Standard category
With a weight of up to 140 kg, the operation takes place under the most favorable conditions: shorter anesthesia, more technical stapler suture along the probe 36–40 Fr with strengthening of the line, faster activation. Preparation includes gastroscopy, ultrasound, tests, consultations with an endocrinologist and anesthesiologist, and a 2-week diet to shrink the liver. After surgery: liquid phase for 2 weeks, puree for 2 weeks, then training in the “rules of a small stomach”; vitamins and protein are under control. Weight loss is active for the first 6–9 months; concomitant diseases (hypertension, apnea) regress.
Indications
- BMI 40+ is a direct indication for bariatric surgery;
- BMI 35+ with type 2 diabetes, hypertension, sleep apnea, joint diseases;
- BMI 30–35 with poorly controlled type 2 diabetes (by decision of the council);
- ineffectiveness of diets and therapy over the years, weight swings.
How the operation is chosen
Sleeve resection - removal of 75–80% of the stomach with the formation of a narrow “tube”: the most common operation in the world, reduction of excess weight by 55–70%; gastric bypass (LGB) - a small ventricle is connected directly to the small intestine: more powerful in effect on diabetes and reflux; SAGI (gastroiliac anastomosis) is a combined operation with the greatest metabolic effect for complex cases. The choice is made by a bariatric surgeon with an endocrinologist on BMI, diabetes, reflux and eating behavior. All operations are performed laparoscopically with staplers; Type 2 diabetes goes into remission in 60–80% of patients.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
