Bariatrics
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At St. Luke's Hospital, we perform successfully a large number of weight loss surgeries per year. Thanks to our experienced medical team, we are able achieve the desirable results and, therefore, to improve our patients' quality of life. We put patients at the centre of our care and provide all the necessary information in order for them to understand their treatment options, the necessity of preoperative control and the value of postoperative follow-up.
Bariatric Surgery is a specialization of surgery that includes a variety of weight loss surgeries. Bariatric Surgery is addressed to people with morbid obesity, who have exhausted their efforts and choices in weight loss with other methods, such as lifestyle and diet changes, exercise or medication or who simply want weight loss from the outset with the help of a surgical operation. The basic principle of Bariatric Surgery is to reduce the size of the stomach, which is achieved in various ways.
Obesity is a disease that affects about 30% of the general population. In other words, about one in three people is either overweight or obese, which is why it has been declared by the World Health Organisation to be the epidemic of the 21st century. Obesity can be hereditary, since it has a strong genetic substrate, or it may be related to environmental conditions, lifestyle and nutrition. This will be examined by the attending physician.
Excess body weight condemns people to physical pain, serious health problems and social isolation. Some of the problems associated with obesity are the following:
In addition, it has been found that obesity significantly increases the risk of neoplasms, such as colon or prostate cancer. For all these reasons, the World Health Organization describes it as a disease and recommends its timely treatment.
The treatment of obesity can be done by dieting, in combination with physical exertion, with the help of pharmaceutical preparations or with the help of surgical intervention. Surgery today offers a solution to obese patients who have not been able to lose their excess body weight despite repeated diet attempts.
The terms overweight and obese describe gradations of body weight greater than the ideal for a certain height. What determines obesity is the body mass index (BMI), a number that correlates body weight with height.
BMI= Body Weight (Kg) / Height(m)²
Based on the BMI, patients who need surgical treatment are those who suffer from a BMI > 40 or > 35 a concomitant disease, such as diabetes mellitus or hypertension.
Bariatric surgeries are divided into two categories.
The adjustable gastric ring is an operation to limit gastric capacity. The ring can be adjusted over time, adjusting accordingly the diameter of the inner orifice. The operation is performed laparoscopically and hospitalization lasts up to a day. In most cases, the patient may be discharged a few hours after surgery.
Postoperatively, monitoring by a dietitian is needed, as well as ring adjustment depending on weight loss.
In the Clinic "AGIOS LOUKAS" the technique "Birmingham stitch" is applied for the application of the ring. This is a special technique of fixation of the gastric band, with the creation of a form of crimping of the stomach around it. In this way, the risk of slippage rate is almost eliminated, which is the most common complication of the method.
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It is a relatively new technique, with which about 85% of the stomach is removed, as a result of which it takes the shape of an elongated tube or sleeve. The additional advantage of the method is that it removes the canopy of the stomach, which is the main source of ghrelin of the organism. Ghrelin is the messenger who sends the stomach to the hypothalamus of the brain to inform him that he is "hungry". Thus, by abolishing the sending of the message of hunger, the appetite is significantly reduced.
The operation is performed laparoscopically and patients are admitted to the Hospital in the morning of the surgery. After preoperative control, they undergo the operation laparoscopically. They are fed the next morning and are discharged a few hours later.
It is primarily an operation to limit gastric capacity and less malabsorption surgery, with which food bypasses most of the stomach, the duodenum and a part of the small intestine. This results in the excellent regulation of type II diabetes mellitus, due to the fact that food does not stimulate the secretion of hormones associated with insulin resistance.
The operation is also performed laparoscopically. Postoperative hospitalization is one day. Patients who undergo gastric bypass need postoperative monitoring by their attending physician to avoid problems from lack of vitamins, iron or calcium.
Laparoscopic gastric folding is a new technique for the treatment of obesity based on limiting the capacity of the stomach. The operation is performed laparoscopically and the postoperative hospitalization is one day. The advantage of the method over the classic elongated gastrectomy is that:
Its disadvantage against elongated gastrectomy is that it does not limit the appetite, since it does not affect the concentration of ghrelin.
All bariatric operations, if performed correctly by an experienced surgeon, are safe and effective. The most important thing for choosing the most appropriate method is the correct and objective information of the patient:
For this reason, it is important that the specialised obesity surgeon is able to perform all types of operations and does not try to direct the patient towards the type of surgery he performs. The specialised obesity team, taking into account the medical history, the clinical examination, the eating habits and the psychological profile of each patient, will recommend the most appropriate surgery.
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