Who should be operated?

Patients with a BMI over 50 or patients with BMI lower than 50 with important severe comorbidities, as diabetes, arterial hypertension or ICC, caused by the Obesity.

How does it work ?

This is fundamentally a malabsorption procedure. The deviation of the intestinal handles is large, allowing the food be mixed with the digestive enzymes at scarcely 80 cm from the colon, providing a small area for adequate nutritious absorption, causing the protean absorption to be the best, not so, with fats and carbohydrates, the consumption of which would cause diarrheal episodes.

As the stomach still allows an adequate volume of food, some patients that do not continue the prescribed nutritional instructions provided by us can present besides from the diarrheal episodes, a fetid smell in their stools that at times disturbs terribly not only the patient but also those around him.

About post surgery

The majority of our patients leave between the third and fourth day, depending of the clinical observations, the drainage quality, (we always place a test "drain" in the abdomen), vital functions, any uncomfortable symptoms, (nauseas, vomiting), or any sign of alarm in the abdomen that would not permit us to freely discharge the patient.

As with every derivative surgery, the patients come out following a strict liquid diet for three to 4 weeks, with the idea to progressively achieve the equilibrium of the internal areas after the radical change of the nutrients absorption, the change in the physiology of the intestine, like the healing of the gastro entere anastomosis; a balanced diet that progressively avoids potential diarrheal episodes that could bring dehydration, electrolytes deficit, and in summary, states that can complicate the patient's nutrition.

Once the patient is stabilized in his new digestive physiological structure, the diets vary as much in quality, as in quantity and frequency; if this is followed, the patients enjoy an adequate weight loss, without mayor nutritional problems.

What are the expected results?

The patients submitted to this technique, have to estimate a yearly excess weight loss of between 80 to 90%, besides added the benefits of an overall improvement of any parallel illnesses brought on by the obesity as Diabetes, Arterial Hypertension, ICC, important arthralgia, etc.

Risks

As every mayor surgery, this one is not exempt of complications; the most worrisome by the surgeons are the premature fistulas with leaks and peritonitis that in an already high-risk patient, a complication of this type could logically aggravates the prognosis of the surgery. Therefore I want to mention that the surgical teams should be people qualified to carry out the sections and the unions with plenty of dexterity and safety for the patient.

The world's literature speaks of complications of between 5 to the 10% and the mortality in between 1 to 2%, we are pleased to report that our group has had some experience with fistulas of intermediate presentation that have been handled with antibiotics and intravenous nutrition therapy, and we have had no need to do a laparoscopy again .We believe that what has been previously described regarding the dexterity of the surgeons in our group, will assure higher success of the surgery and without complications.

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