Dear patients and interested parties, dear newsletter subscribers,
for the Soccer Bergdorf European Championship 2020 in the Ottmar-Hitzfeld-GsponArena, Prof. Dr. Jörg Zehetner from Swiss1Surgery will provide medical care for the entire tournament. At his side are experienced medical professionals who are constantly dealing with infection events in Switzerland with appropriate preventive care and support, even during the corona pandemic. In addition to the observation and assessment of the situation regarding the corona pandemic, the accident-surgical and surgical departments are also the focus of care during the days from 28 to 30 August 2020.
From June 12th to June 14th 2020 the games of the Small Mountain Village European Championships took place in the Ottmar-Hitzfeld-GsponArena. The games of the upcoming official Bergdorf European Championship 2020 have already been played here on the professional kicker table. And with great national and international interest. Belgium ultimately won the tournament, followed by Germany and Switzerland. Whether this will also be the final result of the true Bergdorf European Football Championship 2020 in Staldenried / Gspon is still up in the stars high above the Valais mountains.
Jörg Zehetner on the Bergdorf EM and the health situation
In total, Prof. Dr. Jörg Zehetner commented on the tournament in the mountains and the health situation at the Small Mountain European Championship. Due to the extremely low and well-controlled infection rate in Switzerland, he has so far seen no obstacles that would call the Bergdorf European Championship 2020 into question at the end of August. Special observation is given by Dr. Jörg Zehetner the Swedes, who have to report significantly higher infection numbers than Switzerland and other European countries because of a different way of dealing with the crisis.
Jörg Zehetner always focuses on the health of active players, referees, helpers and the people from the audience. The doctor is always in discussion with the official offices and authorities as well as with the organizers of the Bergdorf EM 2020 regarding the current situation assessment.
There is no denying the great interest that the doctor is bringing to the extraordinary football tournament. Even the Small Mountain European Championship as a preliminary tournament for the big mountain football meeting demands respect and appreciation, since he also likes to see his own children at the table at home. And of course, the sporting aspect and the charitable commitment are also the focus here.
Before we now read the full text of the interviews with Prof. Dr. Jörg Zehetner summarize, we would like to refer you to the recordings of the interviews on the occasion of the Small Mountain Village European Championship. You can find the links here.
For more information, use the website of the Bergdorf EM 2020 www.bergdorf-em.com or the information directly on the website of Swiss1Chirurgie or in the app m.swiss1chirurgie.ch .
We wish you a pleasant summer time and maybe see you again at the Bergdorf European Championship 2020 from 28th to 30th August 2020 in Staldenried / Gspon in the Valais mountains.
People are more interested in their health and use different sources to inform themselves about healthy lifestyles but also about diseases and their symptoms as well as treatment options. Especially widespread diseases such as obesity (morbid overweight) or reflux diseases (for example chronic acid reflux) are moving further into the focus of public interest and thus also opening the doors to media such as radio or television.
Swiss1 Surgery, led by Prof. Jörg Zehetner, has long been committed to professional public relations and welcomes all measures and ways to promote social awareness of such diseases. Jörg Zehetner sees the stigmatisation of affected women and men as a problem that prevents many patients from undergoing appropriate medical examinations. Ultimately, this leads to a vicious circle, which is associated with a long path of suffering and rarely leads to an improvement in the lives of those affected, usually not at all. Old but also new widespread diseases are not only a problem for those affected themselves. The economy and society as a whole are also affected when rising case numbers lead to more incapacity to work, occupational disability, disability to work and, ultimately, rising health insurance costs.
With a lot of commitment, Jörg Zehetner has therefore now spoken out on the radio as part of his efforts to be heard more in public. On 17 August 2020, as part of the podcast series “Medical Knowledge”, the topic of oesophagectomy (resection of the oesophagus) was a focal point on which the specialist physician at the Hirslanden Klinik Beau Site positioned himself. When and why an oesophagectomy may be indicated was explained very clearly by Jörg Zehetner in just two minutes.
The very next day, 18 August 2020, Jörg Zehetner could be heard again on Radio Bern1. This time on the topic of obesity, which is becoming more and more important as a disease in Switzerland and all other highly developed industrialised countries in the world. Here, too, Jörg Zehetner took a clear position on those affected and, with his many years of experience as a visceral surgeon, spoke about the classic methods of treating morbid obesity.
Here too, Jörg Zehetner impresses with his ability to present the essential treatment options in just two minutes.
