Bariatric surgery in Estonia
Bariatric surgery in Estonia section, includes general infrmation about Bariatric surgery Procedure, Bariatric surgery Estonia Local News, Bariatric surgery Estonia 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 Procedures
Bariatric surgery Estonia (current)
Estonia Buttock Augmentation
Estonia Calf Augmentation
Estonia Liposuction
Estonia Body Contouring
More Estonia info...
Estonia Get in As Estonia is a member of the European Union, citizens from these countries can enter Estonia with a valid passport or a valid identity card. In addition more than 30 other nationals (including the United States, Canada, Australia, New Zealand and Japan) can enter Estonia without a visa (detailed list at Estonian Ministry of Foreign Affairs).
A growing number of foreign visitors have been traveling to Estonia in recent years. According to Statistics Estonia the nation's statistical agency, 1.3 million foreigners visited the country in 2000, and that number climbed 38 percent to 1.8 million foreigners by 2005.
Estonia Holidays
National holiday : Independence Day, 24 February (1918); note - 24 February 1918 was the date of independence from Soviet Russia, 20 August 1991 was the date of reindependence from the Soviet Union. Each 24 February a grand ball is held in the building of Estonia Theatre by the president for the prominent and important members of society and foreign dignitaries.
Jaanip?ev : St John's Day or Midsummer Day held on the night of 23-24 June. The evening of the 23rd and well into the morning of the 24th is celebrated with bonfires and a traditional festive menu concentrating on barbeque and drinking.
V?idup?ha (Victory Day) : 23 June is celebrated to commemorize the decicisive victory over Baltic-German forces in the War of Independence.
Christmas : or J?ulud is also celebrated in Estonia, this is strictly family event.
New Year's Eve : During the period of Soviet occupations the authorities sought to promote New Year as Christmas was all but forbidden for it alleged "religious" and "nationalist" character. After restoration of independence the significancy of the New Year decreased, but it is still a day-off and celebrated. This day is used by the leaders of the country to address the nation.
Plastic Surgery News...
- A meta-analysis published in the Annals of Internal Medicine has concluded that N-acetylcysteine is the most effective agent for preventing contrast-induced nephropathy in patients with chronic renal insufficiency. However, whether this risk reduction translates into a benefit in clinical outcomes remains to be proven.
Researchers conducted a meta-analysis to quantify the effects of individual strategies on the prevention of contrast-induced nephropathy and to facilitate the comparison of preventative effects across strategies.
The meta-analysis included 41 trials in which treatment groups received either N-acetylcysteine, theophylline and other agents such as dopamine, fenoldopam, iloprost, statin, furosemide, trimetazidine, bicarbonate, ascorbic acid or mannitol. The primary outcome was the development of contrast-induced nephropathy, defined as an absolute increase in baseline creatinine greater than 44.2 micromol/L or a relative increase greater than 25% at 48 hours after contrast injection.
The researchers reported the following results:
• N-acetylcysteine decreased the risk for contrast-induced nephropathy compared with saline alone (relative risk 0.62, 95% CI 0.44 to 0.88)
• The effects of theophylline on nephropathy were not statistically significant (0.49, 0.23 to 1.06)
• Ascorbic acid reduced contrast-induced nephropathy (0.46, 0.23 to 0.90)
• Bicarbonate reduced contrast-induced nephropathy (0.12, 0.02 to 0.95)
• Furosemide increased the risk of contrast-induced nephropathy (3.27, 1.48 to 7.26)
The researchers concluded that pre-procedural treatment with N-acetylcysteine and theophylline reduce the risk of contrast-induced nephropathy, but although theophylline reduces the risk, the reduction is not statistically significant. Additionally, the researchers state that fenoldopam, furosemide and mannitol did not produce beneficial effects. They recommend that the results of this meta-analysis should be evaluated in a head-to-head study to identify the most efficacious regimen for preventing contrast-induced nephropathy.
The researchers also mention the following limitations of the meta-analysis:
• All trials evaluated surrogate end-points of contrast-induced nephropathy i.e. increase in serum creatinine
• Only data from published trials were incorporated
- Daytime naps may boost memory by giving the brain a chance to consolidate new knowledge, City University of New York researchers report.