Bariatric Surgery at UPMC Salvator Mundi International Hospital

About Bariatric and Metabolic Surgery

Bariatric and metabolic surgery is a subspecialty of general surgery that sets the international therapeutic standard for treating morbid obesity. Its effectiveness is widely recognized and evidenced by the growing number of procedures performed each year. This type of surgery not only helps patients achieve significant weight loss, but it also brings remarkable improvements to their quality of life by treating and reducing the risks of disease-related complications such as:

• Hypertension (coronary artery disease, myocardial infarction, brain hemorrhage).
• Metabolic syndrome (type II diabetes, hypercholesterolaemia).
• Colorectal and breast cancer.
• Erectile dysfunction and infertility.
• Sleep apnea.

Bariatric or metabolic surgery is typically reserved for cases where weight loss cannot be achieved through other therapeutic approaches. At UPMC Salvator Mundi International Hospital, we believe in a multidisciplinary approach to patient care. Our team of experts includes a surgeon, endocrinologist, cardiologist, gastroenterologist, dietician, and a psychologist or psychiatrist. Together, they work collaboratively to assess each patient's unique needs and determine the most appropriate treatment plan.

Surgery may be indicated in the following cases:

• BMI ≥ 40.
• BMI ≥ 35 in the presence of obesity-associated comorbidities.
• BMI ≥ 30 and type II diabetes mellitus.

Definition of Obesity

Obesity is a medical condition characterized by the excessive accumulation of body fat, which can have a negative impact on an individual's overall health and well-being. The most common tool for assessing obesity is the Body Mass Index (BMI). In the metric system, BMI is calculated by dividing a person's weight in kilograms by their height in meters squared.

According to the World Health Organization (WHO), a BMI of 25 to 29.9 is classified as overweight, while a BMI of 30 or higher is classified as obesity in adults. However, it is important to note that BMI is not always an accurate indicator of overall health. Other factors such as age, gender, muscle mass, and ethnicity can also affect an individual's risk of developing obesity-related health complications.

Robotic Bariatric Surgery

The use of robotic technology in bariatric and metabolic surgery represents a significant advancement over traditional laparoscopy. It greatly reduces the risk of complications and is particularly beneficial for patients with severe obesity, enabling safe and highly effective complex surgeries.

At UPMC Salvator Mundi International Hospital, we use the da Vinci® robot for bariatric and metabolic surgeries. This technology has revolutionized the field by drastically reducing the risk of complications to less than 0.5% compared to a 25% risk with traditional laparoscopy (source: CECRO/Prof. Senner, Nov. 2022).

The da Vinci® robot is guided by experienced surgeons using a computer. The use of digital tools and 3D HD imaging of the surgical field enables precise movements, minimizing the risk of damage to nearby organs. This results in faster recovery times, reduced hospital stays, and improved patient outcomes.

Our team of skilled surgeons at UPMC Salvator Mundi International Hospital are trained and experienced in using the da Vinci® robot to perform safe and effective bariatric and metabolic surgeries, providing our patients with the latest advancements in technology and care.

It has several advantages over traditional surgery:

• Minor surgical incision with reduced tissue trauma.
• Greater precision.
• Greater patient safety.
• No bleeding and no suture dehiscence.
• Faster recovery time.
• Reduced post-operative pain (reduced use of pain medication).

The Procedures

UPMC Salvator Mundi International Hospital is proud to house the Centro Europeo di Chirurgia Robotica per l'Obesità (CECRO), an internationally renowned institution with over 20 years of experience in bariatric and metabolic surgery. With centers in Germany, Switzerland, Russia, and Egypt, CECRO is a leader in the field and is dedicated to providing the highest quality care to patients.

Restrictive and functional methods

A stomach resection/restriction is performed, with or without a bypassed section of the intestine depending on the type of operation. These methods act on hormones to induce a sense of satiety.

• The sleeve gastrectomy (partial vertical gastrectomy) involves the creation of a gastric tube, a longitudinal resection of the stomach to reduce the food intake and alter the secretion of appetite-regulating hormones, such as ghrelin, creating a new and healthy balance between hunger and satiety. It can be performed as a primary operation or as a first operation in anticipation of a subsequent gastric bypass in super-obese patients with BMI greater than 50.
• Gastric bypass is a simplified version of Roux-en-Y gastric bypass surgery (Omega Loop) performed in patients with a BMI greater than 40 who also have a severe metabolic syndrome (type II diabetes). It is recommended in particular to patients with gastroesophageal reflux, to sweet eaters and to people unable to consistently and accurately follow a correct diet. It involves the creation of a very small gastric sleeve that is connected to the small intestine to reduce the intake of food. After this operation, the excluded stomach, duodenum and bile ducts can no longer be explored with standard radiological and endoscopic methods.
• Duodenal diversion is a very invasive operation, recommended where the standard procedure is not successful.
• Complication surgery.

Bariatric Surgery at UPMC

Learn more about bariatric surgery at UPMC.