Listen to the two podcast contributions from Radio Bern1 in full length here:
It should be noted that these short podcasts cannot replace a comprehensive and thorough diagnosis and counselling. If you think you are confronted with one of these two problems, contact one of the Swiss1Chirurgie clinics. A visit to the website www.swiss1chirurgie.ch can also be helpful. Extensive content on the subject areas is offered here. In addition, all contact details for Prof. Jörg Zehetner and the Swiss1Chirurgie clinics can be found there.
Life always comes with particular challenges and some of them we like to think of as a threat to our own existence. Epidemics, pandemics, forces of nature, cancer, accidents, other serious illnesses and, last but not least, violence instil a good deal of fear and anxiety in each of us.
Yet there is a modern widespread disease that is much more dangerous and deadly in the long term than anything already listed here. We are talking about morbid overweight, which is also called obesity in different stages in professional circles. Far more people are affected by morbid obesity, including its accompanying symptoms and secondary diseases, than we generally realise. Trend: Rapidly increasing!
Oversupply of food and lack of exercise
Obesity is particularly rampant in the developed industrialised countries, for example in Europe, but also on the American continent. However, more and more regions in Asia are also affected, and obesity does not even stop at the African continent.
An overabundance of constantly available food, wrongly learned eating habits passed on to one’s own children, lack of exercise and a fast food culture that is often far too rich in fat and sugar are certainly partly responsible for obesity.
Know what is happening
But first and foremost, it is the people themselves who fall into the obesity trap due to lack of knowledge, lack of contextual thinking and out of convenience. And they often do so with their eyes open, but without a keen awareness of the consequences of poor nutrition. Liver disease, joint problems, circulatory problems, disorders in fat metabolism, shortness of breath, stroke and psychological impairments due to subsequent stigmatisation are only a sample of a wide range of concomitant and secondary diseases that can ultimately be traced back to morbid obesity. This is accompanied by a significant impairment of the quality of life and sometimes the only way to get a grip on the situation is to have surgery. And even that alone is not the solution to the actual problem, but only a last resort for people who are particularly severely affected by morbid obesity.
Obesity as a widespread disease threatens existence
From the medical view of the overall situation, it can indeed be concluded that in the longer term, humanity’s existence is threatened by the widespread disease of obesity. This may be an unimaginable scenario now, but it gains in threat potential when we consider the development of obesity on a global scale.
It is up to each individual to decide how to influence his or her diet and physical constitution. Provided there is a firm will to do so and the insight that the blessing of always having enough food in the existing abundance may not be a real blessing at all.
Determine your own score
We have presented a quiz at https://ch.run/20sekunden that everyone can use to determine their very own overweight risk score. Valuable conclusions for necessary action can be derived from the results. From the experience of decades of research and practical medical and surgical work with severely overweight people, we know that only timely action can offer a way out of morbid obesity. And often it is the early realisation that a change in lifestyle and eating habits can be the best step towards a healthier and ultimately happier life.
In view of the threat that morbid obesity actually poses, our recommendation is to use the simple quiz to determine one’s personal score with regard to possible medical conditions related to obesity. For many, this can be the first important step towards a more conscious approach to their own lives. And even if life itself always seems to be threatened by serious illnesses, accidents, worldwide pandemics or unavoidable forces of nature, we should never underestimate the dangers to which we voluntarily expose ourselves every day through too much and the wrong diet with a simultaneous lack of exercise.
With our quiz at https://ch.run/20sekunden you can quickly and easily determine your risk score and at the same time receive important information on what you can do now or should do urgently. Because there is nothing more precious than life.
With the newly created Bariatric Curriculum, the ZfbC, Thun Abdominal Surgery and Swiss1Chirurgie prepare their patients even better for the upcoming obesity surgery. In a seminar, all questions regarding preparation and execution, anaesthesia and the time after the surgical intervention are answered and essential procedures are explained. More information and safety are the objectives of the Bariatric Curriculum, which was developed especially for the overweight patients.
Every operation is a serious procedure that always involves certain risks. This also applies to bariatric surgery, even if it can be carried out minimally invasively in large numbers, i.e. without large surgical openings of the abdominal wall.
Many patients have a great interest in knowing how such operations are carried out and what is actually done. This is less about the specific techniques and procedures. Rather, patients are interested in how such an operation is prepared, how it proceeds and what risks are to be expected. And it is also interesting how to behave after such an intervention.
In order to be able to cover this justified interest as far as possible, the Centre for Bariatric Surgery ZfbC, the Abdominal Surgery Thun and Swiss1Chirurgie, under the essential leadership of Dr. med. Sebastien Trachsel, have developed a Bariatric Curriculum, which can provide answers to the most important but also personal questions of patients. This will make a significant contribution to more information, education and patient safety.
