Morbid obesity is hard to eliminate! Laparoscopic minimally invasive surgery

Mr. Cai, who is in his 40s and lives in Tainan City, is 170 cm tall. He often overeats and once weighed more than 140 kg. At the doctor's suggestion, he underwent laparoscopic gastric bypass surgery. Three months after the operation, his weight changed significantly, from more than 140 kilograms to the current 90 kilograms, almost the weight of an adult woman. His diabetes was also completely relieved and he currently does not need to take any medication to control it.

According to the Department of Health, there are nearly 100,000 people in Taiwan who need weight loss surgery each year, that is, those with a body mass index (BMI) of 37 or above, or 32 or below 37 but with serious chronic diseases.

Li Kuo-ting, a general surgeon at National Cheng Kung University Hospital, pointed out that National Cheng Kung University Hospital has been using weight loss surgery to treat patients with morbid obesity since 2009. To date, more than 100 patients have undergone surgery, with significant weight loss results. For patients who have undergone gastric banding surgery, the average weight is 115 kg, and the maximum weight loss can be up to 50 kg.

For gastrectomy, the average patient weight is 120 kg and the maximum weight loss can be 80 kg. The average weight of gastric bypass surgery patients is also 120 kg, and the maximum weight loss is as much as 110 kg, which is quite amazing. Currently, with the assistance of minimally invasive surgery, several major weight loss surgeries can be performed through total laparoscopy. Patients only need to be hospitalized for 4 to 6 days and can return to work in a short period of time, with minimal impact on patients' daily lives.

The doctor emphasized that there are four options for laparoscopic minimally invasive weight loss surgery: gastric bypass, sleeve gastrectomy, gastric folding, and gastric banding. It can be completed in an almost invisible way by making only 3 to 5 small holes in the belly. The most effective surgery after gastric bypass or sleeve gastrectomy is to reduce hunger, which can reduce excess weight by about 70%.

Although the safety of the operation is guaranteed, it is a major transformation of the stomach after all, so sufficient communication and detailed evaluation before the operation are very important. In addition, the medical definition of successful weight loss is to maintain no weight gain for 5 years without the yo-yo effect of weight going up and down, so that you can get rid of the troubles of chronic diseases.

Mr. Cai, who is in his 40s, once weighed more than 140 kilograms (left picture). After weight loss surgery, his weight dropped to 90 kilograms at present. (Photo provided by National Cheng Kung University Hospital)

【3 things to note during morbid weight loss surgery】:

1. Group: People aged between 14 and 65, those who have failed to lose weight with medication or other methods for more than half a year, those whose obesity is not caused by endocrine problems, those who do not have mental illness or drug abuse, those who do not have major organ dysfunction, and are suitable for surgical methods such as general anesthesia. Only patients who meet the above conditions can undergo weight loss surgery.

2. Screening: An abdominal examination should be performed before weight loss surgery, because obese patients often have gallstones, gallbladder diseases, etc. If there are lesions in the abdominal organs, they can be treated at the same time as the weight loss surgery. Take cholecystectomy as an example. During the weight loss process, about half of the people will develop gallstones. If the gallbladder is found to be diseased or has stones before the surgery, the gallbladder can be removed at the same time as the weight loss surgery, and biliary diseases can be avoided in the future.

3. Choice: There are many different surgical methods for weight loss surgery. The main principle is to limit the patient's food intake or limit the absorption of the digestive tract. Common restrictive surgeries include: gastric banding and intragastric balloon, and common restrictive combined malabsorption surgery includes gastric bypass surgery. Currently, gastric banding and gastric bypass surgery are the most widely used weight loss surgeries.