Advantages
and disadvantages of bariatric surgery (weight loss surgery) What are the risks
of rebound and complications?
National
Center for Global Health and Medicine Hospital Surgeon
Table
of contents
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on an item to jump to that location.
· Benefits
of bariatric surgery (weight loss surgery)
· Disadvantages
and precautions of bariatric surgery (weight loss surgery)
· Bariatric
surgery (weight loss surgery) is only part of obesity treatment
· Bariatric
surgery (weight loss surgery) is a treatment aimed at helping patients with
severe obesity who have complications such as diabetes to live a long and healthy
life. While it is a treatment option for those who have difficulty controlling
it with medical treatment, it is said that there are many disadvantages.
Continuing, National Center for Global Health and Medicine Hospital. The doctor
talked about the merits and demerits of bariatric surgery and the precautions.
Benefits
of bariatric surgery (weight loss surgery)
The
obesity issue is a health disorder that is caused or related to obesity, such
as diabetes. one of the treatment options for patients.
Disadvantages
and precautions of bariatric surgery (weight loss surgery)
It
does not mean that you will become “a body that does not gain weight even if
you eat”
The
disadvantage of bariatric surgery is that you cannot lose weight without
reviewing your lifestyle, or even if you lose weight once, it may rebound.
Sleeve gastrectomy" is a technique that
cuts the stomach to reduce its volume, but it does not suppress the absorption
of nutrients itself, so if you eat more than you need, you will gain weight (
In other words, even if you lose weight after surgery, if you return to your
original eating habits after discharge, it will be difficult to obtain the
effects of the treatment.
Don't
expect too much.
Even
if you were able to lose weight temporarily after surgery, you may rebound
depending on your lifestyle. It is important to face the cause of obesity
properly and try to improve your lifestyle after surgery.
May
consider revision surgery
If
surgery is not effective in weight loss, if diabetes is poorly controlled, or
if gastroesophageal reflux or obstruction occurs, revision surgery such as
bypass surgery may be considered.
Postoperative
complications may occur
Obesity
increases the risk of general esthesis and the surgery itself. economy class
syndrome embolism operation Special attention should be paid to respiratory
complications such as pneumonia, pneumonia, and atelectasis. Obese people often
have sleep apnea even if they are not aware of it, and in this case, the risk
is even higher.
Also,
among bariatric surgeries, the main complications that can occur with
laparoscopic sleeve gastrectomy are:
Suture
failure *
· bleeding
· gastroesophageal
reflux disease
· obstructions
· bowel
· malnutrition
· dumping
syndrome
· embolism
· pulmonary
complications
· Such
*Suture
failure: Delayed healing of sutured wounds, failing the tissue to heal,
resulting in the dissection of part or all of the suture.
Bariatric
surgery (weight loss surgery) is only part of obesity treatment.
Bariatric
surgery is only one part of obesity treatment. Efforts to control weight by
changing one's behavior are necessary after surgery. If you go back to your old
lifestyle after leaving the hospital and continue to eat and drink, your weight
will return to normal. It is a relatively new treatment in Japan that requires
various precautions, so for those who wish to have bariatric surgery, we have
explained in this article the precautions, risks, and disadvantages of the
surgery, so please read in advance. are various risks and precautions, but we
only perform bariatric surgery for those who still wish to have it.
In
addition, to improve the prognosis of patients through bariatric surgery, our
hospital has a wide range of specialists, including surgeons, physicians,
registered dietitians, certified nurses for diabetes nursing certified by the
Japanese Nursing Association, and clinical psychologists. building a system to
watch over patients from multiple angles with a team. For each patient, a
bariatric surgery treatment team consisting of multiple professionals is
created, and comprehensive support is provided while regularly discussing
surgical indications, postoperative progress, and the patient's mental health.
I think this is the strength of our clinic.
As of
January 2021, our hospital is also conducting clinical research on bariatric
surgery (laparoscopic sleeve gastrectomy) for obese and diabetic patients who
meet certain criteria. Bariatric surgery at our hospital is currently
self-funded. The cost (the patient's self-pay amount) is the sum of the
following charges.
Self-pay
for hospitalization in internal medicine for preoperative weight loss
(preoperative hospitalization, approximately 140,000 yen, covered by insurance)Out-of-pocket
expenses for surgical hospitalization (hospitalization for surgery,
approximately 250,000 to 300,000 yen *, treatment not covered by insurance)Expenses
for formula meals (600 yen + tax per meal if purchased at mail-order price
through our clinic or at our store)
*Before
surgical treatment, you must be admitted to the internal medicine department,
and the final surgical indication will be based on the results.
* The
cost of surgical hospitalization varies depending on the hospitalization period
and symptoms.
*In
the case of replacing one meal, the cost of a formula meal per month is about
20,000 yen.
Surgery
indication.
・Primary (primary) obesity between the ages of 18 and 65
・Those who have not received sufficient medical treatment
and who meet any of the following conditions.
1) BMI
of 35 kg/m2 or more is indicated for surgery whose main purpose is weight 2)
Surgery is mainly for the treatment of comorbidities
(diabetes,
hypertension, dyslipidemia, liver dysfunction, sleep apnea syndrome, etc.)
It is
a clinical study and requires strict informed consent, clinical registration,
and follow-up.
Due to the revision of insurance conditions in 2020, in principle, surgery indication at our hospital corresponds to cases that meet insurance coverage. Due to the COVID-19 epidemic, surgery for benign diseases, including bariatric surgery, may be suspended or postponed.
Indications
for laparoscopic sleeve gastrectomy covered by health insurance
-Patients
with a BMI of 35 kg/ m2 or more who have not obtained a sufficient effect even
after 6 months or more of medical treatment, and who have diabetes,
hypertension, dyslipidemia, or sleep apnea syndrome.
Obesity
with a BMI of 32.5 to 34.9 and diabetes with hemoglobin (Hb) A1c of 8.4% or
more who have not obtained sufficient effects even after 6 months or more of
medical treatment, and who have hypertension, dyslipidemia, Or have one or more
obstructive sleep apnea syndrome (severe cases with AHI ≥ 30).
Bariatric
Surgery Technique.
Currently,
four types of bariatric surgery are mainly performed in Japan: laparoscopic
sleeve gastrectomy, laparoscopic adjustable gastric banding, laparoscopic
Roux-en-Y gastric bypass, and laparoscopic sleeve bypass. In December 2017,
laparoscopic sleeve bypass surgery (laparoscopic sleeve gastrectomy and
duodenal jejunal bypass) was approved as an advanced medical treatment. At our
hospital, we mainly perform laparoscopic sleeve gastrectomy covered by health
insurance, but for patients with severe diabetes, we have established a system
to perform laparoscopic sleeve bypass surgery with the approval of the Ethics
Committee.
We
select the surgical method according to the condition of the patient.
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