What the Bariatric Curriculum does
Anyone preparing for obesity surgery has many questions. The better such questions can be answered, the greater the patient’s confidence in dealing with the upcoming operation. Patients can take part in this bariatric curriculum as early as two to three weeks before the planned surgery.
The short but very informative seminar explains which clinical procedures are required and how the anaesthesia will proceed. In addition, of course, there is the general information provided by the surgeon, so that after about two hours of seminar the patients are well prepared for their individual operation. Of course, this does not exclude personal counselling and care directly at the clinic. Rather, this is part of the preparation for the operation and helps to objectively classify concerns, fears and reservations. This is also helped by the fact that directly after the bariatric curriculum there is the opportunity to ask personal questions and receive the appropriate answers.
This is especially important for patients who are undergoing surgery for the first time or who have already had less positive experiences in other operations. Knowing everything that is coming is an essential part of obesity surgery, which is a not insignificant intervention in the future shape of one’s life.
This also means that the dietary changes required before and after the operation can be discussed in detail. This way, the patients already know what their special menu will look like in the clinic. Physiotherapeutic counselling and care are also part of the obesity surgery. How do you get up after the procedure? What should be considered in the movement? How is scar protection ensured? These are also questions of general and personal interest that should and must be discussed in the run-up to the operation.
The bariatric curriculum also includes thrombosis prophylaxis, so that our patients know in advance how they can set the points themselves and thus actively participate in the success of their obesity surgery.
The strength of the bariatric curriculum, which we have developed especially for our overweight patients, lies in the totality of counselling, care and support already two to three weeks before the surgical intervention.
We see more information, more security and more self-participation in the process as an important and essential contribution in the interest of our patients, whom we also want to prepare well for the upcoming operation and life afterwards with the Bariatric Curriculum in seminar form and by answering their personal questions.
Swiss1Chirurgie offers aftercare following obesity surgery
From their many years of experience, the specialists at Swiss1Chirurgie know that many patients do not receive any or only inadequate medical aftercare following obesity surgery. In this context, consistent and regular follow-up care of patients is enormously important if the success of gastric surgery is not to be gambled away. Furthermore, complications after bariatric surgery can endanger the health or even the life of the patients concerned.
Based on this knowledge, the Swiss1Chirurgie clinics offer continuous follow-up care and treatment for patients, even if they have not been operated on in a Siwss1Chirurgie clinic. In this way, the Swiss1Chirurgie clinics make a valuable and important contribution to the sustainable success of obesity therapy for all patients who have not yet received regular, long-term follow-up care.
Swiss1Chirurgie offers an end-to-end treatment concept
Those who face up to their obesity problem must also be aware that successful long-term treatment is an ongoing process that also requires specialist medical support. Especially when the problem of morbid obesity is associated with surgical interventions, long and professional aftercare is needed.
Time and again we meet patients in the Swiss1Chirurgie clinics who are left to their own devices after bariatric surgery. And yet, especially after stomach reduction or similar surgical procedures, it is urgently necessary to accompany and care for these patients in their further development.
The success of obesity surgery always depends on the follow-up care that follows. Follow-up surgeries and counselling also help to ensure long-term and lasting weight loss success. Here, the specialists at Swiss1Chirurgie offer a professional concept of aftercare and further treatment.
After the operation comes the actual treatment
In cases of morbid obesity, surgical treatment is always only one of many steps to improve the health of the affected person. Even in the run-up to the surgical procedures, we work together with the patients to ensure that the conditions for the stomach operation can be created. Once the operation is over, however, the process continues.
In addition to the regular discussions and examinations in the follow-up care, it is not uncommon for further interventions to be necessary if the success of the first stomach operation is not to be jeopardised. In many cases, follow-up operations are even part of the treatment concept and are designed to ensure overall success in the treatment of obesity.
Accordingly, thorough counselling, care and support for patients after the first operation is not an optional extra, but a must. For the sake of the patients, their health and their efforts to achieve an improved quality of life.
Aftercare is often neglected
As already noted, we repeatedly come across patients from other clinics where follow-up care after obesity surgery is clearly neglected or, in the worst case, not carried out at all. This not only poses risks to the success of the obesity surgery, but can even be life-threatening.
Complications that are recognised too late or not at all, unabated inappropriate dietary behaviour and a number of other reasons lead to the success of the stomach operation being gambled away and, in an emergency, the patient’s life being put at risk. We therefore urge all patients who have undergone obesity surgery to contact one of the Swiss1Chirurgie clinics with their problems in the event that follow-up care is lacking or inadequate. Online you will find a simple questionnaire that will give you first clues and possibilities for a professional and continuous aftercare. Use this questionnaire to get into initial contact with us.
