What do German clinics do that clinics in most other countries don't?
The whole world knows the well-deserved reputation for German thoroughness, precision, quality and performance. These qualities are the result of cultural factors and a long tradition of perfectionism that are reflected in our attitude to most everything we do, but especially to our work.
If you are seriously considering putting your life and health in the hands of a physician and his team, please consider your options carefully. Our team of physicians are recognized experts in the field of weight loss and have extensive experience. We are uniquely qualified to advise you on the right choice for your situation. Our institute provides a comprehensive range of treatments: from nutrition advice to high-tech surgery including gastric bypass and stomach reduction followed by body correction.
At MISITA, overweight patients are consulted, treated and attended to in an interdisciplinary fashion to ensure not just effective weight reduction and cosmetically optimal results, but also the long-term health of the individual. Weight-loss surgery is the beginning of a whole new life, and we apply our expertise to every aspect of the process.
The institute
MISITA in Munich was designed to realize the vision of the interdisciplinary treatment of adiposity and of the accompanying diseases under one roof.
Science and experience
The findings and results of the world's largest research study, the "Swedish Obese Subjects" (SOS) as well as the internationally-adopted criteria used by the study form the basis for our institute's work.
Today we are setting new standards for the treatment of obesity and contributing to the scientific community's understanding of the problem and its treatments. Our extensive experience is unrivalled in Central Europe: in 2006 we performed twice as many weight-loss surgeries as in the rest of Germany combined, in 2007 three times as many.
Our three-pillar approach and high-technology
In order to guarantee the optimum of care and recovery, our interdisciplinary institute follows a three-pillar approach:
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consultation
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treatment
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long-term care
High-tech surgery and anaesthesia procedures lead to significantly increased treatment accuracy. The optimisation of treatment minimises the risk decisively and therefore increases the efficiency of the treatment.
Surgical treatments
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Stomach reduction
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Gastric bypass
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Gastric banding
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Plastic surgery
Non-surgical treatments
Treatment of accompanying diseases
Quality assurance
As a result of our innovations in high-tech surgery and anaesthesia procedures we have achieved the following results:
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improved ergonomics during the surgery
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minimized risks of complication, especially important for patients with a BMI over 60
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optimal wake-up phase after anaesthesia, especially in patients with a BMI over 60
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patients can be back on their feet only two hours after surgery
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in some cases performance of the surgery on an outpatient basis
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successful surgeries in patients weighing over 200 kg – one of our patients weighed 240 kg (528 lbs.) and had a BMI of 78.4
The team
The team of MISITA Munich consists of experts with unparalleled experience in the treatment of adiposity.
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Treatments & Prices
Surgical and non-surgical treatment
In the Munich Institute MISITA obese (overweight) patients are consulted, treated and attended to in an interdisciplinary way. In this way an optimal weight reduction as well as clinical improvement of accompanying diseases can be achieved, which leads to a new quality of life.
Indications: surgical treatment
Indications for surgical stomach reduction (stomach-tube/sleeve resection), stomach-bypass or gastric banding are differential. High-tech surgical techniques, anaesthesia and operating room observation stand for quality at the highest level. For overweight patients with a BMI over 35, who have accompanying diseases that are very difficult to treat, and in whose case all conservative treatment methods have failed, the surgical treatment can be considered. Patients, who are suitable for that, are selected by means of a special computer analysis. Patients with a BMI over 40 will also undergo a surgical treatment in the case they can present documented evidence of repeated unsuccessful conservative attempts to reduce weight. It is always decided on an individual basis whether a surgery - stomach reduction or alternatively stomach bypass, which will be carried out by means of a robot-assisted laparoscopy in our partner institution - is necessary. The stomach-bypass can be considered if the BMI is over 50.
Indication: non-surgical treatment
Patients with a BMI up to 35 are conservatively treated by means of individually adjusted diets and fitness programmes. The stomach balloon is used as an interventional supporting alternative. Patients with a BMI over 35, who do not have any accompanying diseases that are difficult to cure, are also treated according to the conservative scheme. Still according to the guidelines of the German Obesity Society and according to the results of the world’s largest research “Swedish Obese Subjects" (SOS) a surgical therapy is recommended to this group of patients in the case there is an accompanying disease, which is difficult to treat and the conservative therapy has resulted in no weight loss.
Stomach reduction
(sleeve gastrectomy, tube gastrectomy, resection of stomach)
The main principle of a stomach reduction is reducing the stomach volume (restrictive procedure) and at the same time deactivating the part of a reduced stomach (the fundus), in which the hunger hormone “Ghrelin” is produced. The future stomach is calibrated according to certain criteria so that the maximum effect in terms of efficiency can be reached with the help of this surgery. The absent impulses (usually sent by the hunger hormone Ghrelin) lead to a feeling of fullness earlier.
