The necessity of surgery and its exact form are addressed with the patient. Our clinic’s multidisciplinary team – surgeon, endocrinologist, gastroenterologist, psychologist, therapist, cardiologist, and anesthesiologist – makes the choice.

Body mass index (BMI), which is determined as the ratio of body mass (kg) to height squared, is required to establish whether we are overweight, to what degree, and whether we have a surgical indication. BMI is computed as the ratio of body mass (kg) to height squared (cm). The operation will only be conducted if the body mass index is greater than or equal to 33.

If the body mass index is greater than 50, it is probable that:

• Performing Laparoscopic Sleeve Gastrectomy (LSG) surgery, also in patients who are 16-23 years old and over 60 years old;
• If body mass index <50, gastric bypass surgery is possible;
• Unilateral and Oranastomotic Stomach Bypass Operations – OAGB, RYGB.

Preparatory studies that provide comprehensive information about a patient’s general health. Describes what changes we are dealing with, approximately how long it will take to prepare for surgery, accompanied by a nutritionist-endocrinologist, and a certain type of diet, for at least two weeks to a month.

It is important to have a multidisciplinary review of a particular case, as it is essential to:

• Strictly recommend giving up on bad habits;
• Consulting a psychologist;
• Preoperative studies that determine the day of surgery.
  
  

Bariatric surgeries are divided into two types – restrictive and malabsorption.

1 . Unilastomosin Gastric Bypass Surgery (Mini Gastric Bypass) – a malabsorption operation in which a small part of the small intestine is removed from the digestive tract, its advantages are:

• • Reducing the absorption of food intake;
  • 70-80% weight loss in 12-15 months;
  • Reducing calorie intake by the patient;
  • 95% of sick patients were cured of type 2 diabetes after surgery;
  • The chance of gaining weight 5-7 years after surgery is practically zero.

 2. Gastric Bypass Surgery By Roux-en-Y Method – Bariatric surgery is a type of surgery that is a very good, time-tested surgery for weight loss. It has been around for over 20 years and its results are confirmed by long-term studies. Surgery is a procedure that turns the stomach into a small bag of 2-4 liters with a capacity of up to 30 ml, splitting the upper part of the stomach. To enhance weight loss, a small bowel loop is attached to the pouch and then connected to the other bowel to allow bile and pancreatic fluid to drain through the bypass. The rest of the stomach remains in place. One year after surgery, weight loss is 75-80% of excess weight.

3. SADI-S Surgery – means “bypass duodenal-ileum of one anastomosis with sleeve gastrectomy.” Preliminary studies indicate that he is losing more weight than a standard gastric bypass or sleeve gastrectomy without increased complications. This two-step operation effectively avoids the absorption of food from the metabolically active part of the intestine.

The first step – the surgeon will perform a sleeve gastrectomy, removing about 80% of the stomach;

Second step – The bowel is cut just below the stomach and then attached again to the small intestine loop, about 2 feet below. This process reduces the total length of the intestinal loop where nutrients are absorbed. Surgery leads to decreased appetite, reduced nutrition, and hormonal changes that have a positive effect on metabolism.

In particular:

• You will lose more weight than by vertical gastric resection or standard gastric bypass method;
• Provides a stronger metabolic effect than other types of bariatric surgeries. It is beneficial for people with less controlled, type 2 diabetes;
• May be performed on patients who have already had a sleeve gastrectomy. This is beneficial for those who are experiencing weight reversion or insufficient weight loss;
• Reduces the risk of diarrhea and nutritional deficiencies often found during normal duodenal modification;
• Compared with gastric bypass or duodenal modification, this technique aims to reduce the long-term risk of intestinal obstruction;
• The pylorus is maintained above the loop connected to the small intestine. Pylorus regulates the rate at which food and acids are excreted from the stomach into the intestines and prevents bile reflux. This helps reduce the likelihood of certain problems during gastric bypass surgery: dumping syndrome, unstable fluctuations in blood sugar, food restriction, intolerance, and marginal ulcers.

Repeated bariatric surgeries are required for those who:

• had a very high body mass index and were unable to obtain the desired result with a single procedure. Patients who require two operations, first vertical gastric resection of the stomach, and then gastric bypass surgery; 
• Patients who underwent bariatric surgery but gained weight despite the procedure.

Postoperative period

A few hours after surgery, the patient becomes active, although initially he or she is inactive and later active.

• The duration of hospitalization is 1-2 days;
• After discharge, they are given an outpatient diet for two months and are under the supervision of a surgeon and endocrinologist. After two months, they return to their usual rhythm of life. They no longer need restrictions on exercise and nutrition.

Frequently Asked Questions Before Bariatric Treatment:

1. At what age is obesity considered a disease?

Obesity and overweight are the most common chronic pathologies in children, adolescents, and adults. Recently, its spread around the world has increased so much that it has taken the form of an epidemic. According to WHO 2013 data, 42 million children under the age of 0-5 in the world were overweight, with that number expected to increase to 70 million by 2025. As for adults, approximately 1.7 billion people worldwide are obese and this number is growing rapidly.

2. How or by what means is abnormal obesity measured?

The body mass index is a determinant of obesity and morbidity (extreme degree of obesity). Which is calculated by the formula – weight divided by height squared and denotes what weight should be distributed per 1 square cm of body.

3. Obesity rate in the world and in Georgia – what place does Georgia occupy in this list?

Without exaggeration it can be said that obesity is a world pandemic. The theme is equally similar in Georgia.

4. What are the main causes of obesity?

Such exacerbation of the problem of obesity and overweight is directly related to poor nutrition, insufficient physical activity and genetic predisposition.

5. Is obesity accompanied by pathological diseases? What are the most common comorbidities?

Obesity and overweight in children and adults is a serious and severe pathology and is associated with many health risks such as diabetes, cardiovascular disease, liver damage, musculoskeletal disorders, sleep disorders, asthma, puberty and psychosocial problems.

6. Obesity is known to be a complex disease. Does a psycho-emotional state affect weight gain, in this case?

It can be said unequivocally and resolutely that the psycho-emotional state is directly related to weight gain.

7. What is bariatric surgery and what interventions does it involve?

Bariatric surgery is one of the main directions of surgical treatment of pathological obesity (morbid obesity). It serves to improve the quality of human life and the general state of health. It involves the production of both restrictive and malabsorption types of surgery, such as vertical gastric resection (sliv) and gastric byppas surgeries.

8. The fact is that the American Hospital Tbilisi is fully equipped with state-of-the-art medical equipment, which allows large-scale operations to be performed with minimal damage, thus saving patients time, which is the most important thing today. What equipment do you use during bariatric operations?

• SYGNIA – is the latest generation, disposable sewing machine, equipped with artificial intelligence, is the most accurate and the sewing technology is the most sophisticated, which means virtually no possible complications
• 3D OPERATION – is the latest generation device of the company “Olympus” with 3D image equipment, which allows to deliver the highest quality image during the operation
• OPIOID FREE ANESTHESIA – Premature activation is vital for the prevention of thromboembolism after surgery on any overweight patient, allowing anesthesia performed without opioids.

Answer: Do you have any other comparable clinics to run a parallel in the Caucasus? Then we can talk about the advantages, before that AHT is not an alternative !!!

9. What do you recommend to patients?

I advise all overweight patients to address the issue of weight correction as soon as possible, as this is a step that will determine their tomorrow!

They came to a place where their fundamental right to health will be protected !!!!

“We are getting ready for your visit.”

The primary objective of the management of “American Hospital Tbilisi” is to obtain accreditation from JCI (Joint Commission International) and to provide medical services of the highest quality – for the betterment of your health!