Swiss1Chirurgie takes over the aftercare
Knowing that many patients do not receive consistent and long-term follow-up care after a surgical procedure related to an obesity problem, we offer such regular and professional follow-up care for all obesity patients.
This offer also expressly applies to patients who have undergone an operation for obesity surgery at another clinic. In this way, we want to ensure that all patients receive exactly the follow-up care and treatment that is appropriate to their particular situation. After all, the long-term success of obesity surgery is always based on professional, regular and lasting aftercare.
As an affected patient, contact us to schedule an initial consultation. Ideally, you should fill in our online questionnaire. We will then contact you as soon as possible to discuss the further steps of targeted obesity therapy, even after an obesity operation has already been performed.
In an in-depth interview, Dr Steffen from the Centre for Bariatric Surgery ZfbC discusses the importance of follow-up care for overweight patients. In addition to the actual bariatric surgery, structured aftercare is of enormous importance. Only if those affected are actively involved in the process throughout their lives is sustainable success possible. A detailed article on the interview and the interview with Dr Steffen himself can be found here.
Anyone who talks about bariatric surgery, such as stomach reduction or the formation of a tube stomach, must also talk about professional aftercare and further treatment for patients.
This is exactly what Dr Steffen from the ZfbC, Centre for Bariatric Surgery, does in the featured video interview. With over 30 years of experience and 3,600 stomach operations performed himself in the field of obesity surgery, Dr Steffen is one of the leading luminaries in this medical speciality in Switzerland.
Evaluation of the risks
Whether gastric banding, gastric bypass, stomach reduction or other techniques, there is always a certain risk of relapse for the treated patients. It is precisely the reduction of the recidivism rate, ZfbC, when it comes to professional aftercare following obesity surgery. Dr Steffen makes this unmistakably clear.
Obesity treatment is a lifelong process
It should also be clear that after an initial operation for the majority of those affected, there will be further interventions to ensure the success of obesity surgery. At the same time, this means that in the majority of cases, surgery alone will not be enough for the rest of one’s life. Accordingly, it is important to accompany and care for the patients continuously and individually in the aftercare.
Children in obesity surgery
According to Dr Steffen, children are not excluded from the problem of morbid obesity. Fat children usually also become fat adults, so that early intervention can make sense if there is an appropriate indication. It is important to note that the rules and regulations for bariatric surgery must also be observed for minors.
Follow-up care is the decisive success factor
Dr Steffen believes that ongoing follow-up care is more important than the timing of the surgical intervention. From experience, he knows that many patients do not take proper care of themselves after an initial overweight operation has been performed. However, it is also the professional colleagues who must be held accountable, as they do not always focus on special aftercare in their further care. Here, the ZfbC can definitely fill treatment gaps. One should understand morbid obesity similarly to an incurable disease, so that a good strategy for lifelong aftercare must be presented here as well. What Dr. Steffen cannot understand is the fact that he repeatedly encounters patients who are left alone in their problem situation after obesity surgery and are not sufficiently perceived.
Accordingly, the ZfbC would also like to open up to patients who have not been treated in a Swiss1Chirurgie clinic or an affiliated clinic. Here, anyone who complains about a wide range of problems after bariatric surgery should get a sympathetic ear and professional support. What definitely does not work is that patients are simply left to their own devices after obesity surgery with reference to their diet programme. This contradicts every ethical and medical claim.
It should also be clear in this context that anyone who cannot successfully deal with their excess weight before an operation will not be able to do so without help even after the operation has taken place.
Understanding aftercare as a standard
For Swiss1Chirurgie, structured aftercare is part of the standard in obesity surgery. Even though this is unfortunately not the case everywhere, the experts at Swiss1Chirurgie, together with the ZfbC, attach great importance to professional and structured aftercare in the best interests of the patient. This is the only way to ensure initial success, to identify problems in time and to build on the long-term success of the therapy. Anything else doesn’t make much sense.
It is also worth noting that deficiency symptoms can always occur due to the way the different treatment methods work. Such processes must of course be monitored and controlled to show patients how to compensate for certain deficiencies such as calcium deficiency or vitamin deficiency.
Follow-up care for overweight patients is a team effort at ZfbC. In addition to Dr Steffen himself, other specialist colleagues also devote themselves to the patients’ problems in special aftercare consultations. Around 8,000 patients are now being cared for. In the regulations, the Federal Office of Public Health requires follow-up over five years. However, the experts at Swiss1Chirurgie know that, in fact, lifelong follow-up of patients is sensible and necessary. Here, the legislative requirements obviously fall short.
