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[Modern surgical interventions in the treatment of morbid obesity]
János Bende1, Miklós Csiszár, Miklós Ursu
1Péterfy Sándor utcai Kórház, Sebészeti és Plasztikai Sebészeti Osztály, Budapest.
Introduction:
The incidence of obesity keeps increasing in the developed countries. This tendency can be observed also in Hungary. According to scientific literature the extremely obese patients die 12 times more often than ones with normal body weights in the same age. Even with the most thoroughly planned, performed and medicine supported diets it is impossible to achieve a weight loss of more than 10-15 kg. Thus it is the surgical solution from which more and more people around the world expect promising and permanent results. Only in Europe 30 thousand gastric band operations were performed in the last 6 years.
Aim:
The surgical treatment of extreme obesity has gone through tremendous improvement in the past 10 years. In the articles the authors describe the most often performed surgical procedures. They list and evaluate the used methods in the treatment of extreme obesity from the modern stomach reduction operations to the various bypass procedures.
Methods And Results:
The authors also give a report on their 54 operations performed in the last 4 years and also on the achieved results. During this period they have mounted 52 gastric bands with laparoscopic procedures and performed 2 vertical gastric band operations. No deadly or life threatening complications have occurred in any cases. Four of their patients with the best weight loss results have lost an average of 116 kg in 18 months. The patients' diabetes, hypertension, sleeping apnea and other diseases have partially or completely disappeared after the loss of 25% of the body weight.
Conclusions:
The authors believe that the application of adjustable gastric bands is a more humane and more physiological solution than the practically irreversible resection and bypass operations. The authors state that depending on the patients' cooperation the modern surgical solutions give a real chance of significant weight loss. They help to cure the additional diseases and assist the re-socialization of the patient as well. Based on their own and literature data the authors claim that the surgical treatment--with acceptable risk--helps the rehabilitation of the patients and significantly improves their quality of life.
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