Hospital San Roque, benchmarks in bariatric surgery



Obesity is a disease that is a risk factor for other diseases such as diabetes, cardiovascular disease and cancer. Breast cancer, especially hormone receptor-positive postmenopausal cancer, has been extensively linked to obesity.

San Roque University Hospitals has the Overweight and Obesity Unit with a large and experienced medical team and the latest surgical techniques.

One of its most important causes is lifestyle. Insufficient physical activity, a diet rich in fat and high in calories leads to the development of obesity. It is necessary to understand it from a broader perspective where different medical, psychological, social, nutritional and genetic aspects are involved, so in HUSR a comprehensive approach to “obesity” is carried out in a personalized way and with a multidisciplinary vision, counting on all the necessary specialists, such as endocrinologists, nutritionists, general and digestive surgeons, digestive specialists, psychologists, among others.

MEDICAL TREATMENT

1.-Endocrinology consultation: a personalized assessment is made of the characteristics of each patient, their dietary habits and physical activity. A complete measurement of body composition is performed (weight, body and visceral fat mass, muscle mass, height, basal metabolism, etc.) and based on this, the diagnosis, dietary recommendations, adequate exercise and treatment to be followed are obtained.

Pharmacological treatments: there are multiple pharmacological treatments that must be evaluated by specialists and will only be recommended in specific cases where their efficacy and safety are justified. All drug treatments should only be used under strict medical supervision. GPL-1 analogues: These are drugs that cause a decrease in appetite and allow, associated with a correct diet and adequate physical activity, better control of body weight. According to the existing literature you can achieve losses of more than 10% of excess weight.

Treatment with the Elipse® Swallow Balloon: it is a solution for weight loss without the need for surgery, endoscopy or anesthesia, it is installed by swallowing a glass of water with the capsule and an X-ray confirms that the balloon is correctly positioned. With this method, food intake is reduced, being able to lose an average of 10-15 kilos in 16 weeks. The balloon takes up space in the stomach, which produces a feeling of less hunger and satiety, eating less food. After 16 weeks, a programmed flush valve is opened in the balloon that empties it and allows it to be eliminated naturally through the digestive system.

2. Nutrition Consultation

Food plays a fundamental role in weight control and in the prevention of a multitude of pathologies. The role of the nutrition service in this setting includes the complete assessment of the patient’s nutritional status, eating habits, and lifestyle. In addition, he is in charge of planning and preparing menus or diets appropriate to each situation and individual characteristics or preferences. It plays an active role during all phases of treatment and helps with the resolution of doubts in the field of food to improve adherence to a healthy lifestyle and the achievement of goals.

4. Consultation Clinical Psychology-Psychology of Obesity

In Obesity, emotions play a fundamental role, since they produce physiological consequences in the body. Patients counteract these effects with certain foods that generate “food addiction” are foods called “comfort” (such as refined sugars and carbohydrates that generate pleasant effects because they produce more serotonin, dopamine, opioids and endorphins in the brain, with the consequent relief of negative emotional states). Psychology in these processes is based on the detection, diagnosis and treatment of those psychological variables related to obesity (relationship of patients with their own body, distortion of their image, behavior with food, their self-esteem, their personal relationships and lifestyle.)

ENDOSCOPIC TREATMENTS

1. ORBERA® ball

It is a device designed to achieve a healthier lifestyle. You don’t need surgery and you lose an average of 3.1 times the weight that people who only diet and exercise lose. Most are lost in the first three months, but the gastric balloon remains in the stomach for longer, so the patient learns to recognize the amount of food he needs to maintain his new weight.

2. Apollo® Method (Endoscopic Gastric Sleeve)

Endoscopic suturing is a minimally invasive and non-surgical technique for treating obesity, with all the advantages it entails in terms of comfort, speed of recovery and risks. The reduction in stomach capacity acts on satiety levels, making the patient feel full with less food. In addition, the area of ​​the stomach where the hormone that controls appetite is produced is also reduced, making changing eating habits much easier. Weight loss after the procedure depends on each person, however, with this technique, between 50-60% of excess weight is usually lost.

SURGICAL TREATMENTS

Bariatric Surgery

The prevalence of morbid obesity has increased exponentially in recent years. Excess weight associates potentially serious comorbidities such as type 2 diabetes mellitus (DM2), arterial hypertension (HTN), respiratory, metabolic, joint pathologies, anxiety or depression, among others, in addition to increasing the risk of suffering from cancer diseases.

Candidate patients for obesity surgery are those with a Body Mass Index (BMI) greater than 35 kg / m2 with one or more severe obesity-related comorbidities.

The management of the morbidly obese patient requires coordination carried out by a multidisciplinary team, in which in addition to the bariatric surgery team and the endocrinologist, nutritionists, anesthetists, intensive medicine, nursing staff, rehabilitators and physiotherapists are included, with the collaboration of psychiatrists or psychologists, pulmonologists, cardiologists, plastic surgeons, radiologists, and digestive specialists. Teamwork has four fundamental stages: the selection and evaluation of the candidate for bariatric surgery, the preparation and optimization of the patient for surgery, surgical intervention and perioperative care, as well as long-term follow-up.

Hospital Universitarios San Roque is the private center of reference in Bariatric surgery. It has excellent technical, human and professional resources backed by extensive experience in the study and treatment of obesity. Each case will have to be individualized to indicate the best treatment. Gastric Bypass and vertical gastrectomy carried out by laparoscopic approach allow to achieve excellent results.

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