Complications can occur at any time
The problems of the individual patients are very different. The aftercare must be correspondingly individualised. Some of the problems are real complications such as chronic abdominal pain, persistent diarrhoea, deficiency symptoms, vomiting or other functional problems. In principle, every affected person must expect that some kind of problems will occur over a short or longer period of time. Even if this ultimately does not affect everyone, it is still a clear proportion of patients who have to deal with certain problems after obesity surgery.
Alcohol and obesity
As Dr Steffen clearly explains, alcohol has a special effect on obesity and even more so on patients treated accordingly. In his opinion, alcohol has just as high a caloric value as pure fat, in addition to the typical symptoms of intoxication. Accordingly, it makes little sense or is even counterproductive for overweight patients to consume alcohol beyond a low level. The best thing would be to abstain completely from alcohol. This is also the aim of good aftercare.
With every intervention, the risk increases
Regarding the general risks in obesity surgery, Dr Steffen emphasises that laproscopic surgery as such is first of all extremely safe and associated with only a few risks. The first operation is always less risky than every subsequent one, although it also depends on how experienced the surgeons are in the respective clinics. Much more common are the complications that can occur after the procedures. First and foremost are deficiency symptoms, digestive problems and problems in the area of the oesophagus. This must always be expected after obesity surgery, which is why lifelong aftercare is also sensible and recommended. This must also be clear to the general practitioners and is already addressed in the first educational discussion.
Obesity and Corona
Currently, the corona virus plays a significant role in society as a whole. Those who are overweight must expect a more severe course after an infection due to their physical constitution. If overweight people already have breathing problems, these will certainly be even greater with COVID disease, even more so with assisted or artificial ventilation. It is difficult to decide not to operate on overweight people now, as they will then be much more affected in the event of an infection later on.
The role of general practitioners
The first way for overweight people who want to improve their situation is always to see their family doctor. The latter will then make a referral to the specialists in the given case. Here, the Swiss1Chirurgie clinics are recommended as competence centres for bariatric surgery. The family doctor could also be the first point of contact for appropriate information to the patient. In addition, we as Swiss1Chirurgie offer a comprehensive information service for all those affected. This ranges from our special consultation hours to the detailed and extensive information on the internet and via our app. However, information about any site or place on the internet is always associated with the risk of getting the wrong information. Here, Dr Steffen likes to refer to the pages of Swiss1Chirurgie, which, in contrast to any forums or chat rooms, provide extremely professionally correct, comprehensive and structured information.
From 01 January 2021, it will be possible to have obesity surgery from a BMI of 30+ with concomitant type 2 diabetes. One of the prerequisites is that diabetes can no longer be safely controlled by conventional means. Only a few specialist clinics are authorised to perform such operations. This also includes the clinics of Swiss1Chirurgie, which offer such procedures in the Helvetia Holding AG network. Learn more about the BAG’s decision.
Overweight surgery possible from BMI 30 with diabetes as of 2021
Being overweight is not something to be trifled with. All those affected know this just as well as we do as medical specialists. For years, the experts at Swiss1Chirurgie have been observing the development of obesity in modern industrialised countries. It is becoming increasingly clear that the proportion of overweight people is growing. Associated with this are not only the individual restrictions and complaints. Healthy societies quickly become sick societies through an oversupply of food at any time in any place and correspondingly wrong nutritional behaviour, whose lack is above all abundance.
So far, health insurers and medical organisations, together with politicians in Switzerland, have agreed that surgical interventions to reduce weight are only possible for a BMI of 35 or higher and are financed accordingly. It was completely ignored that a BMI of 35 or more is already an enormously high value, which is already associated with numerous secondary diseases and complaints. Such concomitant diseases not only complicate the lives of the patients themselves, but are often also a clear obstacle in the preparation and implementation of necessary obesity surgery.
From 2021 the threshold is BMI 30
In accordance with the interventions of the medical specialists and a close observation of the development, the politicians together with the medical profession have decided to lower the threshold value for bariatric surgery in the context of obesity surgery now to a BMI of 30, provided that the patients are affected by diabetes at the same time.
This long overdue decision will benefit patients who, despite being diagnosed with obesity and the corresponding symptoms, were previously not included in the group of patients for whom obesity surgery was an option.
This means that a wide range of conditions closely related to obesity can be treated much sooner and necessary and desired surgical interventions can also be carried out. This will have a lasting impact on the quality of life of people with a BMI over 30 and diabetes, and ultimately reduce the proportion of severely overweight people, along with the social and economic costs.
Advantages especially for humans
The decisive advantages of this decision now lie above all with those people who, with a BMI of 30 or more and diabetes, are already clearly affected by morbid obesity. Now the suffering of these people can be significantly shortened. This is also because it obviously does not make sense to wait for an enormously high BMI of 35 and more until a surgical intervention for weight reduction is made possible by the regulations.
