Varied surgical techniques to reduce stomach size and achieve significant weight loss

Operations for obesity are carried out by laparoscopy and are minimally invasive

Ángel Escalera
ÁNGEL ESCALERA

The technique used most in bariatric surgery is the gastric sleeve, or vertical gastrectomy. This system leaves a stomach volume of between 200 and 250 millilitres. The rest is removed. It means that when the patient eats they feel full and they also lose a large amount of a hormone, removed with the stomach, called ghrelin, which favours appetite.

Another technique surgeons use is a gastric bypass, a method which is a little older than the gastric sleeve. It was the golden technique because it used to be considered the best due to its excellent results. Now it is mainly used for diabetic patients and those with oesophageal reflux.

If patients undergo surgery but gain weight afterwards and have not complied with the advice they were given about how to lose weight, they are given a second chance with a technique called duodenal switch, which reroutes the intestinal circuit so the food is not absorbed.

Operations for obesity are carried out by laparoscopy and are minimally invasive. The surgeons who perform the operations are accredited by the Spanish Obesity Surgery Society. It is this type of surgery that has successfully reduced the mortality rate to less than 0.1 per cent.

Obesity is calculated by using a mathematical formula. This works by dividing the weight in kilograms by the height in metres. This gives a variety of ranges. The patients eligible for surgery have a body mass index of more than 35 and, in addition, suffer from illnesses such as diabetes, hypertension, lipids or fat in the blood, venous insufficiency and others.

Surgery is also carried out on obese patients with a body mass of more than 40, even if they have no other illnesses associated with their obesity. This group includes people who weigh between 45 and 60 kilos more than they should.