Bariatric surgery abroad: Lithuania
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Obesity
Obesity is a medical condition in which misbalance between calorie intake and expenditure leads to excessive fat accumulation in human body. Small yet long-term positive energy balance may cause significant increase in body fat mass. According to studies, positive energy balance of approximately 10 kcal per day leads to an annual fat mass increase of 1 kg. There are many factors that may cause obesity including genetic, cultural, socioeconomic, psychological, and metabolic factors. Genetic predisposition plays major role in the development of obesity and accounts for about 80 % cases. It is also important to emphasize metabolic-organic factors, because in particular endocrine diseases causing hormonal disorders, primary management of the disease is the key to weight reduction.
Obesity increases the morbidity of various diseases and causes a mean decrease in survival by 6 to 7 years. Obesity may cause the diseases listed below:
- Cardiovascular system: ischemic heart disease, myocardial infarction, cardiac insufficiency, arterial hypertension.
- Dysfunction of endocrine and reproductive systems: type II diabetes mellitus, infertility, menstruation disorders, pregnancy / delivery complications.
- Digestive system: gastroesophageal reflux disease, cholelithiasis, hepatic steatosis.
- Respiratory system: obstructive sleep apnea, hypoventilation syndrome, asthma.
- Musculoskeletal system: osteoarthritis, impaired mobility, gout.
- Nervous system: migraine, carpal tunnel syndrome, idiopathic intracranial hypertension.
- Chronic renal insufficiency.
- Increased risk for cancer.
Treatment options for obesity:
Conservative treatment: diet, medications, physical activity.
Surgical treatment is used in cases of failure to achieve desired weight control with conservative treatment. Several techniques are available for surgical treatment of obesity. They are widely used worldwide, and their efficiency in weight correction and management of associated co-morbidities is substantially higher as compared with conservative methods.
Indications
Special indications and particular conditions exist with regard to surgical treatment of obesity
- Obesity lasting for at least 5 years
- BMI >= 40
- BMI >= 35 + a co-morbidity:
- Diabetes mellitus
- Impaired glucose tolerance
- Hypertension
- Hyperlipidemia
- Sleep apnea
- BMI > 50 can be considered as a nearly absolute indication for surgical treatment of obesity, because such body mass has a considerable negative effect on patient’s quality of life, and may cause serious concomitant pathology.
- Ineffective conservative treatment (at least for 6 months)
- Age of 18–65 years.
Appropriate patient’s psychological preparation for the surgery is essential. It is necessary that the patient understood the mechanism through which the surgery causes weight reduction, the importance of adherence to postoperative recommendations, and the fact that the surgery alone (without individual effort of the patient) cannot guarantee desired weight loss.
Contraindications
- Endocrine diseases causing obesity (e.g. hypothyroidism, Cushing’s disease).
- Impairment of cognitive and learning functions, emotional instability.
- Addiction to medications, alcohol.
- Inflammatory diseases of the gastrointestinal tract (e.g. ulcers, esophagitis, Crohn’s disease).
- Severe cardiovascular, respiratory or other diseases significantly impairing general patient’s health condition.
Surgeon
• Surgeon Almantas Maleckas is adoctor of medical science
• The surgeon is a member of World Weight Loss surgery group
• Works in Lithuania and Sweden
• Had practical courses and seminars in Germany, Greece, Switzerland.
Contact surgeon directly here:
