Laparoscopic surgery for the treatment of obesity

Obesity is a serious disease that endangers the quality and duration of life of those who suffer from it. It causes physical limitations that are proportional to the degree of obesity, causes diseases such as type 2 diabetes, sleep apnea, arterial hypertension, some types of cancer and increases the risk of other diseases such as COVID-19.

The causes are multiple (excessive intake, bad dietary habits, sedentary lifestyle, stress, sleep deprivation, anxiety…) and cause an imbalance between the amount of energy ingested in the form of calories and the amount consumed with a positive balance that leads to an excessive accumulation of body fat.

What does laparoscopic obesity surgery consist of?

Laparoscopic obesity surgery consists of altering the size of the stomach and the absorption of food with special instruments that are introduced through small incisions in the wall of the abdomen.

What are the advantages over other procedures?

The advantages are scientifically proven and are a consequence of the minimal aggression with this type of surgery. The wounds are very small, so postoperative pain and respiratory and infection complications are drastically reduced. In addition, recovery is much faster than with conventional surgery and normally in one or two weeks patients can return to their normal activity.

Who are candidates for this type of surgery?

Candidates for this type of surgery are all patients with obesity (defined as body mass index -BMI- higher than 30 kg/m² and who present some obesity-related condition such as diabetes, hypertension, hypercholesterolemia…) or with a BMI higher than 40 even if they have not been diagnosed with any alteration.

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What other options are there if a patient is not a candidate for this surgery?

If the patient is not a candidate due to high risk or simply because he/she does not wish to undergo surgery, there are other treatment options, which normally the patient who comes to surgery has already undergone.

Diet and physical exercise should always accompany any treatment, in addition to pharmacological treatment or endoscopic treatments such as intragastric balloon or endomanga with the Apollo method that can help. And in a significant number of patients psychological support also helps in achieving weight loss goals.

Results after laparoscopic surgery

The results will depend on the surgical technique used. Currently the most widely used techniques in the world to treat obesity are, in order of frequency, vertical gastrectomy, gastric bypass and single-anastomosis bypass. With any of them it is possible to lose more than 70% of the excess weight and maintain it in the long term.

What complications can appear?

Currently these are very safe surgeries. However, both immediate and long-term complications may appear. Among the immediate ones, the most feared is the leakage of the sutures, which occurs in less than 1% of the patients who undergo surgery. Another possible complication is thromboembolic disease, so it is necessary to prevent deep vein thrombosis in the postoperative period.

In the long term nutritional complications may appear due to lack of vitamins or other nutrients that will be different according to the techniques, normally the most effective operations for long term weight loss also entail more nutritional problems especially in relation to iron metabolism, metabolic bone disease and vitamin B12; hence it is necessary to have long term follow up to detect and treat them as early as possible.