An obese person hardly may be integrated into society, they can find a job or a partner for life. But they are the smallest issues that may arise. Because the health is much more serious. But there are surgical operations that can record real victories in fighting obesity.

Dr Rubin Munteanu , laparoscopic primary physician, specialized in good years obezitatii surgery in the hospital clinic St. Ioan from Bucharest, explain the advantages and disadvantages of gastric ring, gastric sleev discovery and the gastric bypass.

Reporter: – What are the problems that face most often an obesity?

Rubin Munteanu: – Obesity, affection accepted the World Health Organization, by itself trigger diabetes, arterial hypertension problems, cardivascualare problems, but also breathing problems, difficulties integrating socio-professional difficulties of finding a partner for life, problems Fertility in women and the list is not far to be finished. The number of patients, constantly increasing our place in an amazing place three in Europe.

– What treatments can be applied in the case of people with a very large number of kilograms?

– Preventia is the best treatment for sure, but when a person has passed a number of kilograms should make personal efforts of the will so that we can reduce caloric intake by supply and to increase consumption through physical exercise, constantly and supported. Then it comes to the aid of specialized doctors nutritionisti who treat these patients through diet. However, there are a significant number of people who do not make it through diet down to give kilogramele or, once they have given below repun them in a very short time. For them, nechirurgicale solutions are not sufficient. For them, there are surgical methods that help to effectively solve the problems.

– In what stage of obesity can we talk about gastric bypass surgery?

– I have to keep the body mass index, a thing that is easily calculated, the ratio between the weight expressed in kilograms and the square of height, expressed in metres. Depending on the IMC report, there are: normoponderali, between 19 and 24; overweight, between 25 and 29; morbida affected by obesity, between 30 and 39; morbida with obesity, between 40 and 50; superobeziate morbida, between 50 and 60 , And super-superobezitate morbida, over 60. For the IMC over 40, surgery is the most effective method of treatment currently, the issue proved countless statistics and the world. In recent times, has undergone surgery an extraordinary development because of the results. Because it can be done by laparoscopie, meaning that without a large incision in the abdominal peretului, because of this, surgical procedures bariatrica win a land increasingly greater, and patients benefit fully from the surgery “Velvet.”

– What are the surgical methods most popular and what each implies?

– Best-known is adjustable gastric ring, a device that is placed around the stomach, portiunea his superior. Ring is adjustable, when the patient down in May gave a number of kilograms ring may be tight and so, the method to address a number of patients on the basis of clearly defined specialist surgeon respctiv. Gastric ring behavior change people’s food, the learning how to eat so must the body. After it became normoponderal, the ring is complete and weakens over a year remains in the body, without be adjusted. Hundreds of people have implantat such a device and the results are amazing. A number of increasingly large Romanian resorting to this type of operations, both in the country and abroad. Regarding safety act operator, the results obtained in Romania in the field of statistics us situated at the same rates as those of Europe. Other methods are less drastic, but also more efficient. Among them are “Gastric sleev”, meaning gastrectomia longitudinal, a procedure to leave 80-85 percent of the stomach. Stomacul has a banana, has a much reduced capacity compared to capacity initially and they leave portiunea fundica the stomach, the secret to a hormone involved in the mechanisms of hunger and satietate, patients with this surgical procedure is not so hungry. They can consume small amounts of food at each meal, 3-4 in portionate meals a day, almost all food (food without major restrictions) and lose weight, reaching normoponderale in a range of up to 2 years. There are the more drastic, such as “gastric bypass”. And it can be done about laparoscopica he associate food restrictions by creating a small stomach and a process malabsorbtie, suntarea foods that take a different circuit digestive toward normal anatomy. In this way, the patient will eat a little, and it will also eliminate a portion of food nedigerare completely. It is a procedure with a long history in the U.S. in 70 years. Besides the gastric sleev represents radical methods, but effective treatment of obezitatii morbide and super-superobezitatii morbide.

– What are the age limits for these interventions?

– On the world, are accepted as 18-60 age limits at all chiurgicale methods. But in the world of medical confruntandu are serious problems with teenagers, began to be fitted rings and age less than 18 and even other procedures in certain situations very well defined, could come into consideration. And even over 60 if his health allows a surgery, if the risk-benefit balance is in favor of net benefit, then it can perform these procedures, including Romania.

– It may apply one of these methods even to a child of 10 years?

– For a child of 10 years, should help of a nutritionist, a pediatrician, but also a family counseling and must incercate all methods nechirurgicale a period so that this child is growing. Of course, if you are an excessive number kg more, then a method reversibila, such as gastric ring, may come into consideration. I think it is still too small for a surgery.

– What are the risks of gastric bypass surgery?

– As is well known, any method chiurgicala has certain risks. The role of any medical teams anstezico-surgery is to assess them. For patients who are subjected to interference, we have a protocol preoperator investigations, which is sometimes expanded greatly, so that we know everything that is patient and associated diseases, so we can treat them preoperator and thus to avoid complications. Some patients have diabetes, have some very big weights over 200 kg, others are great smokers, all these factors contribute to the growth of such risks. And the extent of surgical intervention is obviously an issue to be taken into consideration. Of course, adjustable gastric ring is a simple procedure and, consequently, the duration of hospitalization and the risks are lower. Gastric sleev-May and not talk about the gastric bypass procedures are more complex in that, obviously, the risks are greater. Always be carefully assessed this risk-benefit report.

– What are patients who can not benefit from such operations?

– There are some patients with major mental diseases. The surgical procedure involves a collaboration with the doctor, involve some further restrictions. Patients who, for example, suffer from dementa are exceptati from these operations. And other significant medical conditions, with a major impact on health may contraindica disease at a given moment. For example, cardiac afectiunile extremely severe. In this case, the risk exceeds the benefit.

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