In order to undergo Bariatric Surgery it is necessary to meet a number of conditions, which is why the selection of candidates for the surgical treatment of obesity requires a thorough psychological evaluation to ensure the success of the procedure and discard the unwanted effects or it ineffectiveness.
Therefore, Clinica Serralta has a Bariatric Psychology Department, which is responsible for making the assessment of suitability for our patients. This detailed assessment of the eating habits and behaviors are a key to decide the surgical technique that will be the most effective for each patient.
Firstly, the medical history and the causes of the illness of a patient are analyzed in order to rule out possible pathologies that are incompatible with surgery. Then the preparation process is initiated in order to achieve an emotional stability creating a high level of willpower and motivation in patients to make a definite change in their diet.
In some cases a postoperative follow-up is also necessary to reinforce good eating behavior.
Gastric Bypass surgery involves reducing the stomach and making food go directly towards the end of the intestine. Laparoscopic surgery is used and it is performed in two steps:
Firstly, the stomach is reduced, cutting it in its top, and leaving it divided into two parts:
- A very small part of the stomach (about 50 cc) that receives the food.
- A “residual” pat of the stomach, where no food passes, but that is not removed, and which continues secreting juices.
Secondly, the intestine is cut and joined with the small part of the stomach to make that the secreted biliopancreatic juices and food join from 75 to 200 cm far from the stomach.
Therefore, the capacity to accommodate food in the stomach is reduced (from approximately the standard 1000 cc stomach of an obese person to a 50 cc capacity after surgery), and also we bypass the intestine so a great amount of eaten food is not absorbed.
The malabsorption that this technique produces makes this procedure the most successful in losing weight, but for its risk characteristics should only be used in selected patients.
The Gastric tube surgery or Sleeve Gastrectomy is carried through laparoscopic surgery, and it consists of reducing the stomach’s ability to hold food.
To make this stomach reduction we insert a tutor standing inside which has the shape of the tube we want to let inside. Then a cut is made in the stomach following this guide and the rest of the unnecesary part of the stomach is removed. This cut is made using automatic staplers, designed specifically for this purpose, which prevent leakages through the cut area. Thus, the patient will have a feeling of fullness and satisfaction after eating a small amount of food. This feeling of fullness and satisfaction facilitates the compliance of the patient’s diet plan.
Stomach retains its normal operation, except for the volume of food that it can receive, which is much lower. This way, it can digest any kind of food.
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The Gastric Band is a restrictive method for the treatment of obesity. It comprises a silicone ring with an inflatable chamber therein, connected to a device which allows modifying its internal diameter.
The gastric band is placed in the upper stomach, reducing the capacity of the stomach to receive food, so with a food intake of less than 50 cc it produces an important feeling of fullness and satisfaction. This feeling of fullness and satisfaction facilitates the compliance of the patient’s diet plan.
The implant is performed using laparoscopic surgery so there is minimal discomfort and may be an ambulatory procedure in selected cases.
The Gastric or Intragastric Balloon is a silicone balloon that is inserted into the stomach through an endoscope, and then it is filled with water occupying the entire space of the gastric cavity. Thus, it automatically produces a feeling of being satiated which helps us to follow a diet facilitating the weight loss as well as long-term maintenance.
The instructions for this technique should always be individualized and will take place after the evaluation by our experts in nutrition and digestive surgery. Our clinic works with the best professionals in endoscopy and in the placement of intragastric balloons. They are specialists from Clínica Merello, located in Valencia, with more than thirty years of experience in dealing with digestive problems and they are also pioneers in the placement of intragastric balloons.
Surgical treatment of cancer continues to be a key part of the definitive cure in cases with early diagnosis. Similarly, surgical resection of the tumor is still needed in the first instance (completing it with adjuvant therapies such as chemotherapy and radiotherapy) in the vast majority of cancers.
Therefore, we have created a team of specialists who are specifically trained and who use updating formation programs in cancer treatment using surgery.
Our specific areas of focus are:
- Thyroid cancer
- Cancer of the esophagus, stomach and duodenum
- Pancreatic cancer
- Metastatic and primary liver cancer
- Bowel cancer, including colon, rectum, anus and gastrointestinal stromal tumors
- Spleen lymphoma
- Peritoneal carcinomatosis, where we are conducting a research program with surgical cytoreduction and hyperthermic intraperitoneal chemotherapy.
All cancer surgeries we perform are multidisciplinary, in coordination with medical oncology, internal medicine and clinical psychology.
Endocrine Surgery is used to treat surgical diseases that affects the organs responsible for producing hormones: thyroid, parathyroid and adrenal glands.
This surgery involves the partial or total removal of these glands. Other disorders such as hyperthyroidism or thyroiditis may also require this surgical treatment.
Thyroid surgery is performed at our facilities always with a continuous monitoring of the recurrent nerve, which significantly reduces its possible injuries.
The adrenal gland surgery is performed at our facilities preferably using laparoscopic surgery.
This surgery is a procedure that is performed to strengthen the muscles and tissues of the abdominal wall, which have been damaged by herniation.
The operation of an abdominal hernia is used to correct body segment protrudes through an opening or weak area of the abdominal muscles.
Often the use of meshes is needed to help to strengthen the hernia area in order to prevent recurrences. These meshes are usually made of monofilament of polypropylene, which is integrated in the intestinal walls of the patient, so that human tissue cells are integrated between the fibers to form a strong tissue. There are other materials that are also used in our services.
The most common procedures in this type of surgery are:
- Inguinal hernia
- Femoral hernia
- Incisional ventral hernia
- Abdominoplasty
Coloproctology is a subspecialty of general surgery that is used to give diagnostic and surgical- medical treatment for colon, rectum and anus diseases.
Among the most common diseases in this area we find:
- Inflammatory bowel disease
- Colon diverticula
- Hemorrhoids
- Anal fissure
- Anal fistulas
- Rectal prolapse and defecation disturbances
- Intestine tumors
Hepato-biliary-pancreatic surgery solves the problems of this area which require surgery to be treated. Among them we find:
- Gallbladder surgery
- Bile duct surgery (common bile duct)
- Liver resection of segments, including the hemiliver (half of the organ)
- Pancreatic head resection
- Resection of the body and the tail of the pancreas
- End of liver derivation
Sometimes this surgery is motivated by benign diseases but, unfortunately, sometimes it is also motivated by malignancies. However, advances in surgery have given all patients a glimmer of hope, including oncologic patients. These advances include better diagnostic methods, better anesthesia methods, new and more effective operative equipments and a greater knowledge of the postoperative management of these patients.
