Surgical
Treatment

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Why surgery? Concept of metabolic surgery

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Surgical treatment may be suggested after a multidisciplinary screening.

 

Several studies have shown that for severe obesity, when traditional dietary measures have insufficient results, an important and long-lasting weight loss can be achieved by means of a surgical treatment. 

Over the course of the years it has become clear that, in addition to significant weight loss, surgery often also leads to a remarkable improvement of the following conditions, in which in some cases the disease even resolves completely.

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• Type 2 diabetes

• Arterial hypertensions

• Sleep apnea (OSAS)

• High cholesterol

• Reflux disease (GERD)

• Stress incontinence

• Polycystic Ovary Syndrome (PCOS)

• Osteoarthritis

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Because the impact of surgery on conditions such as type 2 diabetes is more important than weight loss itself, it is  often referred to as 'metabolic' surgery.

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Types of interventions

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Traditionally, weight loss operations are classified according to their mode of action:

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• Restrictive procedures: This limits the amount of food that is ingested. : (eg sleeve gastrectomy)

• Malabsorptive procedures: the ingested food and calories are only partially absorbed by the gut

• Combined restrictive/malabsorptive procedures: This procedure combines both mechanisms of action (e.g. gastric bypass)

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In recent years, however, it has become clear that the mechanism of action of the sleeve gastrectomy and the gastric bypass is more complex than this simple subdivision, in which hormonal mechanisms in particular play a crucial role.

 

For more information about the scientific background of obesity surgery, please click here .

 

Both the sleeve gastrectomy and the gastric bypass are performed via keyhole surgery (laparoscopy) . This means that the operation can be performed through a number of small incisions (max. 12 mm) instead of a classic extended incision (laparotomy). This ensures less pain and a faster recovery after surgery.