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Obesity surgery

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Tel. 04 75 70 30 00

Dr. Stéphane BARCET

Dr. Jean-Louis LORIN

 

 

Description :

Obesity surgery has been performed in La Parisière since 2000.

HISTORY:

The development of laparoscopy combined with gastric banding (new surgical technique) has contributed to the rapid development of obesity surgery in France. This minimally invasive surgery has helped reduce the complications that were quite common until then.
La Parisière has been offering this type of surgery since 2000, together with other interventions which have been adapted to laparoscopy such as Mason-Mc Lean intervention and gastric bypass.
In the 2000s, a new technique called “sleeve gastrectomy” was developed and validated for obesity surgery.

CURRENT TECHNIQUES:

Several techniques have been validated by surgeons but only 3 are frequently performed and proposed to patients according to their age, condition, BMI and the possible complications of obesity:

- Gastric banding
- Sleeve gastrectomy
- Gastric bypass

These 3 techniques are performed laparoscopically in La Parisière.

- GASTRIC BANDING:

This intervention consists in putting an inflatable silicone device placed around the top portion of the stomach intended to slow consumption of food and thus reduce the amount of food eaten. This type of surgery is quite simple and quick, and involves few immediate complications. However, it requires regular follow-up afterwards to avoid possible secondary complications. The great advantage of this intervention is adjustability.

- SLEEVE GASTRECTOMY:

Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 25% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The first results of this recent technique are positive but long-term outcome remains unknown yet. Initial complications are more common and serious in this intervention as compared to gastric banding, but it requires less follow-up afterwards and avoids prostheses. Gastric bypass is possible as second-line therapy in case sleeve gastrectomy fails, and involves fewer risks as compared to gastric banding. This intervention is COMPLETELY IRREVERSIBLE.

- GASTRIC BYPASS:

In this intervention, gastrointestinal derivation is performed between the stomach and the intestine. The surgeon first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch, and then re-arranges the small intestine to connect to both. Mini bypass system is a recent variation of gastric bypass.

INDICATIONS:

The HAS (Haute Autorité de Santé – French National Authority for Health) proposes a system of reference for obese patients to know whether they need surgery or not:

http://www.has-sante.fr/portail/jcms/c_765529/obesite-prise-en-charge-chirurgicale-chez-l-adulte (in French)

Only patients who first tried a 6-month diet and failed to obtain satisfactory results can apply for surgery.



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