Treatment of obesity including associated diseases (especially diabetes) by surgical methods.
Obesity is a serious chronic disease that must be treated to prevent further damage to health. Treatment can be conservative or surgical (through surgery). Appropriate surgical intervention has been shown to significantly aid weight loss, with significant improvement or cure of associated diseases (comorbidities). These diseases are part of the so-called metabolic syndrome.
The most important of these diseases are:
- Type 2 diabetes (type 2 diabetes mellitus),
- high blood pressure (hypertension),
- fatty liver or the resulting chronic inflammation of the liver (steatosis of the liver, steatohepatitis),
- increased blood fats or an unfavourable ratio of fats (hyperlipidaemia, dyslipidaemia),
- sleep apnoea (sleep apnoea syndrome),
- in women, hormonal changes that contribute to the formation of multiple ovarian cysts (polycystic ovary syndrome) and make pregnancy impossible,
- gout, which is caused by high uric acid, also belongs to this group.
Therefore, in surgical treatment, the emphasis is on the metabolic part. So-called metabolic-bariatric surgery is particularly effective in the treatment of type 2 diabetes. Most patients dependent on insulin treatment are discharged with medical treatment only.
A well-performed surgical procedure and its correct selection for a particular patient is an obvious condition for success, but it is not a guarantee of it. The patient's cooperation is the most important and necessary condition.
The patient acknowledges that:
- the outcome of the entire treatment depends on him,
- he will cooperate with the treating physicians and follow their instructions,
- will work towards lifestyle changes including:
- dietary habits
- diet composition
- physical activity
- self-acceptance
Patients suitable for bariatric surgery:
- obese with BMI > 40 kg/m2
- obese with BMI 35 - 40 kg/m2 +
- obese with comorbidities, especially any of the manifestations of metabolic syndrome (diabetes)
- obese with a psychological or psychiatric indication
- obese with a need to reduce weight before orthopaedic surgery
- obese with a need for weight reduction before cardiac surgery
- obese with a need for weight reduction for oncological reasons (especially breast cancer)
- obese with the need for weight loss after failure of primary surgery, especially gastric banding, gastric plication, but also after sleeve gastrectomy, gastric bypass or in patients who have not achieved the desired weight loss after any type of surgery
- management of gastroesophageal reflux (gastric reflux) including hiatal hernias during or after bariatric surgery
BMI calculator
Appointment for consultation
If obesity is making your life difficult, causing health problems and you are determined to address it, then don't hesitate to discuss your treatment options with Michael Vraney, MD. The consultation is covered by health insurance companies and does not require a referral from a GP or other treating physician.
To make an appointment for a consultation, please fill out this online form. After submitting the form, we will contact you.
Contact email: bariatrie@akeso-poliklinika.cz
Basic types of surgery
- One-assisted gastric bypass (OAGB) - called minigastric bypass
- R-Y gastric bypass (two connections)
- Sleeve gastrectomy - removal of a larger part of the stomach - called a tube
- SADI-S - single-joint gastric bypass, followed by sleeve gastrectomy at one or two times
- conversion of the type of operation after a previous procedure - the expected weight loss is not achieved or weight gain is resumed - so-called 'redo' operation
- other types of surgery, less frequently performed
Česky
