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Inicio >> Obesity surgical management

What is morbid obesity?

This term describes a body mass index over 35. This index is the result of dividing the patient's weigh (in kilograms) by the square of their height (in meters). For example: 115 kg and 1'55 m BMI = 115/1'55 x 1'55 = 47)

Criteria for the study of obesity

ClassificationBMI
Insufficient weightlower than 18’5
Normal weight18’5 - 24’9
Grade I overweight25 - 26’9
Grade II overweight (preobesity)27 - 29’9
Type I obesity30 - 34’9
Type II obesity35 - 39’5
Type III obesity (morbid)40 - 49’9
Type IV obesity (extreme)over 50
BMI = body mass index

Surgical techniques

Small incisions are done in order to introduce gas in the abdomen and perform the surgery. Thanks to laparoscopy, the recovery is faster and less painful. The patients are discharged from hospital after a few days and can return sooner to their normal life compared to more aggressive techniques.

  • Técnicas restrictivas
    • Banda gástrica: The surgery only affects the stomach.

    • Tubular gastrectomy: The stomach is removed and left as if it were a tube.

  • Técnicas mixtas
    • Gastric bypass

    • Biliopancreatic Derivation

    • Duodenal switch

Conservative surgery indications

If the body mass index is over 40 or in case it is 35 but the patient presents illnesses related to obesity (diabetes, hypertension, bone-related pathology...), surgery is the only alternative after having tried all endocrine options for at least 6 months (diets, medicines, etc.).

The patient must be between 18 and 60 years old, but certain cases must be considered individually (and the patient must receive all necessary explanations).

The patient and their closest relatives must understand what the technique consists of.

This surgical procedure is not indicated for patients with severe psychological or liver alterations (cirrhosis), or any other in which the surgery means a higher risk than the obesity itself.

How is laparoscopic surgery performed?

Depending on the technique, several small incisions are done in the abdominal wall in order to insert the necessary equipment for the intervention. In the case of gastric banding, a subcutaneous pouch is left in the abdomen in order to inflate or deflate the gastric band.

The intervention is performed under general anesthesia and inside the abdomen insufflating gas (CO2) for the surgeon to see the process through a camera. The CO2 will be removed when the intervention is finished.

Gastric banding What results are expected after this surgery?

During the first 6 months, weight loss is significant but it decreases with time and finally stabilizes after 2 or 3 years. Losing about 70% of the overweight in the first year after the intervention is considered a good result.

Mixed procedures present better results, but the complication rate is higher. Similarly, illnesses related to obesity improve or will even be cured (diabetes, arterial hypertension...).

Monitoring after surgery

The patient will be checked periodically by experts on:

  • Endocrinology and Nutrition
  • Psychiatry or Psychology
  • Surgery

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