Bariatric surgery in Aarau Switzerland
Bariatric surgery in Aarau section, includes general infrmation about Bariatric surgery Procedure, Bariatric surgery Aarau Local News, Bariatric surgery Aarau Surgeon Locator and other Bariatric surgery related material.
Bariatric surgery Procedure
Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
The term “bariatrics” refers to "weight medicine". Bariatrics generally deals with pharmacotherapy of obesity and with obesity surgery.
Overweight and obesity are strongly related to medical problems in today’s world. There are many health effects of obesity, such as heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, and others.
In addition to medical concerns regarding obesity, appearance (look) has a major relevance to weight and obesity.
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes.
Before someone can become a candidate for bariatric surgery, certain criteria must be met. The basic criteria are:
[1] An understanding of the operation and the lifestyle changes the patient will need to make;
[2] A body mass index (BMI) of 40 or more, which is about 45 kg (100 pounds) overweight for men and 35 kg (80 pounds) for women; or
[3] A BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).
Risks involved
Past studies found that 10 to 20 percent of bariatric surgery patients had complications while they were in the hospital. In 2006, federal researchers found that 39.6 percent of patients had complications within 180 days of surgery. The most common complications are:
[1] A composite of gastrointestinal symptoms including vomiting, diarrhea, dysphagia, and reflux (20%)
[2] Anastomotic leaking (at the surgical connections between the stomach and the intestine) (12%);
[3] Abdominal hernia (7%)
[4] Infections (6%).
About 7% of patients were re-admitted to the hospital within 6 months to treat complications specific to the bariatric procedure.
The in-hospital death rate in adults undergoing obesity surgery in 2003 was 0.2%.
Laparoscopic surgery has become an important addition to this field of surgery, and demand soars, amidst scientific and ethical questions.
Surgical procedures in bariatrics
There are a number of surgical options available to treat obesity, each with their advantages and pitfalls. In general, weight reduction can be accomplished, but one must consider operative risk (including mortality) and side effects. Usually, these procedures can be carried out safely.
The surgical procedures can be grouped in three main categories:
[1] Predominantly malabsorptive procedures: although also reducing stomach size, these operations are based mainly on diversion and bypass.
[2] Predominantly restrictive procedures: a surgery that primarily reduces stomach size: Vertical Banded Gastroplasty (Mason procedure, stomach stapling); Adjustable gastric band (or "Lap Band"); Sleeve gastrectomy.
[3] Mixed procedures: applying both techniques simultaneously: gastric bypass surgery, like Roux-en-Y gastric bypass; Sleeve gastrectomy with Duodenal Switch Implantable Gastric Stimulation.
Biliopancreatic diversion
A complex operation, also known as biliopancreatic diversion (BPD), or Scopinaro procedure.
This surgery is rare now because of problems with malnourishment. It has been replaced with the Duodenal Switch, also known as the BPD/DS. Part of the stomach is re-sected, creating a smaller stomach (however after a few months the patient can eat a completely free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. This results in around 2% of patients severe malabsorption and nutritional deficiency that requires restoration on the normal absorption.
The malabsorptive element of BPD is so potent that those who undergo the procedure must take vitamin and mineral supplements above and beyond that of the normal population. Those that do not run the risk of deficiency diseases such as anemia and osteoporosis.
Because gallstones are a common complication of rapid weight loss following any type of weight loss surgery, some surgeons may remove the gall bladder as a preventative measure during BPD. Others prefer to prescribe medication to reduce the risk of post-operative gallstones.
Far fewer surgeons perform BPD compared to other weight loss surgeries, in part because of the need for long-term nutritional follow-up and monitoring of BPD patients.
Vertical Banded Gastroplasty
a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.
The same effect can be created using a silicone band, which can be adjusted by addition or removal of saline through a port placed just under the skin. This operation can be performed laparoscopically, and is commonly referred to as a "lap band."
Adjustable Gastric Banding
The first lower pressure, wider, one-piece adjustable gastric band called the MIDband® was introduced in 2000. Unlike many of the early bands this was designed specifically for laparoscopic insertion.
Other Bariatric surgery Procedures
All Body Procedures
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Aarau Mid-range
Aarau West (Swiss Quality Hotel), Muhenstrasse 58, 5036, ? +41 (0)62 737 01 01 (hotel@aarau-west.ch, fax: +41 (0)62 737 01 00), [1]. CHF 87-220.
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Plastic Surgery News...
- 'Truthiness,' according to television satirist Stephen Colbert, represents the human preference to follow our intuition despite the presence of facts or evidence. For example, the more ambiguous an answer to a question, the more likely an individual will believe it is truthful.
- A retrospective case review of elderly patients readmitted shortly after hospital discharge found that communication gaps, especially for medicines management, appeared to be a major factor in emergency readmission.
The authors of the study aimed to quantify the extent to which preventable deficiencies in communication played a role in emergency readmissions in one UK centre. They carried out a case-note review for elderly (age 75 and over) patients who were readmitted to hospital as an emergency within four weeks of previous discharge. Outcomes studied were proportion discharged with inadequate arrangements or information for discharge care, proportion discharged with missing medication management information, the proportion for whom incomplete medication information contributed to readmission and the proportion of these patients for whom this was considered preventable.
The notes for 108 consecutive patients were reviewed, and of these, nearly three-quarters (78, 72%) returned within 7 days: 30 (28%) within three days, and 48 (44%) within 7 days. Nearly two-thirds (67, 62%) returned before a discharge letter was typed or had no discharge letter. Changes in medication were poorly documented in two-thirds of available discharge documents. Medication problems were considered to have led to readmission for over a third of the patients (41, 38%), and for most of these (25, 61%) this was considered to be preventable.
The authors conclude that in the patients they studied, incomplete discharge communication was common: this was particularly a problem for medicines management. They suggest that these communication gaps may have contributed to many of the preventable adverse events and readmissions.