Eduardo Bolaños y Felipe Chaux

   Eduardo Bolaños Quintero and Carlos Felipe Chaux.

Surgery for obesity

A proven way to recover your normal life, your health and your ideal weight.

We are the most experienced team in bariatric surgery in Latin America.

Our certification is 12 years of experience and more than 9,000 patients operated satisfactorily.

Among our patients are Argentine soccer player Diego Armando Maradona, the presenter and sexologist Alessandra Rampolla and Colombian actors like Carlos "El Gordo" Benjumea and Jhon Mario Rivera and others

Our surgery team headed by doctor Eduardo Bolaños Quintero and Carlos Felipe Chaux, who work supported by several specialists (physiotherapist, beauty consultants, sports medicine physicians and psychologists) who also support patients in every stage of the process. So far the amount of patients successfully treated  and fully recovered exceeds the amount 9000 people from all over the world, which converts us in the most experienced medical team in bariatric of Latin America.


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Morbid obesity.

Basically said, obesity is the result of excessive fat accumulation that exceeds skeletal and physical body levels.


According to statistical data provided by the National Institute of Health (form United Sates of America). If someone gets 20% or move overweight, obesity should be considered a serious health risk factor.


Obesity becomes “morbid” when it reaches the point of significantly increasing the risk of one or more obesity-related conditions or serious diseases that can result either in significant physical disability or even death.


There are several criteria for defining morbid obesity. If a person weights more than 100 lbs. over your ideal body weight, or have Body Mass Index (BMI) over 40, or have a BMI over 35 and are experiencing severe negative health effects, such as high blood pressure, diabetes, joint damage related to being severely overweight or unable to achieve a healthy body weight for a sustained period of time, even though medically supervised dieting.

It is classified as a chronic disease, meaning that its symptoms build slowly over an extended period of time. It should be treated immediately.


The reasons for obesity are multiple and complex. Despite conventional wisdom, it is not simply a result of overeating.


Research has shown that in many cases a significant, underlying cause of morbid obesity is genetic. In some cases hereditary, environmental metabolic and nourishing type causes have been considered.


Besides there are certain medical conditions that can produce obesity,  such as steroid consumption and hypothyroidism.


Studies have demonstrated that once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.

Bariatric surgery.

Bariatric surgery is a medical treatment to control obesity, it’s been used for over the past 44 years and it’s considered nowadays as the only successful treatments for weight lose improving the quality of life.


The treatment consists in reducing the stomach capacity through several techniques (gastroplasty, gastric bypass, adjustable band, etc.), and by changing the intestinal path to stop absorbing fat during the digestive process.


In the past, this surgery was made through standard open surgery (laparotomy) dealing with high rate of mortality and posttraumatic diseases.


Nowadays the patient is intervened through small incisions (no larger than 6mm) where all surgery equipment, lights and cameras are inserted, which allow the doctors to perform with accuracy inside the abdominal cavity: therefore the patient enjoys a quicker painless recovery with minimum damage on the abdominal wall. Bariatric surgery by laparoscopy must be only performed by a qualified team (of at least two surgeons) with high level of training due to its complexity.

A surgeon will be considered up to the bariatric surgery after performing  a minimum of 100 procedures; however, then he will become nothing but an advanced beginner; the optimum level will be achieved over the 9000 cases.


The American Society of Bariatric Surgery states that a high experienced level team would be the one who has performed over 400 cases and has made at least 320 surgeries per year. Our team has reported so far 9.000 cases of bariatric surgery, and perform between 80 and 100 surgeries on a monthly basis with a complication rate lower than 1%.


Another point related with the effectiveness and security of this procedure is technology. Not all the equipment is suitable to use in this kind of surgery. High resolution screens, cameras and lights, are needed besides high quality dissection and stapling instrumental.

 

The result of all of this is a high medical security level, less post-operative discomfort, quicker recovery times and a very high rate of successful surgeries.

Bariatric surgery types

Bariatric surgery is a generic medical term which involves several types of surgical techniques to reduce the food intake capacity and modify the intestinal path to avoid fat absorption during the digestive process of a given patient.


Under that context, there are two basic approaches that can be followed to achieve optimum results.

 

1) Restrictive Approach:   The main focus of this method is to decrease food intake by reducing the stomach size. The following techniques are included into this category:

Intragastric Balloon:



It is a high resistance silicone bag, designed to provide short-term weight loss therapy for up to 6 months, after which it must be removed.

The risk of balloon deflation and intestinal obstruction (and therefore possible death) is significantly higher when balloon are left in place longer than 6 months.



Click on the numbers to see illustratively consisting procedures.


Adjustable Gastric Band:

 

The Adjustable Gastric Band simply acts like a let around the top portion of your stomach, creating a small pouch.

As the digestion process remains normal, since the digestive system anatomy has not been modified, the band only helps you to reduce weight by restricting the amount of the food you eat.



Click on the numbers to see illustratively consisting procedures.


