL SLEEVE GASTRECTOMY AND OTHER TYPES OF TREATMENTS LIKE GASTRIC BYPASS?
Both surgical techniques are indicated for the treatment of morbid obesity and offer excellent results. Although both use laparoscopic techniques, the two procedures are quite different. The most notable difference is that vertical sleeve gastrectomy does not alter the digestive system in any way, meaning patient recovery tends to be associated with a shorter recovery time, fewer complications, and fewer malabsorption problems.
IS GASTRIC BANDING EFFECTIVE?
At Quirónsalud Sagrado Corazón hospital we do not recommend this surgery and stopped performing this type of procedure more than 5 years ago. It is associated with high failure rates, so the current global trend is to not use it as a weight loss method. Some of the reasons why this technique is no longer advisable is due to the damage to the stomach that has been observed, as well as migration of the band, stomach prolapse through it, and esophageal motility disorders, among others.
WILL I STILL WANT TO EAT AFTER BARIATRIC SURGERY?
You will want to eat but you won't feel anxious and you will feel fuller with less food. This, paired with healthy, balanced eating habits will help you achieve a healthy weight
WHICH SURGERY IS THE MOST EFFECTIVE?
This will depend on the patient's profile. The doctor will evaluate which technique will be more effective for your case and will explain the benefits of each one. Laparoscopic gastric bypass is generally recommended for patients with a BMI between 35 and 50 kg/m². Vertical sleeve gastrectomy is the best option for most patients with moderate obesity, with a BMI between 35- 45 kg/m².
IS GASTRIC BALLOON PLACEMENT USEFUL?
No, only in exceptional cases.
IS IT A HIGH-RISK SURGERY?
No. Minimally invasive laparoscopic surgery represents important advances for obesity treatment and offers significant patient benefits, particularly in terms of hospital safety. Specialized integrated units, prestigious and internationally-renowned professionals, multidisciplinary teams and technologically advanced operating rooms are key to ensuring that nowadays this procedure is considered safe and success is guaranteed. Ask your surgeon about any questions or concerns you may have.
WHEN IS RE-INTERVENTION RECOMMENDED?
At our Obesity Treatment Center of Excellence, we perform revision bariatric surgery as a less invasive surgical option to treat patients who have undergone a gastric bypass or other less recommended techniques who have gained back weight or who present complications resulting from the initial technique. Also for patients with poor control or reappearance of associated illnesses. We treat patients who are unhappy with their results from interventions at other centers or hospitals. Following a thorough medical examination by our multidisciplinary team, we assess whether revision surgery is the best option for their case or we suggest new treatment options to help resolve their issues.
Prestigious experts in the treatment of obesity and overweight
We have a comprehensive clinic and multidisciplinary team comprised of multiple specialists: expert surgeons in metabolic and bariatric surgery techniques, endocrinologists, nutritionists, psychologists, specialists in exercise and fitness education, and more.
In addition, our patients can choose from a wide range of services at the Quirónsalud Sagrado Corazón Hospital, and the experts they may need from any specialized units: Intensive Care, Anesthesiology, Internal Medicine, Radiology, etc.