The patients with a reduced stomach lose weight significantly better than the patients with a stomach band, who almost never report a feeling of fullness.
It seems that the combination of two components:
- reducing the stomach volume or the stomach mucosal lining surface (contact surface)
- absence of impulses sent by the hunger hormone Ghrelin
- effectively leads to an early feeling of fullness and therefore to a reduced food volume without frustration or initiation of an internal struggle. (Empirical values MISITA Munich)
High-tech tools as well as robot-assistance decreases complications of these surgeries. Our specialised team is well trained to perform such surgeries. Specific complications such as stomach leak, stomach fistulas, or abscess formation are significantly reduced due to using special instruments, which offer the highest degree of accuracy. In addition to that, special biological tissue is used in order to seal the resection border of the new stomach. The stomach reduction or the stomach tube can be transformed if necessary (pancreas diversion).
The indication for tube gastrectomy is decided on an individual basis after the initial multi-disciplinary examination. The decisive factors for performing such a surgery are: existing risks, eating habits, patient’s motivation, heartburn (reflux-disease) and failure of the other procedures (often a gastric band).
The surgical technique: laparoscopic robot-assisted.
Anaesthesia technique: general anaesthesia with EEG measurement to control anaesthesia and neuromuscular monitoring.
Gastric bypass
The gastric bypass is a malabsorptive procedure in which 2/3 or more of the stomach is removed and the remaining part of it is connected to a lower portion of the small intestine. Proportionally to the length of the first intestinal loop the amount of nutrients that the body absorbs from the food is brought down to the level, which enables a quick loss of weight. Decrease in nutrient utilization can be neither controlled nor is it reversible. The procedure is very invasive, and it is associated with serious complications and a high mortality rate.
Possible complications:
- postoperative not controlled malnutrition or undernourishment
- dystrophy caused by protein deficiency
- vitamin deficiency
- liver insufficiency / liver dystrophy
- small intestine dystrophy
The surgical technique used: laparoscopic robot-assisted
Anaesthesia technique: general anaesthesia with EEG-measurement to control anaesthesia and neuromuscular monitoring
Gastric-Banding
The gastric-banding is a restrictive procedure. The resulting pouch in the upper part of the stomach has a significantly smaller volume, which is responsible for food intake.
The stomach band can be adjusted via a port system. The placement of the band is very complicated and requires a lot of experience. Without a perfect discipline, there can be no results for a long while. Since the gastric band is only a mechanical barrier, the follow-up is very important and intensive.
Possible complications:
- overturning of the band
- dislocation of the band
- inflammation near the port
In such cases, a new surgery is needed. After removing the band, a tube gastrectomy is performed.
The surgical technique: laparoscopic robot-assisted
Anaesthesia technique: general anaesthesia with EEG-measurement to control anaesthesia and neuromuscular monitoring
Lifting after weight loss
The surplus tissue often remains after a successful weight loss, so-called skin apron. The skin that used to be tight has lost its elasticity and the problem areas cannot be eliminated by exercise, massage or liposuction. In many patients, there are also physical and hygienic problems caused by the skin parts rubbing against each other.
One single intervention for lifting the whole body “Total Bodylift” has not proved to be effective due to a long duration of the surgery and the associated risks for the patient. If many areas of the upper and lower part of the body are affected, we have established a multiple approach first correcting the body trunk (belly, back, flanks, buttocks, upper and lower leg) and then the upper body (breast, upper arms and lateral chest wall), if needed.
*Note: Surgeries are performed in our partner institute, mednord.
Non-surgical treatments
Nutrition advice
In order to guarantee a reasonable weight loss for example after stomach reduction, it is especially important to know, how to eat after the surgery. The stomach volume is strongly limited after the intervention, and the opening for food is narrower than before the surgery. In any case, all these changes should be considered for the choice of food and food intake in the future, in order to avoid complications from the very beginning.
Psychological counselling
- to find reasons of such eating habits
- raising and stabilising self-esteem and self-confidence
- learning to deal with stress and strain
- knowledge transfer about psychology of eating (eating disorders, change of eating habits and prevention of recurrences)
- weight loss hypnosis
Gastric balloon
A gastric balloon is a weight reduction aid, which can be used in combination with a diet that you keep to under control and a behaviour modification programme.
The use of a gastric balloon can be reasonable in the case of overweight and when all other weight loss measures have failed. A plastic or silicon balloon is placed into the stomach by means of gastroscopy (orally), and there it is inflated with a sterile salt solution. When inflated, the balloon is too big to migrate into the intestine or into the gullet, it swims freely in the stomach. Due to the gastric balloon, the stomach gets full earlier during food intake. Stretching of the stomach appearing afterwards leads to a feeling of fullness.
