In Dr. Liu’s clinic, people often ask: What is gastrectomy surgery? Is gastric resection surgery effective? Will health insurance pay? What are the conditions for health insurance payment?
Today I will share with you what is gastric bariatric surgery: There are many bariatric surgeries to reduce the stomach. Here we will briefly introduce the following four common ones:
[The first is gastrectomy surgery]
Also known as sleeve gastrectomy, this is the most popular surgery at present. It removes 2/3 of the stomach tissue. After the operation, the shape of the stomach changes from the original bag shape to an elongated shape like a sleeve. The surgery can be performed through internal vision. After the microscope is completed, the wound is only about 1 centimeter. The volume of the stomach after surgery is about 100cc, which is about the size of a bottle of Yakult. In addition, the removed gastric tissue includes hunger hormone glands, which will cause the appetite-promoting hormones to decrease, making the patient less likely to want to eat. Therefore, the patient will eat less and lose appetite after the operation.
[The second is gastric bypass surgery]
The weight loss effect is the best among the four, the price is the highest, but the risks are also the highest and the complications are the most. Bypass surgery divides the stomach into large and small gastric pouches, and then connects the small intestine to the small gastric pouch. It also limits gastric capacity and reduces intestinal absorption to achieve weight loss.
[The third is gastric banding surgery]
The weight loss effect is slower. The ring band is banded on the upper part of the stomach through laparoscopic surgery, dividing the stomach into two parts. Then install a tube under the skin and pump water through the tube to adjust the size. If you feel that you have lost too little recently, you can inject a little more water (performed by a doctor of course) and make the band a little tighter. Because the upper stomach has less space to store food, the patient will feel fuller easily, thereby achieving the purpose of controlling food intake.
[The fourth is intragastric water balloon surgery]
The weight loss effect of intragastric water balloon is about 15-20% of the body weight. The intragastric water balloon is usually removed after six months, and the weight will return without diet control after removal. However, the advantage is that the water balloon is not like other surgeries that may cause permanent problems. After understanding the classification of the above four types of gastrectomy surgeries, are we suitable for gastrectomy surgeries? There are two points that need to be carefully evaluated:
Currently, National Health Insurance has conditions to cover [morbidly obese patients] to undergo gastric reduction surgery, excluding those who are physically and mentally unfit.
Age 20 to 65 years old
BMI≧37.5
Or patients with a BMI ≧ 32.5 and obesity-related complications, such as hypertension, diabetes, apnea syndrome, etc., and who have failed to receive relevant medical treatment, diet control or exercise for more than half a year
Those who meet the above conditions are eligible for health insurance benefits
Why do we need psychological assessment? Studies have found that people who have undergone gastric reduction surgery have a higher rate of depression in the future, and even have a relatively high "success rate" of suicide!
Taking the United States as an example, doctors will assess whether the patient has "sleep apnea" before surgery. Because general anesthesia is required during surgery, obese people are at higher risk. On the other hand, during postoperative recovery, patients have more rapid eye movement periods and are more relaxed during this sleep stage, with irregular heartbeats, irregular breathing, and autonomic nervous system disorders. If sleep apnea is added to the sleep apnea, there is a possibility of sudden death. Therefore, doctors will first recommend that patients undergo regular treatment for at least 3 months and lose 10% of their body weight first. The neck will be less bloated so that it is relatively safe during intubation. Losing some visceral fat will make the surgery easier.
During gastric reduction surgery, in addition to experiencing postoperative pain, you can only eat liquid food during the recovery period. After gastrectomy, the body's absorption will become worse, so long-term nutritional supplements such as B12, iron, vitamin D, etc. must be supplemented. You cannot drink sparkling drinks and some painkillers. You are prone to acid reflux, and you need to have regular gastroscopy to track the status of esophageal reflux to prevent repeated reflux from causing cancer of the esophagus or stomach. In addition, due to the rapid weight loss after surgery, a large piece of skin will hang down on the waist from the originally stretched skin, which usually requires skin reduction surgery.
Gastric resection surgery is not a one-time solution. The stomach will not grow back, but it will expand. If you don't change your original lifestyle, you may still gain weight even after surgery. This is especially true for patients who have lost control of their brains. Because gastric contraction prevents them from eating too much at one time, they instead eat small, frequent meals. Generally speaking, if the control is not good, they will usually regain weight one to one and a half years after the operation. Usually, at this time, they need to seek help from a specialist for treatment. Dr. Liu's clinic has many people who have gained weight after gastrectomy surgery and come for treatment, and the results are very good!
Gastric resection surgery causes huge changes to the patient's body. It is recommended that patients undergo physical and psychological evaluation before surgery. After surgery, patients must establish a new lifestyle and eating habits, coupled with regular exercise and perseverance, which is the key to successful weight loss. It does not mean that after surgery, you will never gain weight again. This is impossible! I sincerely recommend that if you are planning to undergo gastric reduction surgery, you may wish to come to Dr. Liu’s clinic beforehand. Through pre-operative medical treatment plus surgical surgery, you can achieve better weight loss results!
