Gastric Ballooning with the IOI in Frankfurt - Gijon – Lugo – Santander
Obesity Surgery Abroad in Spain or Germany with the IOI



The IOI is a leading International Obesity SurgeryInstitution who was founded by Agustin Dominguez Diaz MD and Rafael Blanco Engert MD, two respected professional surgeon who have over 10 years experience in the obesity surgery field .

Quality, Choice & Value define the uniquely professional and caring service from the Interntional obesity Institute .By choosing Obesity Surgery Abroad you can be assured that you will always be in safe hands.
Intragastric balloon
The intragastric balloon is a non-surgical method that is mainly used in moderately overweight persons (BMI 30 - 35 kg/m²). Current studies, amongst others by A. Genco and J. Scherpenisse, show that the intragastric balloon can be applied very successfully for the treatment of grade I obesity.

Indication:
The intragastric balloon is used in moderately overweight persons, i.e., persons with a BMI of 30 kg/m² or more. It is also used in morbidly overweight patients to prepare the patient for a future operation or to allow an operation that is vital for the patient to be carried out.

Operation:
The intragastric balloon consists of soft, pliable silicone and is introduced through the mouth and down the oesophagus into the stomach. Before the physician inserts the balloon in deflated condition, he examines the stomach for abnormalities using an endoscopic camera. Swallowing of the balloon is made easier with the help of anaesthetics applied topically to numb the throat area. Once the balloon is inside the stomach, it is immediately filled with 400 - 700 ml sterile saline through a catheter. Once filled, the doctor removes the catheter and the valve seals itself. The balloon will now float freely in the stomach for six months. After this period the balloon is emptied and removed from the stomach via the mouth.

The operation, i.e., placement of the balloon, is completed within approximately 30 minutes.



Gastric bypass
Gastric bypass is the most commonly performed surgical technique for the management of obesity in the USA. Here, too, the patient must be at least 18 years old and have a history of repeated failed attempts at weight loss.

Indication:
As a rule, a gastric bypass is only used on patients with morbid overweight or grade III obesity, who, as a result of their weight, have already suffered from co-morbidities, such as diabetes, cardiovascular or gall bladder diseases and/or joint disorders.

Operation:
The operation is performed under general anaesthesia using a videoendoscopic technique. Four rows of staples at the entrance of the stomach are used to shut off the stomach completely. Thus, a small pouch is created and the remaining part of the stomach is bypassed, which can no longer be inspected, not even by gastroscopy. A small intestinal bypass is then sutured to this newly created pouch. It is approximately 90 cm long and bypasses the stomach and the duodenum. The duodenum transports the digestive juices and is therefore attached to the lower end of the bypass. Food no longer passes through the stomach, but goes directly from the small pouch into the small intestine. This technique provides the patient a very early feeling of satiety and the bypass distinctly reduces food absorption. That is why the patient is committed to taking vitamin and mineral supplements for life. The operation is performed under general anaesthesia because it involves opening up the abdominal cavity.

The patient can leave the hospital after approximately five days.




Gastric banding
Gastric banding is a surgical technique that is based on the principle of gastric restriction. It is used for the treatment of severe and morbid overweight. As a prerequisite, the patient must be aged over 18 and weigh at least 45 kg more than his/her personal ideal weight.

Indication:
Preconditions for gastric banding: patient suffering from obesity for more than five years, weighing at least 45 kg more than their ideal weight and apparently suffering from health problems, such as diabetes, joint disorders, heart problems or sleep apnea. It is essential that patients be prepared to modify their lifestyle and eating habits.

Operation:
A minimally invasive method, the so-called keyhole operation technique, is used to place the gastric band around the stomach. It divides the stomach into a smaller upper half and a larger lower half or the remaining part of the stomach. The upper pouch is only able to hold a limited amount of food. A small opening, which is fixed by means of an adjustable ring, allows the food to pass only slowly from the upper to the lower part of the stomach. This results in a markedly prolonged feeling of satiety as compared to the situation before the operation. The opening between both sections of the stomach can be adjusted by the doctor to suit the patient’s individual situation and needs without any further operation being required. The gastric band stays around the stomach for the rest of the patient's life and thus assists the overweight person with weight reduction. The band can, however, be removed without any problems should the patient so wish.

The patient can normally leave the hospital after two to four days, but will be required to undergo periodic medical examinations at regular intervals in a specialist centre.

Conservative therapies
In the treatment of severe overweight (obesity), a distinction is made between so-called interventional techniques, such as the placement of an intragastric balloon or gastric band, and conventional therapies, which provide for treatment without a surgical operation. However, also interventional therapeutic techniques take account of conventional methods, for these form the basis of any comprehensive weight management programme. It is, in fact, only by changing one’s behaviour and lifestyle that long-term weight reduction becomes possible. Nutritional, exercise and behavioural therapies all play an important role in this process.

Nutritional therapy:
Nutritional therapy is an important element in any treatment of overweight. It can be provided both through individual and group counselling and is normally supervised by a specially trained dietician. The patients’ motivation and the co-operation of their entire social environment may decisively contribute to the success of a nutritional programme. Nutritional training is aimed at modifying eating behaviour. Only a detailed explanation of nutrition and food will allow a marked reduction in food fats and thus a daily energy deficit of 500-800 kcal to be achieved. Extremely one-sided diets are discouraged by most nutritional experts, not least because of the high medical risks involved.

Exercise therapy:
Increased physical activity positively impacts energy expenditure and thus contributes to weight reduction or weight maintenance. A supplementary energy expenditure of approximately 2500 kcal/week can measurably reduce weight. Regular physical exercise not only results in increased calorie expenditure, but also prevents muscular degeneration and fat generation. An exercise therapy individually geared to each patient’s needs during weight reduction thus becomes a decisive element of the treatment programme. As with nutritional therapy, long-term supervision by a therapist/trainer or an exercise group is recommended here as well.

Behavioural therapy:
Behavioural therapeutic approaches can support patients in their efforts to comply with nutritional and exercise recommendations and are very helpful for long-term lifestyle changes, as they assist patients in getting acquainted with new behavioural patterns, thereby putting them in a position to implement them of their own volition.