Compared to a gastric band, a gastric balloon can be placed without a surgical intervention. Therefore, the surgical risk is decreased.
Treatment of accompanying diseases
Overweight or adiposity is associated with a high risk for developing various diseases and therefore with a significantly reduced life expectancy.
In many cases, strong overweight means a significant reduction of life quality. Extremely obese people are usually very restricted in their mobility and mobility radius. They suffer from shortness of breath and sweat more.
Participating in many activities of the daily life is restricted for highly overweight people.
Heart problems
Being overweight represents a huge strain for the cardiovascular system. After-effects such as diabetes mellitus or metabolic disorders lead to the damage of blood vessels (arteriosclerosis) and therefore to the development of high blood pressure, stroke or heart diseases such as coronary heart disease (angina pectoris) or heart muscle weakness (heart insufficiency).
Dysfunction of respiratory tracts
Snoring is a common problem, which can still be solved. Causes for it are obstruction of the air passages (allergy, deviation of the nasal septum (wall inside the nose), thickened nasal conchae or often everything together) and / or increased hanging soft palate and habit, alcohol and overweight.
After a thorough initial examination, the therapy is determined. Alongside non-surgical measures such as weight reduction, avoiding alcohol before going to sleep, treatment of allergy or breathing mask, surgical measures are usually necessary: the correction of the nasal septum and the reduction of the nasal conchae are carried out under general anaesthesia and help to improve air passage through the nose so that you do not have to breathe through the mouth. During the intervention, the deviated parts of the nasal septum are straightened. A tamponade is seldom required. When the nose is free, we take care of the soft palate, which is trimmed under local anaesthesia or short-term narcosis. If needed, both interventions can be combined, which will help you to sleep quietly. The success rate is 80%!
Getting rid of fat deposits is extremely important for a successful treatment. Adiposity is one of the most important reasons for snoring and therefore these conditions should be treated together.
Snoring is only an acoustic sign of another problem: sleep apnoea. It is characterised by breathing pauses during sleep, which can significantly reduce oxygen saturation of the blood and therefore provision of organs with oxygen-rich blood. You can notice since you lose concentration, have a feeling that you have not had enough sleep; you are tired, listless, your performance decreases. This means a possible reduction in life expectancy of 10%. An appropriate loss of weight means an easier and longer life with a free nose!
Diabetes mellitus
Overweight often leads to the development of diabetes mellitus of type II (sugar disease). If the blood sugar (glucose) increases after a meal, the islet cells of the pancreas produce the hormone insulin and release it into the blood. By activating the so-called insulin receptors or insulin receivers, insulin causes certain body cells, primarily those of the muscle and fat tissue, to absorb glucose from the blood and to use it as an energy source. In the case of overabundant nourishment in the long term, the sensitivity and the number of insulin receptors of the body cells decrease because of glucose oversupply and a chronically increased glucose level associated with it. Since the released insulin is no longer sufficient for decreasing the excess glucose, the body suffers from a relative insulin deficiency and must produce new insulin. The islet cells of the pancreas have to do more and more work, which finally leads to their exhaustion and therefore to the developing of the so-called insulin-resistant Diabetes mellitus of Type 2. The decrease of insulin sensitivity starts already with the Body-Mass-Index (BMI) between 25 and 30. In Germany, about 6 million people are affected (Type 2 diabetes).
Joint disorders
Persistent overweight leads to overloading the joints, especially in the lower part of the spinal area, the hip joints as well as the knee and ankle joints. Early signs of wear (arthrosis) and pain in the joints affected are the result of it.
Hormonal disorders
The hormonal control of fat production is possible due to insulin (see "Diabetes"). Antagonists are catecholamines that lead to fat dissolving. In addition to oestrogen and some other substances, there is a hormone (leptin) produced in the fat tissue itself that controls the feeling of hunger.
A hormonal disorder also exists in the case of thyroid hypofunction: little energy is utilized and a lot of fat is stored in the fat tissue, the person affected feels weak. The main cause for thyroid hypofunction is iodine deficiency.
Metabolic disorders
Overweight causes changes in metabolism, which result in oversupply of cholesterol and triglyceride in the blood. The concentration of the so-called high-density lipoprotein (HDL), which is responsible for removal of cholesterol from the body tissue into the liver and therefore supports its decomposition, decreases. In contrast, the concentration of low-density lipoprotein (LDL) increases. Low-density lipoprotein (LDL) leads to the damage of blood vessel walls (arteriosclerosis).
Further consequences of chronically increased blood fat values are fatty liver and developing of gallstones. Disorders of the so-called purine metabolism with an increase of uric acid concentration lead to the formation of gout.
