Heads of the departments
Types of bariatric surgeries performed in the clinic:
- Gastroplication;
- Gastroplication with resection of the fundus of the stomach ("partial sleeve resection");
- Sleeve resection of the stomach;
- “Classic” Roux-en-Y gastric bypass;
- Minigastric bypass (bypass with one anastomosis);
- Distal intestinal bypass;
- Re-SLIV (repeated SLEEVE resection) when weight returns;
- Gastric bypass after SLEEVE-resection;
- Biliopancreatic shunting (SWICH, SADI);
- Removal of the gastric band;
- Repeated bariatric interventions;
- Post-bariatric surgeries (body correction) in bariatric patients.
All bariatric surgeries in the clinic are performed by modern laparoscopic method (through punctures). The selection of patients for surgical weight correction is carried out on an outpatient basis by the staff of the department (institution). The main criteria that allows assessing the degree of overweight and, accordingly, determining the indications for bariatric surgery (“sleeve” gastrectomy, gastroplication, bypass surgery) is the ineffectiveness of the entire complex of conservative measures for weight correction and the presence of metabolic syndrome. An objective criteria for assessing nutritional status is the body mass index (BMI). BMI is a conditional value depending on the height and weight of the patient, measured in kg / m2.
- Normal BMI is from 18.5 to 25 kg/m2;
- BMI from 25 kg/m2 to 29.9 kg/m2 – pre-obesity (overweight);
- BMI from 30 kg/m2 to 34.9 kg/m2 - I degree of obesity;
- BMI from 35 kg/m2 to 39.9 kg/m2 - II degree of obesity;
- BMI > 40 kg/m2 - III degree of obesity.
BMI over 32 in the presence of concomitant diseases associated with obesity is a recognized indication for bariatric surgery. When choosing the type of surgery for morbid obesity, the following indicators are taken into account:
- BMI;
- concomitant pathology and the presence of metabolic syndrome;
- inefficiency of conservative measures for weight correction;
- social status (ability to pay and the will of the patient);
- type of eating disorder, eating habits and addictions.
- the patient is under 18 years of age (in the absence of parental consent);
- the patient has sub-decompensation of concomitant therapeutic pathology (serious diseases of the heart, blood vessels and lungs, pathology of the esophagus esophagitis, varicose veins of the esophagus; stomach, duodenal ulcers, erosion; there is portal hypertension (without / with liver cirrhosis), chronic pancreatitis; etc…);
- pregnancy;
- active inflammatory process;
- constant use of steroid hormones;
- drug addiction, alcoholism, mental problems
- presence of autoimmune connective tissue diseases (rheumatism, systemic lupus erythematosus, scleroderma…);
- violation of blood clotting.
- lack of motivation for treatment, self-discipline;
- if the patient is unable to clearly follow the needed diet scheme.
All operations are performed under general anesthesia, the type of which is selected individually, taking into account the characteristics of the patient's body and his wishes.
Necessary amount of preoperative examinations (if you don’t have it on hand, you can do it in the conditions of the Department of Surgery or on an outpatient basis, as well as in MSTH):
KLA, TAM, Biochemical blood a-s (protein, urea, creatinine, bilirubin, ALT, AST, K, Na, Ca, Cl, glucose, amylase), coagulogram, lipidogram, ultrasound of the OBP, ECG, conclusion of the therapist (with hypertension, rhythm disturbances, age 45 and above), FGDS, gynecologist, fluorography, polysomnography (according to indications), preliminary examination by an anesthesiologist (with examination results);
According to indications: ECHO-KG, spirometry, conclusion of related specialists (cardiologist, urologist, endocrinologist), etc.
Guaranteed amount of postoperative laboratory examinations: 1) KLA, 2) Biochemical blood test (Protein, albumin, urea, creatinine, amylase, bilirubin, K, Na, Cl, Ca, glucose,) - in dynamics.
The amount of postoperative instrumental examinations: R-scopy of the stomach (-graphy) without fail.
The employees of the center have the greatest experience in performing various laparoscopic bariatric surgeries in the country.