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Tuesday 08 March 2022

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Endoscopic, minimally invasive surgery that does not leave scars on the skin expands the range of treatment options available to patients with complex and chronic obesity, giving them the confidence of treatment when other weight loss methods fail or surgery is no longer the right medical option. Or for any other reason, according to a medical expert at the World Health Organization “Cleveland Clinic”.

Dr. is the director of the department of bariatric endoscopy at the Cleveland Clinic. Roberto Simmons-Linares said that diet and lifestyle changes, medications and weight loss surgeries are the traditional foundations of periatric treatment. A flexible tube with endoscopic functions and light and camera passes through the mouth.

Dr. Simmons-Linares added that endoscopy connects the gap between medicine and surgery, adding that “more aggressive approach, more weight loss” is the general rule, but there are also changes in medications and lifestyle. Below the penetration criteria, these may not work for many.

He added, “At the top end, we have surgery, which is very effective, but not everyone is qualified to have surgery. Also, we found that only 1% of eligible patients actually undergo pariatric surgery, which occurs for a number of reasons, including disability. It is important to choose the right one. Thus, minimally invasive endoscopic procedures performed on the same day provide important additional treatment options for obese patients.

BMI

A patient’s eligibility for parietal surgery is determined by his or her body mass index (weight in kilograms divided by the height in square meters) and whether he or she has any medical conditions related to weight, such as high blood pressure or diabetes. A patient eligible for periatric surgery should have a BMI of 40 or higher, or he or she should have a comorbidity of more than 35.

The medical expert said that if a person’s body mass index is 30 or higher, it would be classified as obesity, which makes many patients unfit for obesity surgery, considering that endoscopic procedures “offer a viable alternative”.

Three endoscopic solutions

Patients currently have three primary endoscopic solutions, and this is expected to increase in the future. Current operations reduce calorie intake and are done in outpatient clinics, but the time to do them varies from one surgery to another.

The first surgery, endoscopic sleeve gastrectomy, aims to create a permanent solution that represents the size of the abdomen to be reduced to the size of a banana, similar to the result achieved by surgical sleeve gastrectomy. As for the second surgery, the abdomen involves a balloon, which occupies a space that stimulates satisfaction and is used for a period of six months, and is endoscopically fitted and removed.

The third solution is to place a small suction tube in the stomach through endoscopy, which allows the patient to remove up to 30 percent of the contents of the stomach after eating, and this tube can be removed after reaching the target weight.

Secondary functions

Dr. Simmons-Linares said that endoscopic methods can also be effective as secondary weight loss procedures in cases where the patient has gained weight after bariatric surgery. Various endoscopic techniques ensure that if the patient’s abdomen is stretched after a previous operation, the patient does not have to repeat the original surgery or undergo a more invasive surgical replacement.

Before deciding to have surgery, the patient undergoes a full assessment of eligibility by a multidisciplinary team, during which treatment is required if there are other factors, such as diabetes or sleep apnea and eating disorders. , Are also determined. Lifestyle changes are the cornerstone of any obesity treatment.

The expert stressed that not all treatments are the same for obese patients; This is a complex disease with many forms and causes, indicating that sometimes complex treatments are needed. Various genetic, biological, developmental, behavioral and environmental factors contribute to weight gain and obesity development, he said.

He added, “There is no quick fix for treating obesity. On the contrary, all treatments require care and effort on the part of patients. The endoscopic procedures we have mentioned represent additional tools for treating obesity and minimizing the significant impact on its health. Population, and not considered simple treatment.”

Patients need to adjust their diet and lifestyle over a long period of time to maintain their weight loss. Dr. According to Simmons-Linares, it is important that they have the support of a diverse group of experts, including physicians and nutritionists and psychologists, who stressed that obesity is a chronic condition. Continue to keep in touch with their doctors and they will be able to resolve any issues that may arise after the surgery.

According to the World Health Organization, the proportion of adults and children worldwide who are over 650 million is obese.

The disease is widely known as an infection and is associated with a wide range of cancers and metabolic diseases such as type 2 diabetes, heart disease, hyperlipidemia, fatty liver, hypertension and osteoporosis.