Vertical Ring Gastroplasty:

Another type of restrictive surgery, in simple terms is an operation during which the stomach is reduced in size using special staples, in order to restrict food intake and thus cause weight loss.

Unfortunately, the use of staples in this way has one big drawback. The stomach wall tends to stretch. This was why stomach stapling operations proved ineffective.



Click on the numbers to see illustratively consisting procedures.


Sleeve Gastrectomy:

The sleeve gastrectomy is an operation in which the left side of the stomach is surgically removed.

This results in a new stomach which is roughly the size and shape of a banana.

Since this operation does not involve any “rerouting” or reconnecting of the intestines, it is qualified as a simple operation. This technique reduces the sizes of the stomach by about 80%. It is divided vertically from top to bottom leaving a banana shaped stomach along the inside curve.



Click on the numbers to see illustratively consisting procedures.



2) Combined Approach of Restriction and Malabsorption: It focuses on reducing the stomach size and modifying the intestinal path, so the food is partially digested, avoiding the absorption of fat and calories. The following techniques are included into this category:


• Gastric Bypass (most suggested)

Considered the standard surgery against which the other ones had to be compared, it has been performed in countless patients during the last 34 years.


Along this time many details have been improved turning this technique into the safest and effective way to obtain permanent weight loss with excellent life quality.



Click on the numbers to see illustratively consisting procedures.


Biliopancreatic Diversion

 

This type of surgery was designed for severe obesity cases. It restricts both food intake and the amount of calories the body absorbs.


Most of the fat and carbohydrate eaten passes through the body without being absorbed. This has the effect that the patient is less restricted in their eating because fats and sugars are not absorbed by the intestine.

The stomach is segmented upper outside curve to the lower inside curve and in the beginning of the small intestine. The resulting portion is totally removed. Due to this fact, this surgery once executed, cannot be undone.



Click on the numbers to see illustratively consisting procedures.


Doudenal Switch:

Highly effective, this type surgery creates two separate pathways and one common pathway in which the contents of the two main paths are mixed before emptying into the large intestine.

The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat.

The stomach is divided vertically from top to bottom leaving a banana shaped stomach along the inside curve. The original volume of this organ is reduced by about 80%.



Click on the numbers to see illustratively consisting procedures.


Complex surgery cases

Bariatric surgery has different complexity grades; all of them depend on previous clinical history and the obesity level of every patient. During all this years, our experience let us found some characteristics which complicate the surgery. Thanks to this fact, our group has a very extensive training in the execution of very difficult surgeries, like the following ones:

 

Previous Bariatric Surgery.


This group includes patients who have had previous bariatric surgery procedures  (by laparoscopy or standard open surgery) with unsatisfied results, such as, stop losing weight, gaining or important changes in their quality of life with correct weight loss. Below you can find some failed cases and the way we correct this issues.


Adjustable Gastric Band failure.


Most frequent causes are: stop losing weight, gaining weight, band sliding movement, penetration, esophagus dilatation, intolerance to the procedure, or dependency of the doctor.


When the band has penetrated surgery must be performed in two steps. The first one is to remove the band (it can be done in a certain group of patients through high digestive endoscopy) and the second is to make a gastric bypass.


We have made 112 conversions of this kind: it is a 3 hours procedure with a failure rate lower than 1% with no alterations in the patient recovery terms.

 

Laparoscopic Vertical Gastroplasty failure or uncutted by laparotomy.


Technically speaking is a less complex procedure than gastric band conversion and often allows performing a gastric bypass with similar surgical times to the previous case and complication possibilities lower than 1%.


Sleeve Gastrectomy failure.


It is a failure in weight loss or when the patient has a disabling post-gastrectomy condition such as esophagi reflux disease or esophagi peptic-related injury. It can be easily convert to gastric bypass, or the sleeve can be recalibrated by laparoscopy (most failures are originated by dilation of gastric pouch) unless the patient presents esophagi reflux.

 

Gastric Bypass failure.


Represented by failure on weight loss or bad quality of life and health of the patient, an extensive endoscopic and radiologic imagery study must be done in order to fix this problem.  Corrections are made laparoscopically and basically consist in making a new proper gastric pouch, calibrate the gastroyeyunal joint and set the correct distance of the bypass segment.  Surgical times are directly related to the complexity of the corrections to be done.

Previous Abdominal Surgery (No Bariatric).

It all depends on how many adherences are found and the type of previous surgeries to the digestive tube (gastrectomy, anti-flux surgery, etc.). Surgeries made in abdominal wall such as mesh eventration surgery, lipectomy with plicature of abdominal muscles, make harder the initial surgical approach: besides in these patients, the laparoscopic vision field is much reduced and even so in younger patients.


These facts make the surgery last longer although aren’t contradictory for itself or for a laparoscopy approach. At in the other cases, the complications rate is not different than in patients without previous surgeries.

 

Severe Central Obesity.


When large abdominal perimeter is present, the surgery will be more difficult to perform because of extra intra-abdominal fat and a fatter liver, which could have operated patients with cirrhosis characteristics (we have operated patients with cirrhosis with satisfactory post-surgery evolution for his health and life quality). Besides medical experience, proper equipment and technology must be on account to guarantee success in the procedure.

