Top Obesity Surgeon in Tijuana Explains Bariatric Surgery

All you need to know about obesity from Dr. Jorge Reyes Mendiola

Obesity Surgeon at Obesity Surgical Center in Tijuana, Mexico

Obesity is a chronic disease, which is strongly associated with diabetes mellitus, high levels of cholesterol, high levels of triglycerides, high blood pressure, sleep apnea, arthritis, low back pain, infertility, heart and lung disease.

That is why it can severely affect the quality of life and needs intervention to improve and resolve the comorbidities.

Obesity is one of the main causes of preventable death in the world, with three in five Americans considered overweight, about seven in ten Mexicans being overweight or obese. There are more than 400,000 deaths each year related to obesity.

Unfortunately, no matter how many diets you try the fact is that they have a minimal and short- term impact on weight loss. Surgery for obesity and related diseases is an established and integral part of the comprehensive management of obese patient, with excellent and sustainable results on weight loss. The best approach that we offer is minimal invasive surgery.

Am I Obese?

The simple way to determine if you are obese is to calculate the Body Mass Index that is a measure of body fat based on height and weight. The way to calculate the body mass index is: body mass (kilograms divided by the square of the body height. Patients are considered obese if they have a body mass index (BMI) greater that 30 kg/m2.

World Health Organization classification: Body Mass Index (BMI)

• 19-24 BMI:  ideal weight
• 25-29 BMI: overweight
• 30-34 BMI: moderate obesity
• 35-39 BMI: severe obesity
• 40-49 BMI: morbid obesity
• >50 BMI: super morbid obesity

All you have to know about GASTRIC SLEEVE

Gastric sleeve consists of removing a 70-80% of the stomach leaving a narrow gastric tube through which food passes. The procedure mixes two mechanisms of action: Restrictive (cutting vertically 70-80 % of the stomach) and

Metabolic (cutting the fundus where hunger hormone is produced that is responsible for satiety).

Indications for Gastric Sleeve

• BMI 35-40 kg /m2 without comorbidities
• BMI 35-40 kg/m2 with co-morbidities such metabolic disorders, high blood pressure, lipid disorder, triglycerides disorder, sever joint disease, obesity-related severe psychological problems, sleep apnea, chronic lumbar pain, fatty liver
• Patients with liver disease
• A second step procedure
• BMI > 40 kg/m2 controlled T2DM
• BMI > 35 kg /m2 uncontrolled TD2M despite medical treatment

What are the benefits of Gastric Sleeve?

• Excellent and sustainable results with loss of 60-70% of your excess body weight.
• Improves health, weakness, mobility, cognitive functions
• When  you  reach  a  loss  of  15%  of  your  exceeding  weight  there  is
• An improvement of comorbidities.
• Comorbidities resolves such as T2DM, high blood pressure, lipid disorder, triglycerides disorder, severe joint disease, obesity-related severe psychological problems, sleep apnea, chronic lumbar pain, fatty liver
• Stops or decreases the consumption of medication
• Low risk of complications comparing to other procedures like Cholecystectomy o Hysterectomy
• Decreased long-term costs

How do I prepare for surgery?

Let me explain the steps to prepare you for surgery:

• Please report any preoperative illnesses to Obesity Surgical Center before surgery.
• It’s important to follow a diet two weeks previous to surgery to decrease the size of the liver and also decrease risk of complications.
• Another important point is to stop the consumption of aspirin or anticoagulant for at least 48 hours prior to surgery to avoid bleeding.
• Bring all your medicine.
• You will arrive at the hotel the day before your surgery to rest from the trip as well as hydrate to avoid risks such as clots in veins of lower limbs or clots in your lung vessels.
• It is required 8 hours of fasting (do not consume neither liquids or solid foods) prior to start surgery.
• The next day you will be admitted to the hospital, two hours prior to the procedure, so we can perform preoperative work up such as hematic blood count, coagulation blood test, and blood chemistry and preoperative surgical risk assessment by Cardiologist or Internist.
• We start a peripheral IV solution and apply medications for heartburn and antibiotic prophylaxis.
• We also place compression stockings to avoid clots.
• Once you have completed all this, you will go to OR to start with your procedure. Do not worry at any time there will be someone from our team to guide you and solve any doubt Intraoperative work up.
• Already inside of the OR you will be monitored and start the process of anesthesia. The anesthetic process is safe and with a percentage of risk less than 1% and our team are qualified doctors.
• Once the anesthesia is done we start with the surgical procedure, which consists of vertically cutting of the stomach with a stapler, previous calibration of the stomach with 36 French calibration tube to avoid inadequate cuts of the stomach. We always do a staple line reinforcement to prevent bleeding or leakage, perform a test with methylene blue to verify that there are no leaks. Before completing the procedure we check the rest of the abdominal cavity and verify that there is no bleeding.

Postoperative workup

After the surgery, which lasts approximately one hour to an hour and a half, you go to the recovery room, where you will be 2 hours monitoring your vital signs and recovering from the anesthesia, then you will go to a room to continue your recovery. You may feel nausea, dizziness, abdominal distension, abdominal pain, pain in the back and shoulders, which is temporary and improves over time.