A major advantage of this decision is that the extent of overweight and the associated concomitant and secondary diseases such as diabetes, cardiovascular diseases and arthrosis can be significantly reduced. The psychological suffering can also be significantly shortened and patients with a BMI of 30 or more with diabetes may now place themselves in the hands of the experienced specialists in obesity surgery. The Swiss1Chirurgie clinics are among the specialist medical clinics that will be authorised to perform surgical procedures to reduce excess weight from a BMI of 30 with diabetes from 01.01.2021.
Determine your BMI here and find out whether and under what conditions you belong to the circle of possible candidates for obesity surgery.
In addition, we recommend that all severely overweight people contact a Swiss1Chirurgie clinic. By doing so, you will take the first step towards a better, healthier future in 2021 and use the possibilities of modern medicine to improve your life.
Those who suffer from morbid obesity look for quick solutions. The use of a gastric balloon promises such a quick solution. However, such a gastric balloon is nothing more than a “crutch” in the treatment of obesity. The obesity experts at Swiss1Chirurgie, the Centre for Bariatric Surgery ZfbC and the Gastroenterology Group Practice Bern know this. In the detailed article, the benefits of bariatric surgery are contrasted with the rapid effects of a gastric balloon. Here is the full report.
The gastric balloon – the best way to cheat yourself?
Why a gastric balloon is the worse alternative to bariatric surgery?
Those who suffer permanently from severe overweight and feel stigmatised by their social environment often look for quick solutions to reduce their body weight. People affected by obesity and the associated concomitant and secondary diseases want effective measures and treatments to change their life situation. The so-called gastric balloon promises such a quick remedy. Without any surgical intervention, without restrictive diets, in the wrong perception and even without a change in exercise behaviour, a quick weight reduction could be achieved with a gastric balloon. But the first impression is just as deceptive as the first successes.
How the gastric balloon works
The gastric balloon promises quick success in losing weight. Find out why this is only half the truth in the detailed article by the obesity experts at Swiss1Chirurgie.
The gastric balloon is usually inserted into the stomach by means of gastroscopy and filled with a saline solution in the same procedure. Recently, some centres have also been promoting a “swallowable” version – the balloon is swallowed and filled via a tube – without the need for a gastroscopy. This installs a foreign body in the stomach that significantly reduces the stomach volume available for food intake.
As a result, a feeling of satiety is produced even after eating comparatively small amounts of food, but this can be very deceptive. Because of this early onset of satiety, many patients think they can lose weight quickly, easily and permanently with the intragastric balloon without surgery. However, this is often accompanied by complaints such as nausea and frequent vomiting, which indirectly help to lose weight in a rather unpleasant way.
In fact, there are reports that the gastric balloon can be used to lose ten to 25 kilograms over a reasonable period of time. It should be remembered, however, that efficient weight loss attempts are less about quantity and more about the quality of the food. Anyone who consumes very high-calorie drinks, fatty foods or a lot of sugar-heavy food to satisfy their needs after the insertion of a gastric balloon will not automatically achieve success even with the reduced mass. Without a consistent change in diet and exercise, attempts to lose weight are hardly successful in the long term, even with the gastric balloon. Especially since a gastric balloon can only ever be used temporarily.
Self-deception with a system
Experts in the treatment of obesity speak of self-deception with a system when favouring a gastric balloon for weight reduction. After all, such a gastric balloon is a foreign body in the stomach and at best something like a crutch in the treatment of obesity. And a crutch is not a leg on which you can stand safely.
It is also worth considering that the gastric balloon is not a permanent solution. Depending on the quality, such a gastric balloon can remain in the stomach for a maximum of 3, 6 or, more recently, 12 months and must then be removed. Although a new intragastric balloon can be placed immediately, this only continues the actual self-deception.
From the reports of those affected, it can also be learned that in addition to some good successes, a large number of negative experiences can also be registered. This ranges from persistent nausea to spontaneous vomiting to an unpleasant feeling of fullness, which does not contribute to the patients’ well-being. If the intragastric balloon is worn for the recommended maximum period of six months, there is a risk that the balloon will lose the saline solution, which in itself is not tragic. Much more dangerous is that the then flaccid envelope of the balloon can migrate into the intestine and lead to a dangerous intestinal obstruction.
