Special therapeutic procedures
Morbid obesity is a chronic –but controllable- situation with a predominant presence in industrialized countries. In Spain, the rate of morbid obesity reaches a 0,4% of the population between 25 and 60 years of age. The situation is worrying as the tendency is to duplicate these figures every 5 to 10 years.
The presence of obesity is associated to different medical processes: arterial hypertension, coronary illness, hyperlipidemia, diabetes mellitus, sleep disorders and bone and joint disorders (sometimes severe). A substantial loss of weight can improve or even cure these processes.
The different non-surgical methods such as diet, physical exercise and pharmacological therapy fail in 95% of the cases when trying to obtain a stable and mantained weight loss.
In the case of failure, the only effective option is surgery. The aim of obesity or bariatric surgery is the loss of weight, the prevention of morbimortality associated to obesity, the reduction of associated comorbidity and the improvement of quality of life. Our department indicates surgery in patients with a body mass index of 40 or higher. In case any of the previously described medical processes are associated, even less than 40.
The different open or laparoscopic procedures are adecuate if they improve quality of life and bring few secondary effects. They benefit over 75% of patients and obtain low morbidity (10%), low mortality (1%) and low surgical reintervention rates (2%).
Restrictive surgical techniques are performed individually in our Department according to the general characteristics of the patient and the type of obesity. These techniques are: laparoscopic grastric banding, vertical banded gastroplasty, or mixed procedure with restrictive predominance (gastric bypass) or malabsorptive predominance (Scopinaro biliopancreatic diversion of or duodenal switch)