Obesity becomes "morbid" when the risk of suffering one or more severe diseases related to it increases significantly. It is defined as the pathology by which a person has a BMI (body mass index= weight/hight2) equal to or higher than 40. It is a chronic, complex condition in which a number of factors intervene. Its symptoms accumulate little by little along the years.

 Morbid Obesity determines your Health status and causes related troubles that, either individually or combined, may diminish your life expectancy significantly.

The surgical procedure for morbid obesity has evidenced better results than other non surgical treatments as it offers changes in the individual that do not depend entirely on his/her will. The restriction of the amount of food entering the stomach, or the diminishment in food absorption obtains more encouraging, life-long effects.

The main aim of the German Hospital Bariatric and Metabolic Surgery Unit (Department of General Surgery – Sector esophagus, stomach and duodenum)is to offer patients suffering from Morbid Obesity sensible advice based on our high quality medical experience. Thus complications are avoided or prevented and patient’s general wellbeing is achieved.

There are two types of procedures, which are prescribed according to the needs of each particular patient:

1. Restrictive Procedures (those that diminish food intake):

• Sleeve Gastrectomy: This procedure has had an important worldwide development in the last years It implies the resection of the stomach segment with a greater curve. Thus, approximately 80% of the stomach is removed, leaving a duct or sleeve with a 100 to 200 ml capacity without altering the intestinal transit.  Excellent results are obtained on obese patients, one of the differentiating characteristics is that it does not modify the digestive transit and thus there is low risk of later nutritional complications caused by vitamin and/or mineral deficits, such as anemia and osteoporosis.         
  
  
• Adjustable Gastric Band: By this laparoscopic surgery procedure, a silicon adjustable band is placed on the upper part of the stomach to divide it into two.  The upper part is smaller, thus the entrance of food to the stomach is limited.  The passing of food from the upper to the lower section of the stomach is adjusted to patient requirements.  This surgery does not change the anatomy of the digestive duct and it can be reversed, but as the band is a foreign body, complications such as migration, displacement or erosion of the gastric wall may happen.
  
  
• Intra gastric balloon: This is an endoscopic surgical procedure that introduces a silicon balloon with liquid content into the stomach. The balloon creates a feeling of early fullness and a delay in gastric drain.  Associated to diet and supervised physical activity, weight loss is obtained. The advantage of the method is that it is minimally invasive and the procedure is nearly ambulatory.  The disadvantage is that the balloon must be removed in six months’ time.  During this period, the patient must lose weight and acquire new nutritional habits.  It is indicated for patients with 30 to 35 BMI, or those who must lose weight before undergoing definite surgery.
                     
  

2. Combined Procedure of restriction and malabsorption (it diminishes intake and alters digestion by means of a lower absorption of food): 

• Gastric By-pass: This procedure shrinks the stomach and adds the method of malabsorption, delaying the mixing of food with bile and pancreatic fluids thus contributing to less nutrient absorption. This is acquired by joining the small intestine to the stomach avoiding part of the intestine. Weight loss is generally higher than that with other methods and it does not require further adjustments. Disadvantages:  there is a life time anatomic alteration; it requires nutrition controls and the life long intake of vitamins.

Patients Eligible for Bariatric Surgery

• Between 18 and 65 years of age.
• 50 kilos over the ideal body weight or a BMI of 40 or more; or over 35 with an obesity related disease.
• Having suffered obesity for more than 5 years.
• Acceptable surgical risk
• Having tried other non surgical methods to control obesity, under supervision, for at least 24 months unsuccessfully.
• No addictions, psychological stability.
• Acceptance and subscription of an informed consent.

How to determine if you suffer from morbid obesity
The answer to this question may be the encouragement you need to take the first step. The tools to help you determine if you suffer from morbid obesity and if you are eligible for an obesity surgical procedure (bariatric surgery) are shown below.

There are several accepted criteria to define morbid obesity.

•  If your weight is over 100 pounds your ideal body weight
•  If your Body Mass Index (BMI) is over 40
• If your BMI is over 35 and you are suffering from serious adverse effects on your health related to overweight, such as hypertension or diabetes.

The German Hospital Bariatric and Metabolic Surgery Unit team is integrated by professionals (doctors, paramedic and administrative staff) committed to the treatment of Morbid Obesity patients.  Control is performed before, during and after surgery, in compliance with the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity (IFSO) standards.

- We provide an efficient, specialized treatment and long term follow up.

- We have one of the most extensive experiences in Argentina: 1300 patients treated.

- Directors of the Bariatric Surgery Unit:

Dr. Rudolf Hermann Baron Buxhoeveden
Dr. Alejandro Luis Grigaites

For further information
Contact us at: comunicaciones@hospitalaleman.com