Hard questions, honest answers
Gastric bypass surgery is a serious procedure, which is why not everyone is suitable for it. What are the reasons for refusing to perform an operation?
Weight loss surgery is an intervention that improves the patient's health condition globally, and it should be seen as an investment in health. Not only will the scale show less, but any existing diseases associated with excess weight will also significantly improve. However, this "investment" only pays for itself after a longer period of time, so the operation should only be performed if the profit associated with the improvement far exceeds the surgical risk.
That's why surgery should be strongly considered for people over the age of 65 or after a recent cancer. Perhaps even more important, the patient understands that surgery is just a tool that must be used appropriately. Therefore, surgery is not recommended in the case of an uncontrolled psychiatric problem or illness, or active drug addiction.
The surgery is preceded by a serious diet. What happens if the patient does not comply?
Strict adherence to a so-called liver-shrinking diet is recommended for 14 days before surgery. This empties the glycogen stores of the liver, and the surgeon has easier access to the stomach. In case of non-compliance with the diet, this can be difficult, and even the ability to perform the intervention during the operation can be jeopardized. It is important to understand that this is not necessary so that the surgeon sweats less during surgery, but so that nothing reduces the success of the surgery.
Why is surgery so expensive?
The costs of the surgery are clearly high: we, for example, use special, single-use sewing machines during the surgery, which can only be obtained from the USA. A gastric bypass operation requires at least 6-8 pieces, and they cost nearly 100,000 HUF. During the intervention, at least 4 doctors and 3 specialist assistant colleagues work in the operating room, and in the 24 hours after the operation, we use special devices to reduce the risk of thrombosis.
What are the most common complications during surgery?
The most common complications during surgery are bleeding, spleen injury, intestinal injury, or rupture of the liver. In recognized cases, these can easily be corrected relatively easily.
What are the most common reasons for reoperation?
In general, reoperation is performed for hemostasis or to control the leakage of intestinal contents due to insufficient intestinal connection, and in most cases it is also performed laparoscopically, i.e. using the keyhole technique.
Bleeding can also occur later, which can appear in the form of bloody vomit or bloody stools. Fortunately, the chance of bleeding requiring repeated surgery does not exceed 1%.
If the intestinal connection created during surgery does not heal, the contents of the intestine enter the abdominal cavity and can lead to severe peritonitis. Fortunately, the chance of this does not exceed 1%, and we can say with considerable pride that this has not yet occurred in the case of the approximately 300 bypass operations performed at the Duna Medical Center. In the same way, we have not yet encountered deep vein thrombosis or pulmonary embolism, which can be fatal.
Complications can also occur after a hospital stay. Your gut needs to kick in, which takes time. During this time, there may be nausea and vomiting, and due to tissue swelling, the permeability of the intestinal connections may decrease, and the intestines may twist, but overall the chance of this is no more than 0.5%.
During the operation, the hernia gates are closed during the procedures performed at the Duna Medical Center, so the internal hernia, which otherwise occurs with a frequency of 10%, has not yet caused a problem for our patients.
Weight-loss surgeries are complex, large-scale interventions, which unfortunately can lead to serious complications that can even lead to death. What are the chances of that?
According to international statistics, the chance of death related to the operation is 1% - (for comparison: for a gallbladder operation or an appendix operation, this is 1 in 300 cases) at Duna Medical Center we have not lost a patient. This is largely due to the very well-accustomed operating room team and the experience and dedication of the post-operative nursing staff. The surgery performed at the Duna Medical Center and the subsequent protocol follow the strict standards of Great Britain, where 4-6 patients die during around 8,000 surgeries every year, which is considered very safe for this type of intervention.
Are there groups of patients in whom death may be more frequent?
Yes, this group can be clearly defined. These are the patients who have been suffering from diabetes and high blood pressure for decades, and who have gained a lot of weight, for whom the previous surgery (mainly the gastric band) makes the intervention difficult. It is important that everyone receives a personalized surgical risk assessment already during the consultation, and knowing this, they can decide in favor of the surgery or reject it.
What happens to the bowel during surgery? Can the excluded intestinal tract die?
During bypass surgery, part of the stomach is removed, not the intestinal tract. The excluded stomach remains in the body, it does not die, it may shrink a little, but it also retains its function. In extremely rare cases, if the surgery has to be reversed, it can be connected to the small stomach again and it will work again.
Previous interviews revealed that many patients hide the fact that they underwent bypass surgery from their friends and family. Is this attitude appropriate? Could there be consequences for the patient?
Of course, it is everyone's private matter what they initiate their environment into. However, it is worth reporting the fact of the surgery to the next of kin and the family doctor, and showing the medical papers received after the surgery. Also because everyone will be faced with the fact that significant weight loss is taking place, and the suspicion of a more serious illness (tumor) arises involuntarily. This is often accompanied by hair loss, and we have already laid the foundation for a complete conspiracy theory, in which several people are sure that a terminal tumor has developed, and we can't even eat anymore, not like before... That's why it's worth briefly letting those around us know that surgical we used help to lose weight.
In the next part, we will ask the doctor about regaining weight, changed movements of the intestines, overeating, "carbohydrate dumping", something about sex and sports after surgery.
Get to know our doctor who performed the procedure:
Learn the stories of our patients:
NEW LIFE: FROM THE FIRST STORE JEANS TO POLE DANCING FITNESS
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Our 22-year-old female patient had gastric bypass surgery at the Duna Medical Center in August 2016, as a result of which her weight decreased from 149 kg to 102 kg in 8 months.
-86 KG IN 6 MONTHS!
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Our patient László Mikla was asked this question countless times. He proved that he can lose weight even without surgery: his doctor, Dr. Péter Vasas, recommended losing 25 kg before the intervention, and he greatly exceeded the request: he lost 41 kg. For him - like many of his peers struggling with overweight - the problem was not losing weight, but maintaining the desired weight. Two months after the operation, the scale was almost minus 61 kilos, and at the end of June 2018, six months later, the weight loss was almost 87 kg. And by March 2020, he reached a weight of 97 kg!
FROM 186 KILO TO HEALTH
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Anita Lakatos had the highest BMI (body mass index) of all the patients we have operated on so far: her height was 157 cm and her weight was 186 kg when we performed gastric bypass surgery on her in April 2018 at the Duna Medical Center.
FEMININITY RE-DISCOVERED
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Recently, three of our patients visited Dr. Vasas. We took the opportunity to ask them questions that many people are afraid to ask. The ladies have lost 70, 56 and 64 kilograms so far and have become friends since their surgery.