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The bariatric surgery involving the reduction of the stomach by the mouth method was performed for the first time in Poland in September 2022. This was done by surgeons from the hospital. F. Raszei in Poznań, using the so-called endoluminar technique. It allows the patient to be operated on through the natural orifices of the body without incising the abdominal cavity.

Bariatric surgery without a scalpel? It's possible now.

Bariatric surgeryis the professional term for an operationof surgical treatment of obesity . The first such procedures were carried out in Poland in the 1970s. Then, in order to get to the digestive system, the surgeon cut open the entire abdomen of the patient. In the 1990s,laparoscopy"entered" operating theaters. What is it about? In the abdominal wall, the surgeon makes a few small incisions through which he introduces special guides into the abdominal cavity, the so-called trocars. Then he places miniature surgical tools and a camera in them, which transmits the image from the operating field to the monitor placed in the room.

Surgery, including bariatric surgery, is entering a new stage. This is due to the so-calledendoluminar technique . It allows the patient to be operated on through the natural orifices of the body, e.g. nose or mouth, without cutting the skin and other body layers.

In mid-September 2022, the first three gastric reduction treatments were performed in obese patients using the endoluminar method. They were conducted by Dr. Gontrand Lopez-Nava Breviere, one of the outstanding European specialists in the field of gastrointestinal diseases and endoscopy, Director of the Bariatric Endoscopy Department at Sanchinarro University Hospital in Madrid. He was assisted by the Polish pioneer of endoluminar technique - Dr. med. Aleksander Sowier, specialist in general surgery, Head of the Department of General, Minimally Invasive and Traumatic Surgery at the Hospital. F. Raszei in Poznań.

Worth knowing

Bariatric surgeryis the most effective method of treating patients with third degree obesity, i.e. enormous (BMI - body mass index - 40+) and patients with 2nd degree obesity (BMI 35+) and diseases that are complications of obesity, e.g. type 2 diabetes, hypertension, heart disease. Every year, around the world, it is used by thousands of obese patients. Currently, 2 to 3,000 bariatric surgeries are performed in Polandlaparoscopic technique, including: sleeve gastrectomy (the so-called sleeve), gastric by-pass and (less and less often) insertion of an adjustable gastric band.

Obesity is a disease
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Obesity has been officially recognized as a disease by the World He alth Organization. Obesity has reached epidemic proportions in Poland. Already 700,000 Poles with third degree obesity need a life-saving bariatric surgery. A bariatric patient requires the interdisciplinary care of specialists in the fields of surgery, psychology, dietetics and physiotherapy.

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Mouth bariatric surgery. How is it going?

Endoluminar bariatric surgery was somewhat reminiscent of a sleeve gastrectomy.

- We insert an endoscope equipped with a special head through the patient's mouth and into his stomach. Then suture the stomach from the inside, dividing it into 2 parts - the smaller one, which fills up first while eating, and the larger one. At the same time, we do not remove the larger one, as we do with the sleev, but leave it in the patient's body - explains Dr. Sowier.

Advantages of mouth bariatric surgery.

To make the stomach smaller, part of it is not cut off, but only pierced. Thanks to this, if there is a need to perform another bariatric surgery, this organ can be stitched in another place, reducing its volume again. The thread can also be removed if it turns out that the stomach has been reduced too much.

- During bariatric endoscopic surgery, the stomach maintains full innervation, good motor and secretory functions, and does not undergo necrosis. But most importantly, the endoluminar technique is minimally invasive for the patient's body. It significantly reduces the risk of complications related to the violation of the abdominal wall. As a result, the process of convalescence in the operated person is very quick - the patient can leave the hospital even within 24 hours after the surgery and quickly return to daily activities - emphasizes Dr. Sowier.

Mouth bariatric surgery - for whom?

Bariatric surgery using an endoscope is intended for those obese patients who, for he alth reasons, cannot undergo classical or laparoscopic surgery or are afraid of them. In Poznań, in September 2022, 3 patients were operated on with this pioneering technique. They were 2 women weighing 110 kg and 150 kg and a man weighing 160 kg. All three of them also had hypertension, problems resulting from a significant strain on the joints, especially the knees, and many years of obesity treatment with a conservative method, i.e. with an appropriate diet and physical activity.

Bariatric operations using the endoluminar technique are not reimbursed by the National He alth Fund. The cost of such an operation is over PLN 15,000.

Important supports safe treatment and a dignified life of people suffering from obesity. This article does not contain discriminatory and stigmatizing content of people suffering from obesity.

About the authorMagdalena Gajda A specialist in obesity disease and obesity discrimination of people with diseases. President of the OD-WAGA Foundation of People with Obesity, Social Ombudsman for the Rights of People with Obesity in Poland and a representative of Poland in the European Coalition for People Living with Obesity. By profession - a journalist specializing in he alth issues, as well as a PR, social communication, storytelling and CSR specialist. Privately - obesity since childhood, after bariatric surgery in 2010. Starting weight - 136 kg, current weight - 78 kg.

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