Bariatric surgery is the better methodology
Given the problems associated with the use of a gastric balloon, bariatric surgery is the better option in the vast majority of cases in patients with BMI over 30 kg/m2 with diabetes, or in patients with BMI over 35 kg/m2 without diabetes. The preferred methods are stomach reduction by forming a tube stomach or gastric bypass. Such interventions aim to consistently and permanently reduce the volume of the stomach or to virtually bypass the stomach. Both methods involve surgical procedures, but these are now performed as minimally invasive laporoscopic operations. In addition to the bariatric operations, further therapeutic offers are provided with the aim of achieving and securing long-term success in weight reduction. This means that in the vast majority of cases, surgical intervention is the better, more reliable and permanently more successful way to treat morbid obesity in the long term.
When the use of a gastric balloon can be useful
Even if a gastric balloon does not appear to be a target for long-term weight reduction, it can still be a sensible temporary solution in individual cases. For example, if a surgical intervention is not (yet) an option because of a very high excess weight. Then the gastric balloon can help to achieve a weight reduction that makes surgery possible. But that’s all.
If we consider once again that the intragastric balloon is basically a foreign body that can only be used temporarily and is ultimately only a “crutch” for weight loss, the intragastric balloon is ruled out as a long-term and efficient solution to the problem of obesity.
Counselling ensures best treatment results
Anyone who is confronted with the physical, social and psychological impairments caused by morbid obesity should seek specialist medical advice and professional care. A good place to start may be the Swiss1Chirurgie clinics, the Centre for Bariatric Surgery ZfbC or the Gastroenterology Group Practice in Bern. Here, patients are advised in detail, individually and openly about the chances, risks and possibilities of permanent weight reduction. Obesity experts are always concerned with long-term solutions and less with quick but less reliable success.
In a special consultation at Swiss1Chirurgie, patients also learn in which rather rare cases the temporary use of a gastric balloon in preparation for bariatric surgery can be useful. At the same time, however, it is always made clear that the use of a gastric balloon can never be the permanently helpful solution to a pathological obesity problem.
Adipositas-Podcast.ch – Know what’s what
With the obesity podcast, you can find the latest and essential information on obesity, its origins, development, consequences and treatment options at adipositas-podcast.ch. Here, real experts talk about the causes and development of morbid obesity, which, with its manifestations such as overweight, cardiovascular diseases, shortness of breath, organ diseases, diabetes, limited mobility and performance as well as social stigmatisation, severely restricts the lives of those affected. On adipositas-podcast.ch we always want to inform you professionally and comprehensively and at the same time show you ways to break the vicious circle of obesity.
One can accept obesity as a seemingly inevitable fate and surrender defencelessly to the dire consequences. But in the same way, obesity can also be understood in its development and ways can be found to return to a self-determined, happy and desirable life. What is your path?
Listen to experts from Swiss1Chirurgie, the Centre for Bariatric Surgery or the Gastroenterological Group Practice Bern and learn what obesity is, what it means for an individual’s life and which paths lead out of the disease. In this way, you will gain valuable knowledge that can significantly accompany your own path out of obesity. Testimonials from patients and sufferers and the knowledge of obesity experts will help you find your own way out of the fatal obesity career and lead a healthier and happier life.
With the obesity podcast, you can find the latest and essential information on obesity, its origins, development, consequences and treatment options at adipositas-podcast.ch. Here, real experts talk about the causes and development of morbid obesity, which, with its manifestations such as overweight, cardiovascular diseases, shortness of breath, organ diseases, diabetes, limited mobility and performance as well as social stigmatisation, severely restricts the lives of those affected. On adipositas-podcast.ch we always want to inform you professionally and comprehensively and at the same time show you ways to break the vicious circle of obesity.
One can accept obesity as a seemingly inevitable fate and surrender defencelessly to the dire consequences. But in the same way, obesity can also be understood in its development and ways can be found to return to a self-determined, happy and desirable life. What is your path?
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If we analyse the cases of oesophageal cancer in Switzerland, we find that around 600 people suffer from this serious disease every year. The main risk for the development of oesophageal cancer are reflux diseases, which clearly favour the development of cancer in the oesophagus due to the pathological acid regurgitation. About three quarters of those affected are men. One of the promising therapies for oesophageal cancer is oesophagectomy, which will be explained in more detail in this article.
More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.
Let’s start by explaining the technical terms that are important for this topic
The medical term reflux refers to the backflow of gastric acid from the stomach into the oesophagus. In layman’s terms, this is described as acid reflux. The cause of the backflow of stomach acid into the oesophagus is a weakening of the muscle at the end of the oesophagus (cardia). In addition to the actual acid regurgitation, patients describe such things as frequent heartburn, burning in the chest area or also stomach burning.
