New hope for obese patients: The University Hospital in Motola presents modern bariatric methods

Prague, June 20, 2023 – Tthe doctors of the University Hospital in Motola and the most modern technology come together to offer patients an effective way to treat obesity and its associated diseases. Thanks to the advanced methods of bariatric-metabolic surgery, patients have the possibility of permanent weight loss and a significant improvement in their overall health.

Obesity treatment center at the Internal Clinic of the 2nd Faculty of Medicine of the UK and Motol Medical Center under the leadership MD Dita Pichlerová, Ph.D. offers its patients a multidisciplinary team consisting of nutritional therapists, psychologists, gastroenterologists, diabetologists, surgeons and other specialties. The advantage is the presence of an interdisciplinary team under one roof, where experts can work closely together in the care of an obese patient. In the treatment of obesity, the department uses the latest drugs in both injectable and tablet form and is developing a unique robotic bariatric surgery program in the Czech Republic.

Bariatric-metabolic operations are surgical procedures in the area of ​​the digestive tract. They can be used to effectively treat obesity and associated diseases, such as type 2 diabetes mellitus, high cholesterol, hypertension and others. They are primarily intended for patients with a BMI higher than 35 with associated comorbidities, but they can also be indicated for the first degree of obesity, i.e. with a BMI over 30 in the presence of diabetes. Currently, this is the most effective method of treating type 2 diabetes mellitus.

"The principle of bariatric-metabolic operations is a kind of reduction of the digestive tract, either through restrictive procedures, i.e. reducing the stomach, or through malabsorptive procedures, when there is partial intervention in the intestine as well. In this way, not only the size of the portion eaten is affected, but the patient's level of certain hormones and neurohormones also changes after the operation, so that he is less hungry and has less appetite, and the body's set-up for weight loss changes overall. At FN Motol, a restrictive type of surgery is performed - tubulization or sleeve gastrectomy, which is also the most widespread procedure in the world." specifies MUDr. Dita Pichlerová, Ph.D., head physician of the Obesity Treatment Center at the Internal Medicine Clinic of the 2nd Faculty of Medicine of the University of Warsaw and the Motol University Hospital.

In addition to the BMI value, the patient must meet several other conditions. A multidisciplinary team headed by an internist - an obesitologist is involved in his care and indication for surgery, the patient must also visit a nutritional therapist repeatedly, undergo a psychological examination and undergo blood tests, a gastrofibroscopic examination of the stomach and sonographic examination of the abdomen. Body composition is measured repeatedly on a bioimpedance scale. All specialists must approve the patient for surgery.

"It is very important that the patient demonstrates the so-called willingness to cooperate. Before the operation, under the supervision of a specialist, it is necessary to start adjusting the menu, reduce portions, learn something about the composition of food and adapt the drinking regime. With this change, patients usually begin to lose weight. Losing weight, even just a few kilograms, reduces the size of the liver, which is usually steatotic, and simultaneously reduces the volume of intra-abdominal fat, making the operation technically easier to perform. At the same time, the patient is actually training how he will eat after the operation - that is, often and less, with a high protein content." explains Mgr. Hana Hrdinová, nutritional therapist of the Internal Clinic of the 2nd Faculty of Medicine of the UK and the Motol FN.

The procedure itself is performed robotically assisted under general anesthesia and takes approximately 90 minutes. The hospitalization period is on the order of several days.

Robotic surgery is likely to be the future of the surgical field. There are still few robotic bariatric surgery sites in the world and FN Motol ranks among the first in the country, “ says prof. MD Alan Stolz, Ph.D., MBA, head of the Surgical Clinic of the 2nd Faculty of Medicine of the UK and Motol Medical University.

"After surgery, patients learn to eat in a new regime, i.e. 100 ml of liquid food several times a day, after two weeks they switch to 150 ml of mushy food and from the 5th week on to normal food. Even with a longer period of time, the principles must be followed - eat regular small portions, choose healthy foods and take care of a sufficient and non-caloric drinking regime. It is possible to drink up to an hour after a meal, it is not advisable to combine food and drink. In addition, it is good to permanently limit alcohol and gradually increase physical activity, i.e. to observe the principles of a healthy lifestyle, which the patient adopts during educational meetings with a nutritional therapist." explains Dr. Pichler.

After the massive weight reduction that follows bariatric surgery, patients may suffer from excess skin and subcutaneous fat. The skin, especially in older age, does not have time to respond to rapid weight loss. In the workplace of the Surgical Clinic of the 2nd Faculty of Medicine of the University of Warsaw and the Motol University of Applied Sciences, as part of follow-up care, abdominoplasty, Lower Body Lift, Upper Body Lift or removal of arm and thigh bulges can be performed.

"The right time to see a plastic surgeon is when the patient has established a healthy lifestyle, after which it is possible to correct excess skin that remains after weight reduction," says MUDr. Jakub Miletín, Ph.D., plastic surgeon of the Surgical Clinic of the 2nd Faculty of Medicine of the UK and Motol University of Applied Sciences.

The goal of bariatric-metabolic surgery is primarily to prolong life and increase its quality. Through neurohormonal effects, the patient not only achieves weight loss, but also improves the compensation of metabolic diseases. In some cases, these diseases can even disappear completely. At the same time, the patient's cardiovascular prognosis improves. Weight reduction has a positive effect on the musculoskeletal system, the occurrence of tumors, lung problems, infertility in women and erectile dysfunction in men.

All types of bariatric-metabolic surgery are available in the Czech Republic fully covered by public health insurance, as well as pre-operative and post-operative care.

If you want to make an appointment directly for bariatric surgery, call the phone number: 224 434 027 or 224 434 082

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