Procedure

There are approximately 300 million people around the world who fight obesity. Above a certain limit, however, any diet, gymnastics, or weight loss medicine is futile. Obesity often couples with serious diseases e.g. diabetes, high blood pressure, laryngopharyngeal reflux (LPR), heart failure, infertility, or arthralgia. In the United States, where 5 percent of the population is obese with a BMI over 40, Weight Loss Surgery has had a long history of several decades. The different types of surgical interventions have recently been narrowed down to the following three basic types among which the most frequently chosen surgery is Gastric Bypass Surgery since 2002.
 
Weight Loss Surgery can be classified into two groups

  • 1. Restrictive Surgery which reduces the effective size of the stomach
  • 2. Gastrointestinal Bypass Surgery, i.e. procedures that divert nutrients and gastric juice

Restrictive Surgery which reduces the effective size of the stomach

ImageThe procedures that reduce the size of the stomach aim at feeling full after eating very little food. The best known of these procedures is Gastric Banding (LAGB) which is a restrictive procedure whereby the stomach is divided into two by the laparoscopic placement of a soft, adjustable silicon ring (gastric band) just below the entrance of the stomach.


ImageAnother, however less known surgery which reduces the size of the stomach is intragastric balloons that are inserted through the mouth into the stomach while deflated by an endoscope, and then it is filled to decrease the amount of gastric space aiming at feeling full sooner. The balloon can be left in the stomach for a maximum of 6 months.



Gastric Sleeve Surgery is a little-known-about procedure in Hungary, during which the stomach is reduced by surgical removal. Weight loss is reached not only by the surgery itself, but when the portion of the stomach that produces the hormone that stimulates hunger (Ghrelin) is removed, the hormone level which makes us feel hungry decreases.




• Gastrointestinal Bypass Surgery, i.e. procedures that divert nutrients and gastric juice


The other type is a typical surgery which diverts nutrients and gastric juice, and is called the Gastrointestinal Bypass Surgery (RYGB, i.e. Roux-en-Y gastric bypass). It is also a little-known-about procedure in Hungary. The surgery permanently divides the stomach into two unconnected parts, with the upper part connected directly to the lower small intestine. As such, food bypasses parts of the stomach and upper small intestine. The resultant small stomach pouch encourages patients to eat less, thus their digestive tract absorbs fewer calories. This surgery has been performed since 1964 but laparoscopic surgery has been in use only since 1994 instead of heroic surgery during which a big incision was made in the abdominal wall. Laparoscopic surgery is made with the help of tiny cameras and some special instruments. The surgeon makes altogether eight independent tiny incisions on the abdominal skin through which the camera and the instruments are inserted. It reduces the risk for the patients and offers them a speedier recovery which also means less complications. That is the reason why this technique could have become widely performed. The effectiveness of the surgery and its long-term positive experience is also shown by the fact that this is the most commonly performed surgery aiming at weight loss since 2002.
Advantages: The best weight-loss results, solves Type 2 Diabetes in the highest proportion, offers the best quality of life.
Disadvantages: It is a complicated surgical intervention the performance of which makes comprehensive laparoscopic experience necessary.
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Consider

You are a good candidate for a surgery if

• your BMI is above 40 kg/m2. Please use the BMI calculator on our website
• your BMI is above 35 kg/m2 with a concomitant illness, e.g. diabetes, cardiac insufficiency, or asthma
• you either suffer from more concomitant illnesses, or one of them could be treated with difficulty, e.g. high blood pressure, diabetes, infertility, painful joints, varicose veins, sleep disorders, etc.
• you had several unsuccessful diets to lose weight
• you had an unsuccessful Weight Loss Surgery before, e.g. intragastric balloon was inserted or Gastric Banding (LAGB) was used

You are not a good candidate for a surgery if you

• are a minor
• are above 65
• have a chronic inflammatory bowel disease
• are pregnant
• are dependent on alcohol and/or a drug addict
• suffer from a serious liver disease and you are at a risk of gastric haemorrhage or esophageal bleeding
• are mentally unstable
• have a malignant tumour or undergo chemotherapy
Checkup before the surgery Identifying the patient’s ability to endure surgery: heart ultrasound, breathing function, expert opinions of the internist and anesthesiologist. Excluding those types of obesity in case of which no positive surgery results can be achieved: Endocrinology, Psychiatry.