 

Severe Associated Disease.


Obesity is generally associated to diabetes, hypertension, hyperlipidemia, fatty liver, cirrhosis, sleep apnea etc.
Many patients show severe health decrease meaning a mayor surgery risk due to related cardio-pulmonary pathology. Success in many of these cases suggests proper evaluation and pre-surgery preparation. Surgical times are critical; less time means major chances of success (surgeries have been performed by us in less than an hour.)


Post-surgery support is needed if patient’s risk is too compromised or coronary risk is high. Experience says that if the two above requirements are satisfied, this stage turns into short and standard.
Patients with metabolic disease must be treated with gastric bypass as first option with possible diabetes cure of 90%, hypertension of 65% and hyperlipidemia with 70%.


Having said all that we would like to highlight that experience allows initial bariatric procedures failures to transform them into successful surgeries in the short and long term keeping quality of life in patients.

Do I qualify for this surgery?

To answer this question, you must be evaluated by an experienced bariatric surgeon and be aware that the surgery is a tool to help you lose weight and become healthy. However, you may be a potential candidate if you meet the following conditions:

1) If you weigh more than 100 lbs. (50Kg.) over you ideal body weight.


2) Body Mass Index (B.M.I) of over 40.


3) Have a B.M.I of over 35 and are experiencing severe negative health effects, such as high blood pressure, diabetes, sleep apnea or joint damage.

If you are unable to achieve a healthy body weight for sustained period of time, even though medically supervised dieting.

 

DEAL BODY WEIGHT
Men
Women
1.50m-50Kg
1.50m-48Kg
1.52m-53Kg
1.52m-50Kg
1.55m-56Kg
1.55m-53Kg
1.57m-59Kg
1.57m-55Kg
1.60m-62Kg
1.60m-58Kg
1.65m-68Kg
1.63m-60Kg
1.68m-71Kg
1.68m-65Kg
1.70m-74Kg
1.70m-68Kg
1.73m-77Kg
1.73m-70Kg
1.75m-80Kg
1.75m-73Kg
1.78m-83Kg
1.78m-75Kg
1.80m-86Kg
1.80m-78Kg
1.83m-89Kg
1.83m-80Kg
1.85m-92Kg
1.85m-83Kg
1.88m-95Kg
1.88m-85Kg
1.91m-98Kg
1.91m-88Kg
1.93m-101Kg
1.93m-90Kg
1.96m-104Kg
1.96m-93Kg
1.98m-107Kg
1.98m-95Kg
2.01m-107Kg
2.01m-98Kg
2.03m-110Kg
2.03m-100Kg
2.06m-116Kg
2.06m-103Kg
2.08m-119Kg
2.08m-104Kg

Body mass index (B.M.I.) is measure of body fat based on height and weight. It is a very accurate mechanism to determine when extra pounds make you a potential candidate for a bariatric surgery.

This calculator allows you to determine your body mass index.


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Risks and lifestyle changes

The emotional factors

Handling obese patients is complex, as bariatric surgery plays a salvation role effects on them.


Strong frustration felling are developed as a result of unsuccessfully trying to lose weight through different methods and often reinforce hopeless sensation, faith losing and anger in obese patients who silently suffer social pressure as established symbols of physical inability or the antithesis of skinny patterns –often abnormal-  present in our culture.


Patients for these procedures must be carefully chosen in order to avoid post-surgical psychiatric complications.

 

PSYCHIATRIC RISK PATIENTS.


It is strongly advised not to intervened patients with psychosis, mental dysfunctions or those whose mental structure reduces the minimum capacity required to collaborate with the whole process.

As high risk patients are considered the ones with severe addictions, poor impulse control or severe compulsive-obsessive disorder.

In a less dramatic category are the ones with moderate to severe levels of anxiety and other with major depression problems.

 

Supporting the patient in getting used to new feeding habits, lifestyle and handling the social pressure for the new small food intake habits are the first steps for a successful post-surgery psychological process.


Supporting the patient in getting used to diet, tolerate olfactory and visual food stimulus and handle the pressing of family and friends for the new feeding habits, are the first steps for the psychiatric post-surgery procedure.


Surgery provides an effective biological weapon lowering anxiety for in taking food. Some patients develop this anxiety dreaming of having plenty of food while sleeping without affecting their lives or their decision of loss weight.


Once first results are gotten, patients who persistently keep symptoms of depression or anxiety must be under psychotherapy.

Consult

Our working group operates in Cali and Bogota, but also we are operating in Neiva, Monteria, Pereira, Ibague, Cucuta, Bucaramanga and Cartagena. In-class clinical and latest equipment for the exclusive use of our patients.

You can contact us with the following information:

Phone: 681-1664 / 682-7771

Cellphone :: 315-288-7610

Email: eduardobq@hotmail.com

Address: Calle 19 North # 2 No 29, Torre de Cali, floor 33.




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