Soon a more advanced surgical follow-up for bariatric surgeries
After the “little French tour” that places Aix-en-Provence as the city of thinness and Argenteuil as the city of overweight(1), a program has developed between the Institute of Cardiometabolism and Nutrition(2) and MXS-telemedicine, a private e-health company. This program plans to establish a serious follow-up for patients who have benefited from surgery: gastric band placement, bypass, sleeve (longitudinal gastrectomy) or vertical gastrectomy…
Small overview of interventions
When the extra pounds become too much, going back is only possible with surgery. These are called non-reversible interventions(3). These have evolved since the 2000s.
Initially the most common practice wasthe placement of a gastric band. However, faced with disappointing results, other, more invasive techniques have developed.
The bypassis a short-circuit assembly where the lower part of the stomach, the duodenum and the small intestine are excluded from the food circuit. This causes incomplete absorption of nutrients and therefore faster weight loss.
A sleeve (longitudinal gastrectomy) consists of a longitudinal stapling of the vertical portion of the stomach. A narrow tube remains without causing malabsorption or deficiency to the body.
As for the gastric balloon, it is not reimbursed by Social Security because it is not, strictly speaking, a surgical intervention.
The choice of technique therefore depends on the characteristics of the patient, the objectives to be achieved but also the wishes of the patient. As such, information meetings are regularly offered in many hospitals in France.
The observation
For Dr. Jean-François Martin, endocrinologist, surgery is necessary when a person suffers from obesity with a BMI greater than 35 associated with pathologies such as hypertension for example. For him, this obesity has increased day by day since it increased by more than 70% between 1997 and 2012. However, the various current surgical techniques are practiced in a disorderly way in France and the Health Insurance has looked into the relevance of these practices.
Experts have already sounded the alarm and the High Authority of Health, which published recommendations in 2009, displays the failures of the care offered to obese people after their bariatric operation. Thousands of patients are operated on without any real follow-up every year.
Improving post-operative patient monitoring
For Dr. Boris Hansel, endocrinologist and nutritionist at the Bichat Hospital in Paris, 30 to 50% of operated individuals are currently lost to follow-up by healthcare teams at five years. This monitoring is therefore not up to the level of technical advances.
Risks of malnutrition, significant deficiencies or even anemia as well as psychological disorders can occur. Multidisciplinary follow-up is necessary for life for these operated patients. Thus, a telemedicine program, “Barianet”(4) is currently being tested in several French hospitals.
Stephen Paul is the lead author and founder of My Health Sponsor. Holder of a diploma in health and well-being coaching with more than 200 articles in the field of health, he makes it a point of honor to offer advice based on reliable information, based on scientific research, and verified by health professionals.