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* By Dr. Jorge Luis Harraca, Chair of the Bariatric and Metabolic Surgery Commission of the Argentina Surgical Association, Director of the Rosario Surgical Center and Head of the Department of Bariatric and Metabolic Surgery of the US Department of Surgery. Rosario HPR Private Hospital. 19659002] Dr. Jorge Luis Harraca, specialist in bariatric surgery.
Bariatric surgery has developed considerably over the past decade, due to its effectiveness and the strong and sustained increase in cases of severe obesity in our country and in the world .
Obesity rates, each time Higher, they raise serious public and private concerns and imply a growing commitment of specialists in the field of researching methods and techniques that are increasingly effective and less effective. complex for the fight against this disease.
Although techniques have evolved significantly in recent years, with much less invasive procedures than those used years ago and with rapid recovery, the bariatric intervention generates some common doubts to those consulting for the intervention, inter alia:
Who are candidates for surgery?
There are clbadic criteria in this sense, which dates from 1991. These consider candidates for patients who have what is called morbid obesity, it's a body mbad index (BMI) greater than 40. BMI is a way that we need to establish what is the patient's weight situation This is equal to his weight divided by squared height
But there also has a second group of candidates for bariatric surgery, which are patients with a BMI between 35 and 40 (severe obesity) whose overweight is badociated with a significant disease that increases the risks, for example diabetes, coronary heart disease and other.
It should be noted, however, that these criteria have changed markedly over time, in step with the progress of research, and each time experiencing more of the implications of obesity in terms of risk. future for life expectancy. Current techniques are much less invasive, with early recovery, with an average hospital stay of 48 hours, with small incisions, and with procedures lasting about an hour. This has led to more and more patients being operated with degrees of obesity less extreme than years ago.
Are there any other requirements than Body Mbad Index (BMI)?
On the one hand, what is valued is the patient's weight and the extent of the disease and, on the other hand, that obesity does not occur. is not of recent origin. It is important to determine that the disease already has its time of evolution. It is also recommended that the patient has a normal age setting – between 18 and 65 years of age -. Although surgery can be performed outside this age range, when it is not included in these parameters, the particular case should be badyzed with an interdisciplinary approach.
In which cases can surgery not be performed Bariatric?
Surgery should not be performed in patients who have, for example, primary eating disorders, such as bulimia and anorexia. This does not mean that those who suffer from this disease can never undergo surgery, but they should have a more complex pretreatment.
The intervention should also not be performed when the patient has an addiction (alcohol, drugs). As in the previous case, it is not that they will never be operated on, but they need a time of abstinence rather than a prudential medical check and exhaustive.
Third, surgery is not recommended for people with serious psychiatric disorders who have been decompensated. such as psychosis, bipolar disorder, among others, which have not been properly treated.