The oesophagus is called the oesophagus in medical vocabulary. Functionally, the oesophagus is a kind of muscular tube that transports food into the stomach through contractions. In the stomach, stomach acid, among other things, is responsible for breaking down the food as part of the digestion process. To protect the oesophagus from the constant acid attack, there is a muscle at the bottom of the oesophagus that closes it when it is functioning normally. If the function of this muscle is impaired, the reflux described above occurs.
In medicine, resection is the surgical removal of an organ or part of an organ. With reference to our topic, oesophagectomy is accordingly the surgical removal of the largest part of the oesophagus.
The risk factors for the development of oesophageal cancer
Over the years, the main risk factors for developing oesophageal cancer have changed somewhat. Whereas in the past it was smoking and excessive alcohol consumption, today it is persistent (pathological) acid regurgitation and obesity that significantly increase the risk of oesophageal cancer. If you follow the relevant advice books, acid blockers and diets are often recommended to get the problem of reflux under control. However, this only addresses the individually noticeable phenomena, but not the cause. Therefore, the risk of developing oesophageal cancer remains in the medium and long term unless the causes of acid regurgitation are consistently addressed. What remains is the no longer correctly functioning “valve” at the end of the oesophagus, i.e. the muscle that prevents the stomach acid from rising into the oesophagus. If no improvement can be achieved here, then the constant acid attack on the oesophagus ultimately threatens oesophageal cancer. Surgery on the reflux muscle at the right time can significantly reduce the risk.
From complaints to diagnosis
One of the most common complaints that bring patients to the doctor is difficulty swallowing. After anamnesis and a more detailed description of the symptoms, a gastroscopy is often performed. If malignant tissue is discovered or suspected in the oesophagus or at the transition to the stomach, it can be removed under a short anaesthetic using a type of mini forceps. A laboratory examination will confirm whether or not this is malignant tissue. In the former case, it must then be assumed that there is oesophageal cancer, which must be treated surgically as a matter of urgency. Once the diagnosis of oesophageal cancer has been made, the decision for a suitable therapy must be made.
Recommendation: Combined therapy
Before therapeutic steps are taken, the severity of the disease and the spatial spread of the oesophageal cancer must first be examined more closely and determined in detail. Computer tomography (CT) of the chest and abdomen is the method of choice for this. In this way, it is also possible to assess whether there are deposits in the lungs and liver. An ultrasound scan of the oesophagus can also assess deposits in the lymph glands.
A common feature of the work of the medical specialists at Swiss1Chirurgie and at the Beau-Site Clinic is an interdisciplinary tumour board, where specialists from all the disciplines involved carry out a precise assessment of the symptoms, risks and treatment options. In addition to recommending therapeutic measures, this also includes timely clarification of follow-up treatment.
In most of the cases, a combined therapy is considered by the tumour board. This combination consists of an upstream chemotherapy, which is to be understood as a preparation for the actual surgical intervention within the scope of the oesophageal resection. If necessary, radiotherapy can also be part of the treatment. The surgical intervention takes place a few weeks after the start of chemotherapy or radiotherapy.
The esophagectomy procedure
Thanks to modern surgical techniques, the removal of the oesophagus (oesophagectomy) can be performed as a minimally invasive procedure (also called keyhole surgery). The operation itself takes about three to four hours and is performed under anaesthesia. Through small incisions in the abdominal wall, the connections of the oesophagus to the stomach and at the diaphragm are loosened. The lymph glands in the abdomen are then removed, followed by removal of the oesophagus itself either through the abdomen or through the chest. The adjacent tissue, which may also be affected by tumour cells, is also removed.
In a further step, the stomach is formed into a tube. This stomach tube is finally connected to the upper remaining end of the oesophagus in the neck area. Afterwards, the success of the surgical procedure is checked using a method specially developed by Dr. Jörg Zehetner. For this purpose, a fluorescent substance is injected into the patient’s bloodstream. Within five to ten seconds, a laser camera can be used to determine whether the result of the operation is satisfactory.
Rapid mobilisation and recovery of patients
A clear advantage of modern surgical techniques in the context of oesophageal resection is the short time patients spend in hospital. With independent breathing, the operated patients wake up from the anaesthesia and remain in the intensive care unit for one to two days, depending on their condition, to monitor their bodily functions. In the normal ward, a swallowing X-ray is taken as early as five days after the operation to check whether the connection between the stomach tube and the beginning of the oesophagus has healed well. If this can be confirmed, the diet can be slowly built up.
Depending on the individual development, the clinic stay itself lasts about one week to ten days. This is followed by a two-week rehabilitation measure, which helps the patient to heal quickly. After just three months, the patient experiences his or her original quality of life, now without oesophageal cancer and the unpleasant accompanying symptoms. In principle, everything can now be eaten again, perhaps in smaller portions, but spread over several meals a day.
More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.