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Testimonials
Losing Weight with the Devid Group
New chances for the overweight:
Obesity can cause severe complications such as heart attack, stroke, diabetes, joint deterioration, as well as other severe conditions.
The formerly obese patient Devid has a remarkable story to tell:
Beginning in February 2009, (160kg) Devid and the MISITA team worked together to lose 60kg within six months. As coach of the 'Devid Group' he now advises and motivates other patients.
23.02.11 20:14 evi
Hi Brigitte ich han in abgesagt, dass heisst vorläufig. Er wollte mcih auch morgen abend nochmals treffen um mir die Angst und die Unsicherheit zu nehmen ich kann in nicht einhalten den termin. Ich habe gesagt, dass ich mich melden würde. Ich weiss das er super ist der Professor Senner und trotzdem ist die Angst viiiiel grösser.
Ja die krankenkasse wür die Op übernehmen.
23.02.11 19:24 Brigitte L
Hallo Evi
und???? wann ist deine OP? kann man Dir schon die Daumen drücken? und was macht deine Krankenkasse, werden die Kosten übernommen? Ich habe nun entlich morgen Abend meinen Termin, für das erste Gespräch. Ich bin gespannt was dabei raus kommt. LG Brigitte
23.02.11 00:10 heise, regina
Hallo, ich bin aus Thüringen, Bad Salzungen und wurde am 15.9.10 auch da operiert. Heute nach 5 Monaten habe ich 29,5 kg abgenommen und könnte die ganze Welt umarmen.Mir geht es gut und habe auch ständig Kontakt zu meinem Arzt und dem Team vom Klinikum.
AN ALLE !!!: Habt keine Angst vor der OP. Fangt ein neues Leben an, so schnell es geht. Jedes verlorene Kilo ist es wert.
22.02.11 17:31 evi
halloooo zusammen heute HAbe ich einen ANruf vom Professor Senner bekommen den termin für die OP wird er morgen durchgeben ich hab sooooo ne Angst habt ihr die Frage schon mal gestellt was ist wenn man Magenkrebs bekommt und man hat ja nur noch einen Teil vom Magen was ist dann??????
Ich träume schon von dieser Op seit wochen ich will sie wenn doch die Angst nicht wäre.
Und werden Die untersuchen kurz vor der Op gemacht? Magenspiegelung Herz u.s.w Danke euch LG Evi
22.02.11 12:53 Brigitte
Hallo Mazlum,
1) trinken schafft man locker 200 ml, allerdings nicht mit zu brezeliger Kohlensäure, und auch nicht mehr so mit Riesenschlucken wie früher, aber völlig ok.
2) Fleischmengen ist glaube ich eher sehr individuell, aber ich schätz mal, im Normalfall 100 g sollte man wohl schaffen. - Mir gehts allerdings so, dass ich auch vor der OP schon immer weniger Fleisch gegessen hab - und mittlerweile dazu übergehe, mich zu weigern, irgend etwas zu essen, was Vater und Mutter hatte ....
3) Die normalen Mahlzeiten passen maximal auf einen kleinen Kuchenteller, man kommt aber auch sehr gut und zufrieden mit einer Untertasse aus, wobei es immer unterschiedlich ist, je nachdem, was man ißt. Bei mir geht Suppe immer am besten, da schaffe ich auch wirklich einen ganzen normalen Suppenteller, bei Salzkartoffeln sperrt der Magen sehr schnell, Nudeln und Reis geht besser, ich denke, dass muß jeder für sich austarieren, was da am besten geht.
Schmerzen nach der OP hat man keine, dafür sorgen die Ärzte und Schwestern, man ist die beiden Tage nach der OP einfach nur "platt" - und hat zu nichts Lust, aber am 3. Tag geht es in Riesenschritten bergauf
20.02.11 23:36 Mazlum
Hallo zusammen! Ich wäre euch sehr dankbar wenn ihr mir Fragen beantworten könntet.
1. Wieviel ml könnt ihr auf nüchternen schlauchmagen trinken. was ist das max. ? Ich hoffe mal mind. 200 ml. :)
2. Wieviel gramm Fleisch könntet Ihr aufeinmal essen? 100 gramm 150 ?
Erzählt doch mal bitte was ihr bei einer Mahlzeit essen könnt. maximal.
Das interessiert mich sehr Ich wäre froh von euch antworten zu bekommen.
Achja hattet ihr nach der OP schmerzen wenn ja wie lange und wie stark.
Bezüglich der Essensmenge wäre ich froh wenn nur leute antworten die von Prof. Senner operiert worden sind. vielen dank.
Grüsse euch alle. Mazlum.
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